Oregon Health and Science University

Guest Stay Agreement
 

Symptoms of contagious illness must be reported to staff immediately. You must also notify staff immediately if you or your guest(s) test positive for COVID-19 or have been recently exposed to COVID-19  

Face coverings throughout the building are optional, but if you prefer that a staff member/volunteer wear a mask during your interaction with them at the front desk, please request as needed and/or practice physical distancing. 

Each adult guest will be given a lanyard to wear during your stay. All registered adult guests must wear lanyards while in the building. When checking out, all guests MUST RETURN LANYARDS AND KEYS to the front desk.  

Rood Family Pavilion does not allow: 

Smoking of any kind in the House or on the property.
Alcohol in any community or public spaces. 
All weapons, illegal drugs, candles, or incense are also not permitted.
Hot plates, electric fryers, electric skillets, pressure cookers, and toaster ovens are not allowed. 
Pets, companion and emotional support animals are not allowed in the House, nor can they stay inside cars parked on House premises.
Unsafe, disruptive, or illegal behavior is grounds for immediate eviction. 

Service Dogs are allowed to stay at the Rood Family Pavilion. Guests will need to fill out the Service Animal Stay Agreement and abide by all the rules, failure to follow the rules may result in the guest's current and future stays being canceled.  

Children 15 and younger must be supervised by an adult at all times. Children under 6 may not use the top bunk of rooms with bunk beds.  

We do not tolerate harassment or discrimination of any kind. We are committed to an inclusive culture that is safe and creates a respectful and healthy environment for all.  

All guests staying at the Rood Family Pavilion must be capable of managing their own needs within the community living setup. It's important to note that the Pavilion is not equipped as a medical facility, and therefore, our staff cannot provide assistance with mobility or personal care requirements.

Please keep staff informed of treatment changes. Your reservation is made based on your treatment plan and appointment times. If there is a change in your appointments, or you are discharged sooner than expected, you will need to checkout earlier than your scheduled checkout date. We expect your room to be occupied every night during your stay. 

Our priority is to provide lodging for patients while they are receiving treatment; please inform us if the patient is unexpectedly admitted to the hospital. If the patient is re-admitted during their stay, caregivers/family members may be eligible to remain in-house for 2 nights without the patient. We will work with your medical team to assess the discharge plan. Caregiver/family member must be prepared to check out if the patient's discharge is delayed. 

If a patient is in the hospital longer than two days, their caregiver must pack up the room. If the patient is alone, they must arrange for their emergency contact, friend, or family member to do so. If the room is not packed by checkout after 2 days, a $50 nightly fee will be charged. Once packed, the storage of luggage and nonperishable food can be requested and granted upon availability. Guest belongings will be disposed of if the luggage is not claimed after 30 days. 

A $50 nightly fee may, in some instances, apply to any stay regardless of payment type. These charges would be applied for nights the patient is not in the building, whether due to hospital admission or an exception to leave the Guest House during a long stay.  This includes guests whose stay is covered by financial assistance or Medicaid. Additionally, extensions may incur a charge as well. Questions may be directed to our Family Placement team at (971) 222-0522. 

Each guest room may have day visitors (total registered guests & visitors not to exceed 6 people) between 8:00am and 11:30 pm. Inquire with staff for visitor parking options. Guest rooms can accommodate a maximum of 6 people.

You are required to maintain the condition and the cleanliness of your room during your stay. If there is any excessive damage beyond normal wear and tear, or if items go missing, you may be responsible for covering the costs of cleaning and repair. In order to ensure quality maintenance of all guest rooms, staff will visit guest rooms approximately once per month during your family’s stay.  Please note: Due to the fragile paint we use in this building, we ask that you do not hang anything on the walls (using tape or other adhesives).   
We may need to enter your room for an emergency, for maintenance work or to do a routine room check. We reserve the right to enter your room for the health and safety of all guests staying with us and appreciate your understanding in advance. 

Quiet hours are from 10pm-7am daily.  

Please see Front Desk for additional information regarding the Stay Agreement. 

Please carefully review the guidelines specific to the Hospital at Home Program if you are a part of this program while you are staying at the Rood Family Pavilion

  1. Hospital at Home participation and lodging at Rood Family Pavilion are completely voluntary. If a patient has additional needs or feels they cannot stay at Rood Family Pavilion or manage their medical condition(s) independently given the resources available, they are expected to notify their medical team through the Command Center platform to assess next steps. 

  2. Medical couriers and healthcare professionals will be permitted to go directly to your guest room after completing a brief sign-in process at the front desk. Front desk staff will call your room phone as a courtesy to inform you when they have arrived.  

  3. Guests will be notified when packages, mail, and food deliveries are received, and should pick up at the front desk/first floor lobby. We are typically unable to deliver directly to guest rooms, and post mail is received Monday-Friday only.  

  4. Medical waste disposal: The Hospital at Home Command Center will offer assistance and guide patients on the disposal of sharps and medical waste. Each patient will be provided with appropriate disposal bins and containers for use in the room only. If containers are full, please ask the Command Center to order more. 

     

Stay Agreement Acknowledgement



*
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First and Last Name of Caregiver/Family Member (multiple names can be entered)

I agree to abide by the Rood Family Pavilion Guidelines. I am responsible for all members of my party complying with these guidelines. Anyone unwilling to follow these guidelines will be asked to leave and may jeopardize my privilege to stay at the Rood Family Pavilion in the future.  
Adult Patient Guest Signature 
Caregiver/Guest Signature

Release of Information

Note: For purposes of this form, “Family” includes you as patient or caregiver of the patient and others residing or visiting with you during your stay at the Rood Family Pavilion. (Operated by Ronald McDonald House Charities of Oregon & SW Washington (RMHC)). 
Can we share with others (outside callers, visitors, friends, etc.) that you are staying at the Rood Family Pavilion? 
Communication with treating medical facility 

I understand that under certain circumstances confidential information, including personally identifying information may be shared between the treating medical facility and RMHC during my stay. I understand that this information may include a patient’s diagnosis, reason for admission, date and time of medical appointments and other information pertaining to the patients’ medical condition.   

Type your electronic signature here (Adult Patient Guest)
Today's Date
Type your electronic signature here (Caregiver/Family Member/Guest)
Today's Date

Emergency Contact Information
 
Please enter the name and phone number of a person who is not staying at the Rood Family Pavilion. This information will only be used in the rare instance that we need to contact someone on your behalf.
Will you have a vehicle on premises?
Yes No

No   Yes