RESIDENCY AND SERVICES AGREEMENT

THIS RESIDENCY AND SERVICES AGREEMENT (“Agreement”) is made between Maplewood Mayflower Place ALF LLC, a Connecticut limited liability company with an office and place of business at 579 Buck Island Rd, West Yarmouth, MA 02673, a successor in interest to Yarmouth Mayflower Place, Inc. (together with its successors and assigns, the “Management Agent”, “Owner” or “we”), and (“you”), for Apartment # (the “Apartment” or “apartment”).

Section I - Introduction

  1. Regarding This Agreement
  1. This Agreement contains terms and conditions of your residency in Maplewood at Mayflower Place (“The Community”), located at 579 Buck Island Rd, West Yarmouth, MA 02673.
  1. This Agreement includes the Responsible Party Agreement attached as Schedule “A”, the Monthly Charges Statement attached as Schedule “B”, the Summary of Payments Due at Occupancy attached as Schedule “C”, the Statement of the Condition of the Apartment attached as Schedule “D”, Entrance Fee schedule attached as Schedule “E”, [Schedules F intentionally deleted], the Fee Schedule attached as Schedule “G”, the Description of Basic and Personal Care Services attached as Schedule “H”, the Guaranty attached as Schedule “I”, the Monthly Residency Fee Amendment attached as Schedule “J”, the Outing and Publicity Waiver attached as Schedule “K”, the Emergency Evacuation Resident Notice Form attached as Schedule “L”, the Health Care Information Form attached as Schedule “M”, [“Schedule N” intentionally deleted]and the Pet Policy attached as Schedule “O”.

The Services we provide are outlined in this Agreement, particularly in the Description of Basic and Personal Care Services. Charges and fees are shown on the Charges Schedule of this Agreement.

  1. Medical Evaluations and Application Information

Eligibility for residence at the Community is contingent upon your providing to the Community medical evaluation from a licensed physician dated no more than six (6) months prior to your move-in date, that is acceptable to us.

You have provided information on our application paperwork, a health history and medical report, an emergency contact and other information in association with your application. You have provided us the results of a medical evaluation by a physician. You agree that all of the information provided by you, or on your behalf, is true, complete and current as of the date it was provided. You acknowledge that we are relying on this information in entering into this Agreement.

You agree that you will have your medical evaluation information updated by a physician annually, after you are hospitalized or when we request updated information because of a change in your health or functional status.

You agree to designate a local personal physician within thirty (30) days after move-in and to provide us with his or her name, address and telephone number. By signing this Agreement, you agree that your physician and other professionals and caregivers involved in your care may consult with our staff as needed with respect to matters affecting your wellness and care.

  1. Responsible Party

If another person is handling your financial affairs and paying your bills, you will provide us with that person’s name, address and telephone number. That person may be the conservator of your estate, your attorney-in-fact, a relative or another individual appointed by you. We may require that individual to sign a Responsible Party Agreement.

  1. Guaranty

If another individual is or may be paying all or part of your monthly fees under this Agreement from his or her personal funds, we do require that individual to sign a Guaranty.

  1. Term of This Agreement

This Agreement is effective on the date it is signed by you (the “Term Commencement Date”) as noted on the signature page.

The term of this Agreement begins on the date you take Financial Occupancy of your Apartment and continues for your lifetime, unless sooner terminated as provided in the Agreement. The date you take “Financial Occupancy” of your apartment is set forth on your Monthly Charges Statement. You or we may end this Agreement at any time as described in Section I(3).

  1. Termination of Residency Agreement
  1. You may terminate this Agreement:
  1. For any or no reason at any time prior to your Move-In Date by delivering to us an advance notice of such termination.
  1. After the Move-In Date, for any or no reason by giving us written notice sixty (60) days in advance. Your notice must state the date you want this Agreement to end.
  1. If this Agreement states that you are sharing your apartment as a Shared Occupancy, please refer to Section II(2) regarding your rights and responsibilities should one person vacate the apartment.
  1. We may terminate this Agreement:
  1. For any or no reason at any time prior to your Move-In Date by delivering to you an advance notice of such termination.
  1. Due to casualty or condemnation, as of the last day of the month in which the casualty occurs or the condemnation becomes effective.
  1. With a date to be determined by us for any of the following reasons:
  1. You fail to pay the full statement balance, including all monthly fees, for any month on or before the tenth (10th) day of the month.
  1. You abandon the apartment by being absent from The Community for at least thirty (30) consecutive days without notice to us of your intention to return to The Community.
  1. Your physical and/or mental needs cannot be adequately met at the Community. This situation may arise if we determine, in our sole discretion, that you require a level of care or services that either are not available at the Community or, if available, you chose not to contract for such services from the Community, and you have not made adequate arrangements for the provision of such services by other care providers and/or family members.
  1. You, your outside care providers or your guests are habitually disruptive, create unsafe conditions, are verbally or physically abusive to other residents or staff, disrupt the rights of other residents to the quiet enjoyment of their apartments and/or the common areas of The Community, or otherwise endanger the health or welfare of yourself, themselves, other occupants and/or staff.
  1. You fail to comply with any material provision of this Agreement.
  1. You make any material misrepresentation or omission in your application for residency at The Community, or in any information or documentation you subsequently provide to us.
  1. Automatic Termination:
  1. This Agreement shall automatically terminate if the apartment is not available for occupancy on the Move-In Date unless you agree in writing to extend the Move-In Date.
  1. This Agreement shall automatically terminate in the event of your death prior to the Move-In Date.

4.Vacating your Apartment

When this Agreement ends, you or your estate must vacate your apartment no later than the ending date. This means that you must remove all of your belongings from your apartment and The Community, must leave the apartment in its original condition (except for normal wear and tear), and return all keys to the apartment and to The Community.

5.Disposition and Storage of Personal Property

(a)If you or your Responsible Party give written notice of termination of this Agreement as provided in Section 3(a) above, and your personal property is not claimed or removed by the date of termination you stated in the notice, or if you or your Responsible Party did not give written notice of termination of this Agreement as provided in Section 3(a) above and your personal property is not claimed or removed within fifteen (15) days of your moving out of the apartment or your death, then we, at our option, may, at any time (a) remove, store and/or dispose of your property, and you or your estate shall be obligated to pay any and all costs of removal, storage or disposition as set forth on the Fee Schedule, or (b) permit your property to remain in your apartment, and you or your estate shall be obligated to pay us one-thirtieth (1/30th) of the Monthly Rent for your apartment for each day your property remains in the apartment. Any such removal, storage or disposition costs may be deducted from any amounts otherwise due as a refund under this Agreement.

(b)We will not be responsible for damage to or loss of any of your personal property, including when your personal property is in your apartment, is being moved into storage, or is in storage.

6.Documentation

The date and reason for the termination of this Agreement, and your destination, if known, shall be recorded in your file.

Section II - Accommodations andServices

The Monthly Rent covers all of the following accommodations, amenities and services:

1.Accommodations:

We will provide the following accommodations and services to you, subject to the terms, limitations and conditions of this Agreement:

  1. You may occupy and use your apartment for your personal residence. Apartments are not furnished. You are encouraged to bring your own furniture.
  1. We provide carpeting and/or floor coverings, draperies and/or window treatments, and paint and/or wall-covering on all interior walls and ceilings for your apartment. We have the exclusive right to determine and select the type, style, design and color of these items.We will also provide a washing machine and a dryer, and kitchen appliances that are affixed to the walls, including a refrigerator, range with oven, garbage disposal, dishwasher and ductless hood fan. No additional furnishings will be provided by the Community. Furnishings provided by you shall not interfere with the health, safety and general welfare of other residents of the Community.
  1. Any alterations, additions, repairs or improvements you make to your apartment must first be approved in writing by the Manager/Executive Director of the Community. Alterations that require approval include placing holes in the walls (greater than those involved in the normal hanging of pictures, mirrors, etc.), ceiling, woodwork or floors; painting, wallpapering or carpeting; or adding window treatments, antenna or cable installations. You may not change any lock or add any lock or locking device to your apartment. Any approved alterations or improvements you make will become our property. You agree to pay any cost involved in returning your apartment back to its original state when this Agreement ends. The condition of, and equipment in, your apartment are described in the attached Statement of the Condition of the Apartment (the “Apartment Report”).
  1. Occupancy Shared

If two individuals, related or not, share an apartment (“Shared Occupancy” or “Companion Occupancy”), each individual will sign this Residency Agreement or two separate Residency Agreements, as requested by the Community, together with a Services Agreement that specifies the Shared Occupancy Rate in the Fee Schedule attached. Once signed, you have consented to sharing your apartment. If a married couple is sharing an apartment, you are agreeing to be jointly and severally responsible for all fees due under this Agreement as well as the Agreement of your spouse for the shared apartment, if two separate Residency Agreements are signed, just as if you and your spouse were each a signatory to this Agreement and such other Agreement.

  1. Included Utilities

The Community will furnish your apartment with water, electricity, seasonal heat and air conditioning (the “Included Utilities”).

  1. Cable Television and Telephone

Charges for internet service and cable are set forth on the attached Schedule “G”. Charges for telephone service shall be ordered, billed to and paidby you directly to the service provider.

  1. Maintenance and Repair.

We agree to maintain The Community facilities, the common areas of The Community, your apartment and the equipment provided by us located in your apartment in good condition, reasonable wear and tear excepted, and in compliance with all applicable laws, rules and regulations of governmental authorities of competent jurisdiction. You may be responsible for damages as set forth in Section V(7). The costs of Repairs, maintenance and replacement of your personal property are your responsibility.

We provide routine personal maintenance services, such as hanging pictures or moving furniture within your apartment, at your request. An additional charge is imposed for these services as set forth in the Fee Schedule.

6. Fire Protection

Your apartment and the common areas of The Community are equipped with smoke detectors and a sprinkler system.

7. Emergency Response System/Security

Regardless of any time of day or night, for any urgent or emergency matters, the Apartments and the common areas, as applicable, are equipped with the following emergency equipment to alert the Community’s staff to urgent or emergency matters.

  • You apartment has (1) operational pull-cord equipped in each bathroom of your Apartment.
  • The common area bathrooms have a fully operational pull-cord installed.
  • When you pull a cord, the signal will register through our radio system and will be transmitted to the members of the wellness staff.
  • The Community shall have 24- hour nurse aides available to respond to urgent or emergency matters.

8.Continuing Care Services

In the event that you require skilled nursing facility services or intermediate care facility services, we shall arrange with the operator of Mayflower Place Nursing and Rehabilitation Center (“Health Care Facility”) for you to receive priority admission to the Health Care Facility to the extent permitted by Law and to the extent beds are available.

9.Entry to the Apartment

We may enter your apartment, with notice to you, at reasonable times and for reasonable purposes, including, but not limited to the following: (a) inspection, (b) maintenance and repairs, (c) performance of scheduled housekeeping and other duties, (d) make alterations required by applicable law and (e) providing personal care and other health services. We may enter your apartment at any time without notice if we reasonably believe that an emergency may exist.

Section III - Fees

You agree to pay all charges set forth in this Agreement, and acknowledge that these charges are subject to change in accordance with this Agreement.

  1. Monthly Residency Fee

The Monthly Residency Fee includes:

  1. Monthly Rent (specified in the Fee Schedule attached)
  1. Personal Service Plan Fees

The Description of Basic and Personal Care Services is attached to this Agreement. Further, the description of available Personal Service Plans forOasis™ is also attached to this Agreement. Fees for Personal Service Plans are based on a point system. In addition to the Personal Service Plans we offer other additional packages such as Medication Management Plans.

  1. Changes in Monthly Residency Fee
  1. Shared Occupancy

Where there are two parties sharing an apartment, in the event of death or transfer of one, you agree that should you be the remaining and only resident, you will be responsible to pay the Monthly Rent at the single occupancy rate for the apartment. Alternatively, you may remain in the apartment with consent to share with another individualand continue to pay the Shared Occupancy Rate. Should you chose to transfer to a different apartment, you may do so when an apartment becomes available and you sign a new Residency and Services Agreement.

  1. Live-in Caregivers

You may employ a live-in caregiver provided that you provide advance written notice to the Manager/Executive Director of the Community and provide information about the caregiver. A Live-In Caregiver Fee will apply as set forth in the Fee Schedule. The Community reserves the right to prohibit a live-in caregiver for failure to comply with Community rules, policies, and procedures or for other good cause as determined by the Community. If you notify us in writing that you no longer employ a live-in caregiver, then the Live-In Caregiver Fee (as set forth in the Monthly Statement) will not be charged effective the first day of the first month following our receipt of your written notice. All other terms of this Agreement will remain in effect.

  1. Change of Accommodations

The Community reserves the right to determine and make all arrangements regarding residency, including moving-in and moving-out of Residents and adjustments in rates and accommodations consistent with state law and our policies. The Monthly Rent may be adjusted from time-to-time to reflect the current rates of The Community for the plan and apartment size chosen.

d.Move to New Apartment
If, at your request, you choose to change apartments within The Community, you will be responsible for paying for any costs incurred by the Community in refurbishing the original apartment for a new resident. We also may charge you a fee to move your personal property from one apartment to another.
  1. A` La` Carte Services

You will pay for any charges for other items or services provided to you during the preceding month that are not included in the Monthly Rent or Personal Service Plan.

  1. Other Amounts

You will pay any other amounts due us under the terms of this Agreement.

g.Annual Increase