Free Nursing Home Resident Fee Agreement Template
Nursing Home Resident Fee Agreement
This Resident Fee Agreement ("Agreement") is made effective as of [Month Day, Year] ("Effective Date"), by and between [Your Company Name] ("Provider"), a duly registered and operating nursing home located at [Your Company Address], and [Resident Name] ("Resident"), an individual residing at [Resident Address].
1. Purpose of Agreement
This Agreement delineates the terms and conditions under which the Resident agrees to pay for the provisions of accommodation, comprehensive care, and ancillary services furnished by the Provider, hereinafter referred to as "Services". This encompasses the physical amenities and care tailored to meet the Resident's needs, ensuring their well-being and comfort during their stay.
2. Fees and Payment Terms
2.1. Monthly Fee: The Resident shall remit to the Provider a monthly fee amounting to five thousand (5,000) dollars ("Resident Fee"). This fee covers the costs associated with accommodation, fundamental care services, nourishment, and utilities. It is to be noted that requests for services that exceed the ambit of basic care provisions will incur additional charges, which will be calculated in accordance with the extent and nature of the services requested.
2.2. Payment Schedule and Late Fees: The Resident Fee is mandated to be paid in full on the first day of each calendar month. Failure to adhere to this payment schedule will result in late fees. This clause underscores the importance of timely payments to ensure the uninterrupted provision of services to the Resident.
2.3. Review and Adjustment of Fees: The Resident Fee is subject to an annual evaluation and may be adjusted to mirror fluctuations in operational costs and enhancements or modifications in the services provided. Any revisions to the Resident Fee will be formally communicated to the Resident in writing, ensuring a notice period of at least sixty (60) days prior to the implementation of the new fee structure. This ensures transparency and allows for ample preparation time for both parties.
3. Term and Termination
3.1. Duration and Continuance: This Agreement is activated from the Effective Date and is slated to continue on a rolling month-to-month basis. Termination of this Agreement by either party requires a written notice to be furnished to the other party at least thirty (30) days in advance.
3.2. Termination Rights: The Provider retains the unequivocal right to terminate this Agreement with immediate effect upon the occurrence of any breach of terms by the Resident, including but not limited to the non-payment of the agreed fees.
4. Rights and Responsibilities
4.1. Entitlement to Services: The Resident is duly entitled to an array of services and care provisions. The Provider pledges to provide, ensuring that the Resident's health, comfort, and overall well-being are prioritized and maintained throughout their tenure at the facility.
4.2. Compliance with Policies: In affirming this Agreement, the Resident commits to a conscientious adherence to the rules and regulations promulgated by the Provider, which are thoroughly documented in the Resident Handbook. This handbook, a copy of which has been furnished to the Resident, encompasses guidelines designed to uphold the safety, privacy, and dignity of all residents and staff.
5. Dispute Resolution
5.1. Mediation: Should any disputes arise under this Agreement, parties will first seek resolution through mediation, aiming for a mutually acceptable resolution. This step underscores a commitment to resolving disputes in a manner that is both collaborative and constructive, minimizing potential conflicts and fostering a spirit of cooperation.
5.2. Arbitration: In instances where mediation does not result in a resolution, the dispute shall escalate to binding arbitration. This arbitration will proceed in strict accordance with the rules set forth by the American Arbitration Association, ensuring an impartial and judicious resolution process. This provision ensures that all parties have access to a fair and enforceable mechanism for dispute resolution.
6. Governing Law
The interpretation and enforcement of this Agreement shall be governed by the laws of the State in which the Provider operates. This clause establishes a legal framework for the Agreement, ensuring clarity and consistency in its application and interpretation within the jurisdictional bounds of the relevant state.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the Effective Date.
Provider Signature:
[Your Name]
[Job Title]
[Your Company Name]
[Month Day, Year]
Resident Signature:
[Resident Name]
[Month Day, Year]
