LasellVillage
Residenceand CareAgreement
Please sign page 37 and return the entireAgreementto LasellVillage.
LasellVillage
120SeminaryAvenue,Newton,Massachusetts02465
617-653-7000
December 2015
Residence andCare Agreement
TableofI.RECITALS / Contents / page
A.Parties / 1
B.D· e_f,.i,ned.Ter.ms.. / 1
C. ApplicationData / 1
D. DisclosureStatement / 1
E. Conditions for Acceptance for Residency: / 1
1.Health / 2
2. Fin. .anciaJ / 2
3. Age andEducation / 2
4.Insurance / 3
F. Consideration for Obligations ofLasell / 3
G. Undertakings byLasell / 3
II. POSSESSIONDATE / 3
IIA. EDUCATIONALPROGRAM / 3
ID. FACILITIES PROVIDED BYLASELL
A LivingUnit / 4
1. SelectedUnit / 4
2.Appliances / 4
3. Fixtures andFurnishings / 4
4. Structural Changes and Non-structualAlterations / 5
5. Emergency Response System / 5
B. Common-Areas / 5
C.Storage / 6
D. ParkingFacilities / 6
IV. SERVICES PROVIDED BYLASELL
A. ResidentMeals / 6
1. MealService / 6
2. Meal RateSchedule / 6
3. Home Delivery ofMeals / 7
4. Medically IndicatedDiets / 7
5. Mea] Credit During Resident's Absence / 7
B. GuestMeals / 7
C. HousekeepingServices / 7
D. Maintenance and Repair Service / 8
E.Grounds / 8
F. Utilities, Television, Internet, and TrashDisposal / 8
G. LocalTransportation / 8
H.Taxes / 8
V.HEALTH CARESERVICES
A.CoveredServices9
1.Lasell House9
2.LasellStudios10
3.Home CareServices11
4.Emergency ResponseService11
B.PhysicianServices11
C.Exclusions andLimitations11
1.Pre-Existing Conditions andExclusions11
2.Illness or Accident Away From The Village12
3.Mental Illness, Dangerous Diseases, and Drug and Alcohol Abuse12
4.Services NotCovered13
D.Insurance14
1. HealthInsurance14
2.AutomobileInsurance14
3.Other Insurance15
E.Right of Subrogation and Power ofAttorney15
F.Indemnification15
VI.SERVICES AVAJLABLE AT ADDITIONALCHARGE
A. PersonalServices16
B.Supplemental Home CareServices16
1.Availability and Approvals16
2.Release fromLiability17
3.Authorization of Periodic MedicalExamination17
VII.FINANCIALCONDITIONS
A.Fees17
1.EntranceFee17
2.Monthly ServiceFee18
a.Payment andAmount18
b.Right to Adjust Monthly Fee18
c.MonthlyStatement18
d.Effect of Hospitalization or Transfer to Lasell Studios19
or LasellHouse
e.Proration ofPees19
B.Fee Adjustments for AlteredCircumstances19
1.Marriage or Other Joint Living Arrangement19
a.Marriage or Other Joint Living Arrangement with a Resident19
b.Marriage or Other Joint Living Arrangement with a Non-resident20
2.Financial Inability toPay20
a.Lasell's Policy20
b.Resident's Responsibility21
I.RECITALS
A.Parties
B. DefinedTerms
C.ApplicationData
D.DisclosureStatement
Residence and CareAgreementTable ofContents
page
1
1
1
1
E.Conditions for Acceptance forResidency1
1.Health2
2.Financial2
3.Age andEducation2
4.Insurance3
F.Consideration for Obligations ofLasell3
G.Undertakings byLasell3
II.POSSESSION DATE3
IIA. EDUCATIONALPROGRAM3
UL FACILITIES PROVIDED BYLASELL
A.LivingUnit4
1.SelectedUnit4
2.Appliances4
3.Fixtures andFurnishings4
4.Structural Changes and Non-structualAlterations5
5. Emergency Response System5
B.CommonAreas5
C.Storage6
D.ParkingFacilities6
IV. SERVICES PROVIDED BY LASELL
A.ResidentMeals6
1.MealService6
2. Meal RateSchedule6
3 . Home Delivery ofMeals7
4.Medically IndicatedDiets7
5.Meal Credit During Resident'sAbsence7
B.GuestMeals7
C. HousekeepingServices7
D.Maintenance and RepairService8
E.Grounds8
F.Utilities, Television, Internet, and TrashDisposal8
G.LocalTransportation8
H.Taxes8
c.Recovery of LasellSubsidy21
d.Maintenance ofResources21
3.Change of Independent LivingUnit21
a.Transfer to a substitue Independent LivingUnit22
b.Transfer to a Hospital, Lasell Sh1dios, LasellHouse22
or an Alternate CareFacility
1.SingleResident22
2. Two People asResidents23
c.Termination of Shared Living Arrangement24
1.Retention of Same Independent LivingUnit24
2.Transfer to Alternate Independent LivingUnit24
VIII.TERMINATION ANDREFUNDS
A Termination on or before the PossessionDate24
1.Termination Due to Death, Illness, or Financial Condition24
2.Termination byResident25
3. Refunds Upon Termindation on or before the Possesion Date25
B.After the PossessionDate26
1.Termination byLasell26
2.Termination byResident27
3. Termination byDeath27
4.Refunds Upon Termination after Possession Date28
a.Termination Within the First Nine (9) Months ofOccupancy28
b. Termination After the Ninth (9th) Month ofOccupancy28
C. Release ofLasell29
IX.RESIDENT'S RIGHTS OBLIGATIONS
A Right ofPrivacy29
B. Responsibility forDamages29
C.Lasell's Responsibility for Protection of Resident'sProperty30
1.Upon Resident'sDeath30
2. Upon Termination of the Agreement30
X.OTHERCONDITIONS
A Power of Attorney andGuardianship30
B.Delegation by Executive Director or Director of the Wellness Center31
C.Guest Policies; Personal Caregiver31
D.Resident's Obligation to Lasell for Arrangements at Death31
E.Rules Adopted byLasell31
F.Non-Discrimination31
G.SoleResponsibility32
H.Use of the LivingUnit32
I.SmokingPolicy32
J.Interpretation
K.EntireAgreement
L.Notices
M.Non-Transferability
N. No OralModifications
0.JointandSeveralLiabilities
P.Severability
XI.DEFINITIONS
EXHIBIT 1: LASELL DISCLOSURESTATEMENT LIST OF ATTACHMENTS
SIGNATURES
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LASELL VILLAGE,INC.RESIDENCE AND CAREAGREEMENT
I.RECITALS
A.Parties
This Residence and Care Agreement (hereinafter, the "Agreement") ismade between (hereinafter"Resident")
and Lasell Village, Inc.(hereinafter called "Lasell"), a Massachusettscharitablecorporation which owns and operates an educational continuing careretirementcommunity known as Lasell Village, in Auburndale, Massachusetts(hereinaftercalled "The Village"). Iftwo persons desiring to share an Independent LivingUnit at The Village enter into this Agreement, the term "Resident" shall applytothem jointly and severally, and to thesurvivor.
B.DefinedTerms
Article XI of this Agreement defines certain terms used in this Agreement thatarenot otherwise definedherein.
C.ApplicationData
Resident has submitted an application to Lasell to occupy an IndependentLivingUnit at the Village (the "Application"). The Application includes healthandfinancial information provided by Resident and, at Resident's request, byothers.Knowing that Lasell relies upon the statements Resident has made intheApplication in entering into this Agreement with Resident, Resident warrantsthatall statements Resident has made in the Application are true, complete andnotmisleading, that Resident will update information contained in the Applicationasprovided for in this Agreement, and that the information contained in eachsuchupdate will contain information that will be true, complete and notmisleading.
D.DisclosureStatement
Resident hereby acknowledges that Resident has received and reviewed a copyofLasell' s Disclosure Statement on or prior to the date Resident depositedfundswith Lasell in connection with the Application. The Disclosure Statementisattached as Exhibit 1 and made a part of thisAgreement.
E.Conditions for Acceptance forResidency
AsconditionsprecedenttotheexecutionofthisAgreement,Residenthassatisfiedthe requirements set forth below to the satisfaction of Lasell, and, as conditionsprecedent to occupying an Independent Living Unit, will have satisfied, to thesatisfactionofLasell,thoserequirementssetoutbelowthataretobesatisfiedbetweentheexecutionofthisAgreementandthePossessionDate.Anyexceptionto such requirements may be permitted only in writing by thePresident.
1.Health
Resident has completed a physical examination, the report of whichhasbeen submitted with the Application, and Resident agrees that theresultsof such examination may be reviewed by Lasell' s Director of theWellnessCenter. As of the date of the examination, the examination resultsmustdemonstrate that Resident is in an acceptable state of health, will beable
to perform activities of daily living without assistance in theIndependentLiving Unit Resident has selected at The Village, and be ableto participate in the Educational Program, as defined in Article IIA,below,all as determined to the reasonable satisfaction of the Director oftheWellness Center. Ifthe Possession Date is more than ninety (90)daysfollowing the physical examination, Resident agrees to undergoan
additional physical examination and to submit its results to the Directorofthe Wellness Center prior to the Possession Date. If, as of the date ofthesecond physical examination, the examination results fail todemonstratethat Resident is in an acceptable state of health, or will be able toperformactivities of daily living without assistance in the Independent LivingUnitResident has selected at The Village, or will be unable to participate inthe Educational Program, all as determined to the reasonable satisfactionof the Director of the Wellness Center, then Lasell mayimmediatelyterminate this Agreement prior to the Possession Date. Resident agreestonotify Lasell immediately, in writing, if there is any material changeinResident's physical or mental health prior to the PossessionDate.
2.Financial
Resident has furnished information to Lasell with respect toResident'sfinancial resources demonstrating that Resident has the financial abilitytopay the Entrance Fee and the Monthly Service Fees, as well asestimatedextra meal charges, charges for additional services and Resident'spersonalliving expenses, during the term of this Agreement. Resident willsubmitupdated financial information in a form satisfactory to Lasell not lessthan sixty (60) days prior to the Possession Date (unless the date ofexecution
of this Agreement falls within said sixty (60) - day period).Residentagrees to notify Lasell immediately, in writing, if there is anymaterialchange in Resident's financial condition prior to the PossessionDate.
3.Age andEducation
Residentmustbeatleast65yearsofageonthePossessionDate.Inthecase of joint residency, at least one of the two Residents must be at least65 on the Possession Date. Resident must have earned a high schooldiploma or an equivalent acceptable toLasell.
4.Insurance
ResidentshallhaveprovidedevidencetoLasellthatResidenthashealthinsurancesatisfactorytoLasell,asrequiredbythisAgreement.ArticleV,Section D describes the health insurance Resident must obtain andmaintain during the term of thisAgreement.
F.Consideration for Obligations ofLasell
Unless specifically stated otherwise in this Agreement, Resident understandsthatall services are provided by Lasell in consideration of Resident's timelypaymentof both the Entrance Fee and the Monthly ServiceFees.
G.Undertakings byLasell
Lasell undertakes to provide the facilities and services described inthisAgreement, subject to such exclusions and limitations herein described andtooperate The Village in a manner consistent with the terms of thisAgreement.
II.POSSESSIONDATE
Resident shall be obligated to pay the Entrance Fee and the Monthly Service Feesinaccordance with Article VII, Section A, Subsections 1 and 2. In accordance withthoseprovisions a portion of the Entrance Fee has been paid upon execution of thisAgreement,and Resident will pay the balance no later than fifteen (15) days prior to thePossessionDate. Resident's obligation to pay the Monthly Service Fees shall begin on thePossession Date. From and after the Possession Date, Resident shall have the righttooccupy the Independent Living Unit and to receive the services described inthisAgreement.
IIA.EDUCATIONALPROGRAM
The Village was established as a non-profit educational community within themeaningof Massachusetts General Laws, chapter 40, section 3A. Pursuant to a 1991Agreementfor Judgment between Lasell College and the City of Newton , each resident ofTheVillage must develop and fulfill an individual learning plan, comprising at least450hours each year of participation in a variety of academic courses, fitness programsandother educational pursuits. The Dean of Lasell Village and the education programstaffwill assist each resident in creating and fulfilling the learningplan.
Resident agrees to cooperate with the Dean of Lasell Village and the educationprogramstaff in developing and implementing the Resident's learning plan. Consistent withtheAgreement for Judgment, if Resident intentionally fails to satisfy theeducationalrequirements for living at The Village, such non-participation will be causefortermination of residency from the community pursuant to Article VIII, SectionB,Subsection1.
IfResident'shealthpreventshim/herfromactivelyparticipatinginthelearningprogram,he/she will be exempted from meeting the learning requirement on a temporary or, ifnecessary,permanentbasis.ExemptionfromthelearningprogramforhealthreasonswillbemadebyagreementamongtheDeanofTheVillage,theResidentandtheDirectorofthe WellnessCenter.
III.FACILITIES PROVIDED BYLASELL
A.LivingUnit
1.SelectedUnit
Resident has selected and Lasell shall provide to Resident the living unit at the Village described as# Seminary Avenue, Unit# (the"Independent Living Unit"). Beginning on the Possession Date, ResidentshallhavetheexclusiverighttooccupyandusetheIndependentLivingUnit, subject to the terms and conditions of this Agreement and the lawsand regulations of the United States, the Commonwealth of MassachusettsandtheCityofNewton.LasellreservestherighttomakechangestotheIndependent Living Unit at any time to meet a requirement of law ordirection of the Fire Marshall or other authorized public official. AnychangetotheIndependentLivingUnitbyLasellshallnotbedeemedamaterialchangeaslongasanysuchchangedoesnotreducethesquarefootage of the Independent Living Unit.
2.Appliances
Lasellshallprovideadishwasher,disposal,stove,microwave, refrigerator,and clothes washer/dryer in the Independent Living Unit.These
appliances are the property of Lasell and shall be maintained byLasell.All other appliances shall be provided by Resident, subject totheconditionthatnoapplianceshallbepermittedtointerferewiththehealth,safety, and well-being of other residents of The Village or increasethecost of Lasell's applicable insurance premium. Lasell shall determineinitssolediscretionifparticularappliancescomplywiththisprovision.
3.Fixtures andFurnishings
Lasell will furnish floor coverings, window coverings and fixtures for theIndependent Living Unit. Requests to substitute other floor coverings,window coverings or fixtures shall be submitted in writing to the Presidentfor approval. Approved substitutions shall be at Resident's expense.
Furthermore, anychangetoorreplacement byResidentofthefurnishings orfixturesprovided-byLasellshallvesttitletothealteredorreplaced furnishingsorfixturesinLasellunlessotherwise agreedinwritingby Lasell. Requestsforredecoration oftheIndependent LivingUnit,in additiontoorotherthanthatscheduledbyLasell,shallbeinwritingand
require the prior written approval of the President. Such redecorationwillbe at Resident'sexpense.
All other furnishings for the Independent Living Unit must be providedbyResident, subject to the condition that no furnishings shall be permittedtointerfere with the health, safety, and well-being of other residents ofTheVillage or to Lasell 's applicable insurance premium . Lasellshalldetermine in its sole discretion if particular furnishings comply withthisprov1s10n.
Notwithstanding any other provision in this Agreement, Lasell maymakealterations to Resident's Independent Living Unit to meet therequirementsof any applicable statute, law, or regulation of the federal, state,ormunicipalgovernment.
4.Structural Changes and NonstructuralAlterations
Resident shall not make any structural changes to the IndependentLivingUnit (e.g. electrical, plumbing, removal of walls) without the priorwrittenapproval of the President. Any request for structural changes shallbeaccompanied by a set of plans detailing the work in detailreasonablysatisfactory to Lasell. Ifrequested by the President, a registered engineeror architect as appropriate shall sign such plans. If approved,suchchanges shall be made at Resident's expense unless otherwise agreedinwriting byLasell.
Resident may, at his/her own expense, make nonstructural alterationstothe Independent Living Unit (including painting, wallpapering ,buildingof attached bookshelves, carpeting, etc.) in accordance withResident'staste and preference, with the written approval of Lasell, whichapprovalshall not be unreasonably withheld or delayed. For Resident'ssafety,Resident agrees not to add, replace or modify, at any time, anylockingdevices to the Independent LivingUnit.
Approval of any changes may be conditioned upon Resident'sundertakingto bear the cost of a later restoration of the Independent Living Unit toitsoriginalcondition.
5.Emergency ResponseSystem
Lasell shall equip and maintain an emergency call system intheIndependent Living Unit and in LasellStudios.
B.CommonAreas
Resident may use, in common with others and on the same terms as for otherresidentsoftheVillage,thediningrooms,lobbies,Ballroom,libraries,socialandrecreational facilities (indoor and outdoor) and other public rooms at TheVillage,
inamannerthatdoesnotinterferewiththehealth,safetyandwell-beingofotherresidents of The Village or the conduct of operations at The Village, asreasonably determined byLasell.
C.Storage
A lockable storage space separate from the Independent Living Unit is assignedtoeach Independent Living Unit. While Lasell shall attempt to protect property storedinsuchspace,anylossordamagetostoredpropertyshallbebornebyResident.
D.ParkingFacilities
At Resident's request, Lasell shall assign to the Independent Living Unit amaximumoftwo(2)parkingspacesinthecoveredparkingareasadjacenttotheresidential meas of The Village. Resident and Resident's guests may also useoutdoor parking spaces to the extent available; however, Lasell makes no assurancesastotheavailabilityofsuchadditionalspaces.AllparkinguseshallbesubjecttoreasonableregulationbyLasell.Anylossordamagetoanownedvehicle shall be borne by Resident.
IV.SERVICES PROVIDED BYLASELL
The costs of the services described in this Article IV are included in the MonthlyServiceFee unless otherwisespecified.
A.ResidentMeals
1.MealService
Lasell serves three meals a day, except that fewer meals may be servedon Sundays and holidays. Payment of the Monthly Service Fee entitlesResident to receive one meal per day in the dining areas. Subject toreasonable regulation by Lasell, Resident may accumulate meal credits duringanyonemonthtouseatResident'soption(toentertainvisitorsorto take more than one meal on another day). Meal credits do not accruemonth to month. Resident may elect to receive additional meals fromLasell at an additional charge, as provided in Article IV, Section A,Subsection2.
2.Meal RateSchedule
Lasellwillpublishascheduleofmealrates.ThisschedulewillbethebasisforestablishingthechargetoResidentformealsnotcoveredbytheMonthlyServiceFee,includingguestmeals.Lasellreservestherighttochange these rates from time to time. Lasell will post any change inmealrates at least 60 days in advance of the effective date.
3.Home Delivery ofMeal
Lasell will provide home delivery of meals to Resident in theIndependentLiving Unit during minor, short-term illnesses when ordered bytheDirector of the Wellness Center. One home-delivered meal per daywillbe covered by the Monthly Service Fee in the event of suchillness.
Additional home delivery meals will be charged to Resident based onthemeal rate and on Lasell 's home delivery charge schedule as in effectfromtime to time, which will be provided to Resident if Resident uses thehomedeliveryservice.
4.Medically IndicatedDiets
Medically indicated diets (e.g., low salt or sugar-free) will be providedatno additional charge to Resident if approved by the Director oftheWellnessCenter.
5.Meal Credit during Resident'sAbsence
Resident will receive a meal credit (in an amount determined byLasellreflecting the food cost savings to Lasell) for a period of absence fromTheVillage of not less than fourteen (14) consecutive days. To receivethemeal credit, Resident must complete a notification of absence formandprovide such form to the President; provided, that no such notificationisrequired if such absence is due to an inpatient admission to a healthcarefacility.
Residents who are permanent transfers to Lasell House and residentsofLasell Studios will not receive meal credits during absences fromLasellHouse or LasellStudios.
B.GuestMeals
Lasell may provide meals for guests accompanying Resident in TheVillage's dining rooms. Guest meal charges based on the meal rate schedule will bebilledto Resident in Resident's monthly statement.
C.HousekeepingServices
Resident is expected to maintain the Independent Living Unit in a clean,sanitaryand orderly condition and to be responsible for all light housekeeping tasks intheIndependent Living Unit. Once a week, Lasell will furnish generalhousekeepingservices and will launder linens at no additional charge, provided thatsuchlaundry service takes place within the time allotted for such generalhousekeeping. If Resident does not maintain the Independent Living Unit inasafe and healthy manner, Lasell, after written notice to Resident, will havetheright to assume the responsibility for all necessary housekeeping services andtobill Resident a reasonable charge for such services. In the alternative, Lasellmay
terminate this Agreement in accordance with Article VIII, Section B,Subsection1.
D.Maintenance and RepairService
Repairs, maintenance and replacement of property and equipment owned byLasell in the Independent Living Unit deemed necessary by Lasell due tonormalwear and tear will be performed by Lasell at no additional charge to Resident.
Repairs, maintenance and replacement of Resident's personal property willbeResident's responsibility.
E.Grounds
Lasell will furnish basic grounds-keeping service at no additional charge toResident. With prior written approval of the President and at Resident's ownexpense,ResidentmayplantandmaintaintheareaadjacenttotheIndependentLivingUnit.TitletosuchplantingisvestedinLasellunlessotherwiseagreedinwriting by Lasell.
F.Utilities, Television, Internet, and TrashDisposal
Lasell will furnish water, trash disposal, electricity, heat, air conditioning andwiringfortelephone,televisionandbasiccableserviceatnoadditionalchargetoResident.
While Resident's Independent Living Unit will be wired for telephone, televisionandinternetcableservicewhenResidentmovesin,Residentwillberesponsiblefor dealing directly with the service providers regarding installation and monthlyservice charges and these services will be at Resident's own expense. At Resident's election, Lasell will connect the Independent Living Unit to LasellCollege's computer network, provided that Resident shall be responsible for theone-time installationfee.
G.LocalTransportation
Lasell will provide transportation for Resident to certain local shopping centers,banks, religious services and other points of common interest on a scheduledbasisat no additional charge. Both the schedule and destinations are subject toalteration byLasell.
H.Taxes
LasellpaysrealestatetaxestotheCityofNewton.Resident'sproratashareofthosetaxes(baseduponthesquarefootageoftheIndependentLivingUnitorSupportedLivingUnitapartment)isincludedinResident'sMonthlyServiceFeeand itemizedseparately.
V.HEALTH CARESERVICES
A.CoveredServices
Lasell shall provide or arrange for the following health care services(hereinaftercalled "Covered Services") for Resident, should the need arise, whensuchservices have been prescribed or approved by the Director of the WellnessCenter.Lasell shall pay the costs of Covered Services only to the extent such costs arenotcovered or paid by Resident's insurance or other third parties responsible for
those costs, and Lasell 's obligation shall be secondary to the obligations ofanyinsurer or other responsible third party. Covered Services are included intheMonthly Service Fee except as providedbelow.