Continuing care retirement communities (CCRC) are gaining in popularity across the United States. Sometimes referred to as life plan communities, the goal is to provide a long-term care option for older residents. These residents prefer to live in the same community, though in different phase locations, during their aging process. In essence, it is a continuum of care that will see you through your pre-planned stages of older life.
The selection process of this community type can be challenging as there are nearly 2,000 CCRCs throughout the country, and each offers different kinds of housing and levels of care, for a price. Most residents will begin CCRC living independently in an apartment or single-story home. As health situations present themselves, the resident will transition to assisted living and, ultimately, to a skilled nursing level. The phases of community living are among the most significant benefits of a CCRC as it provides familiarity and the stability of a wide range of activities, services, and care in one place.
The federal government provides an online public service through the US Administration on Aging known as Eldercare Locator that connects you to services for older adults and their families regarding CCRCs and much more. The service is also available via telephone at (800) 677-1116. LeadingAge is a member group association for non-profit eldercare that provides and maintains an aging services directory where you can plug in a zip code and search for local retirement communities. Caring.com and seniorliving.org also have referral search options to locate a nearby CCRC.
According to AARP, nearly two-thirds of CCRCs will charge an entry fee to join their community. The average initial payment ranges from $239,000 to over one million dollars in some communities. After an initial entry fee, residents will pay a monthly fee, typically running between two to four thousand dollars. Before putting money down, there are questions to ask. LeadingAge suggests these following questions:
- Is the CCRC for-profit or non-profit? What is the financial strength of the community?
- What does the monthly fee include?
- How do you specifically aid me in maintaining my independence and freedom?
- What types of emergency response systems are in place?
- Do you survey residents to measure levels of satisfaction? Can I see the most recent surveys?
- What type of input and feedback about the community do residents enjoy?
- How do you define independent versus assisted living, and at what point would I have to transition to assisted living?
- How is aging in place supported even if my needs change somewhat?
- Who selects community events and programs, and what are the five most popular?
- May I review your residency agreement?
If you locate a community you like, then it is time to ask more detailed questions. Is the CCRC nearby to a hospital? How far away are your medical doctors from the community? How convenient are amenities such as public transit, grocery stores, dry cleaners, and other services?
Check on the credentials of the staff at the CCRC. Is their interaction with you professional? Do they seem willing and eager to help? How available are the administrators of the community? Is their office open throughout the day to deal with issues that may arise?
What are the floor plans and options of available housing? Are residences equipped with dishwashers, washer and dryer, and microwaves? Are homes equipped with grip bars and nonslip floors? Are common areas and green spaces well maintained? Do the assisted living and nursing facilities offer private rooms with baths? What are the locations of emergency exits, sprinklers, and other security features that are in place?
Talk to the people currently living in the community and get their insights as to the value and livability of the CCRC. Ask about meals; in particular, are special diets accommodated? What are the personal services available such as housekeeping, laundry, and hair salons? Is there any transportation service? What are the costs associated with these services? Check on recreation and social activities too. What events are regularly available? Are their clubs and common area for residents? What is the availability of an exercise facility and fitness classes? Are there opportunities for worship?
Regarding health care services, check what is available to you at each level of care. What is included in the entrance and monthly fees? Does the CCRC have specialized dementia care areas or other specific health condition areas? Is there a pharmacy on-site? Are all prescription drugs handled by qualified staff, and do they monitor the medication?
Once you have chosen a community, review the contract very carefully. A CCRC offers three basic contracts:
- Extensive life-care contract or Type A includes a full range of services but also carries the highest fee. This contract provides unlimited assisted living, medical treatment, and skilled nursing care with little or no additional costs.
- Modified contract or Type B offers a defined but limited set of services. Any services beyond the ones in the contract will incur a higher monthly fee.
- Fee-for-service contract or Type C generally has a lower initial enrollment fee, but the residents must pay for the services they require, such as assisted living, skilled nursing, or memory care.
Some CCRCs even offer a rental contract known as Type D and a Type E equity agreement where you purchase a share of your unit instead of an entry fee. No matter what contract type you select, all CCRC contracts are notoriously complex, so it is imperative to retain an attorney to review the specifics to protect your finances and future residency.
There is a lot to consider when joining a continuing care retirement community. Share your expectations and thoughts with family and loved ones and ask for their help. Do extensive research on several potential communities before finalizing your decision. Ask a lot of questions when you visit each community. Carefully review any CCRC contracts or agreements before you sign them. A CCRC can be an enjoyable living experience when you find the one that meets your criteria and needs.
If you have questions or need help reviewing a contract or agreement with any type of facility, we would be happy to help. We can also discuss a plan for how to pay for care on a long term basis and how to protect your savings from being depleted.
— By Rebecca W. Geyer, Attorney at Rebecca W. Geyer & Associates P.C.