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The agreement covers damages, prohibited unlawful activities, refunds after the last day, and facility compliance requirements. It defines living accommodations, decoration permissions, lock and key responsibilities, storage limits, basic care based on individualized assessment, transportation and meal rules, and move procedures under Oregon administrative standards.",{"@graph":63,"@context":119},[64,80,102],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/apd-adult-foster-home-residency-contract-medicaid-resident/200411/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/apd-adult-foster-home-residency-contract-medicaid-resident/200411.png","ImageObject",442,249,{"name":88,"@type":89},"Berry Peter","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/vnd.openxmlformats-officedocument.wordprocessingml.document","2026-10-14","2026-09-04",true,{"@type":98,"interactionType":99,"userInteractionCount":101},"InteractionCounter",{"@type":100},"ViewAction",7,{"@type":103,"mainEntity":104},"FAQPage",[105,111,115],{"name":106,"@type":107,"acceptedAnswer":108},"What payments are required under the residency contract?","Question",{"text":109,"@type":110},"The resident agrees to pay a monthly amount for room and board determined by the Department, plus a service payment if required. Payment is due no later than the specified day each month and may be prorated for partial-month occupancy.","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"What rules apply to damages and unlawful activities?",{"text":114,"@type":110},"The resident is responsible for property damage except for normal wear and tear. The resident agrees not to engage in or allow illegal activities anywhere on the premises, and suspected illegal activities are reported to law enforcement.",{"name":116,"@type":107,"acceptedAnswer":117},"How do moving and removal from the facility work?",{"text":118,"@type":110},"The licensee notifies the case manager and cooperates with screening if the resident wants to move voluntarily. Involuntary move reasons include facility closure, nonpayment, inability to meet evacuation standards, imminent safety risks, repeated interference with other residents’ rights, illegal drug use or criminal acts, certain marijuana policy violations, and medical reasons beyond the facility’s level of care.","https://schema.org",{"og:url":78,"og:type":121,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":123,"canonical":78},"index,follow",{"doc_id":125,"site_id":56},200411,1788508886,{"code":4,"msg":5,"data":128},{"doc_id":125,"user_id":129,"nickname":88,"user_avatar":130,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":101,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":136,"language":137,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":138,"faqs":139,"seo_title":140,"seo_description":61,"update_tm":126,"read_time":76},1374402524268,"https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","APD Adult Foster Home Residency Contract – Medicaid Resident\nResidency Contract and Notification of Policies, Rights and Freedoms\nContract. This Residential Contract (the “Contract”) is entered into between\n“You” \t or\nResident’s name\nand\nResident’s representative on behalf of Resident\n“Licensee/Facility”\nlocated at\nPhysical address of adult foster home\nThe term “you” and “your” includes the Resident and the representative acting on the Resident’s behalf if designated above.\nYou have chosen to rent a:\n\u0003☐\u0004 Single occupancy room\t\u0003☐\u0004 Shared occupancy room\nfor your personal use on a month-to-month basis beginning on \t.\nPayment. You agree to pay Licensee/Facility your monthly payment for room and board in the amount determined by the Department and communicated through an official Department Policy Transmittal.  You also agree to pay a service payment (if one is required of you) in the amount determined by the Department and identified in writing via a department-issued document.  Payment must be made no later than the  \t of each month. Payment shall be made payable to the Licensee/Facility named above according to the terms of this Contract. The payment will be pro-rated for partial month occupancy. The monthly payment will pay for room and board, basic care and services as identified in this Contract.\nDamages. You will be held responsible for any property damage excluding damage caused by normal wear and tear.\nUnlawful Activities. You agree not to engage in or allow illegal activities of any kind anywhere on the care home’s premises. Suspected illegal activities will be reported to law enforcement.\nRefunds. Licensee/Facility will issue applicable refunds no later than 30 days following your last day in the care home. The Licensee/Facility may not retain payment for services beyond your last day in the home. If your monthly payment includes room and board, your room and board payment is refundable and may be pro-rated based on length of stay during the applicable month.\nLiving Accommodations. You are invited to bring your own bed, linens and furniture for your personal use in your bedroom. For your safety, and to ensure Licensee/Facility remains in compliance with all regulatory requirements, you agree to request and obtain Licensee approval prior to moving furniture into your room. You agree all exit ways must remain clear of obstacles that may interfere in evacuation. You may choose to use some or all the accommodations provided by Licensee/Facility which includes:\nBed (mattress and box spring)\nBedding (linens, including fitted and flat sheets and a pillowcase)\nMattress pad\nPillow\nBlankets (as needed for your comfort)\nPrivate dresser\nCloset space\nDécor. You are invited to decorate your bedroom in accordance with your personal tastes.  For your safety, preservation of the facility, and to ensure the Licensee/Facility remains in compliance with regulatory requirements, you agree to request and obtain permission prior to hanging pictures or items on walls, installation of items in the room, painting, or any other surface or structural modification to the bedroom.\nLocks. A lock on your bedroom door is a regulatory requirement, and you may choose not to use the locking feature. You will be provided with one key. You agree to not remove, modify or re-key the lock. You agree to not give the key to any person other than your representative, if named above. Lost or stolen keys should be immediately reported to the Licensee or facility staff. Additional or replacement keys will be provided as needed for the cost of replacement as evidenced by the receipt. Only appropriate staff will have keys to your room.\nStorage. Storage space for your belongings is limited to the room you have chosen to rent. The Licensee/Facility will work with you to ensure your preferences are honored while maintaining compliance with all regulatory requirements.\nStorage Fee after Departure. A daily storage fee of $___\t, takes effect on the 16th day following your de","cbCaiqh3UUM8ugMF","https://ap.wps.com/l/cbCaiqh3UUM8ugMF","docx",44077,8,"English","# Residency Contract and Notification of Policies, Rights and Freedoms\n## Payment\n## Damages and Unlawful Activities\n## Refunds and Living Accommodations\n## Décor, Locks, Storage, and Storage Fee after Departure\n## Basic Care and Services, Transportation, and Meals\n## Voluntary and Involuntary Move","[{\"question\":\"What payments are required under the residency contract?\",\"answer\":\"The resident agrees to pay a monthly amount for room and board determined by the Department, plus a service payment if required. Payment is due no later than the specified day each month and may be prorated for partial-month occupancy.\"},{\"question\":\"What rules apply to damages and unlawful activities?\",\"answer\":\"The resident is responsible for property damage except for normal wear and tear. The resident agrees not to engage in or allow illegal activities anywhere on the premises, and suspected illegal activities are reported to law enforcement.\"},{\"question\":\"How do moving and removal from the facility work?\",\"answer\":\"The licensee notifies the case manager and cooperates with screening if the resident wants to move voluntarily. Involuntary move reasons include facility closure, nonpayment, inability to meet evacuation standards, imminent safety risks, repeated interference with other residents’ rights, illegal drug use or criminal acts, certain marijuana policy violations, and medical reasons beyond the facility’s level of care.\"}]","APD Adult Foster Home Residency Contract - Medicaid Resident | DOCX"]