Request for retirement village operator to pay daily accommodation payments for aged care

Eligible residents can request the village operator pay daily accommodation payments (DAPs) towards the cost of
their aged care placement from their exit entitlement. The village operator is not required to make payment if at least
85% of the former resident’s exit entitlement has been paid.

Requests can be made by using this form before or within 60 days of moving into aged care.

The operator must make the first DAP payment within 28 days of receiving the completed form, or within 28 days
after the resident enters aged care, whichever is later.

Information for residents or their representatives

1. Make sure you have the following information:
   1. the date you entered, or were approved to enter, the aged care facility;
   2. the contact details for your village operator and manager;
   3. the details of the aged care provider and facility where you are living, or intend to live; and
   4. a copy of the DAP schedule provided by the aged care provider showing the dates when the payments are due
      and how payments can be made.
2. Contact your village manager and ask them how to lodge this form with the operator.
3. There is no fee to provide this form to your operator.
4. Keep a copy of this form and a record of the date you provide it to the operator.

Don’t send this form to the Department of Local Government, Industry Regulation and Safety Consumer Protection. This form is for you and your village operator.