For those of you new to the world of senior living, CCRC is the acronym for Continuing Care Retirement Community. Although there are nuances within the levels of care of Senior Living, they are broadly broken down into these four categories: independent living, assisted living, Alzheimer’s or memory care, and skilled nursing. A CCRC usually combines these on one campus to provide a continuum of care for its residents as they age.
The CCRC concept is not new. Created by religious organizations and spreading to other non-profit groups, the CCRC was one of the original senior living prototypes. About 50 years ago, as America’s older population began to increase rapidly, CCRCs became more common, and in the mid-1980s more for-profit companies began to develop and improve the CCRC model.
Lately, it has become somewhat fashionable to bash Continuing Care Retirement Communities as being too expensive and fraught with financial perils. We’re not here to do that. Like other sectors of senior housing, CCRCs aren’t for everybody, but for those that have the resources and do their homework, moving to a CCRC can be the best decision they will make regarding enriching their lifestyle and securing their well being.
The qualifications and procedures for becoming a CCRC resident vary for each community or senior living provider, and, as with any significant financial transaction, some items may be negotiable. There are, however, some general lines of inquiry you may want to follow so that you can make an informed decision about whether moving to a CCRC — or a specific CCRC — is the right choice for you.
1. Do all CCRCs offer independent living, assisted living, Alzheimer’s care and skilled nursing?
No. It varies from community to community. Although many CCRCs offer skilled nursing services, the trend is now to reduce the number of beds in skilled nursing and add more room for assisted living and memory care. Even though your future health needs may be unpredictable, ask about a CCRC’s long-range plans. You don’t know what level of care you may need.
2. What are the fees involved in living at a CCRC?
Most CCRCs charge a significant lump-sum entrance fee — some of which may be refundable to you or your estate (ask)— plus a monthly service fee. These fees give you the right to live in the community and cover such things as meals, housekeeping, maintenance, activities and other community amenities. There are usually three types of contracts (Type A, B and C) that pay for, respectively, all, partial, or no health care services. If you choose Type C, health care services can be purchased a la carte. Choose wisely.
Life care communities are a form of CCRCs that offer Type A contracts only. Type A plans are the most expensive, but guarantee a set or at least predictable monthly service fee no matter what your healthcare needs may become. Types B and C monthly fees may increase as you move from one level of care to another. Ask very specific questions about current fees and projected increases.
There are a growing number of CCRCs that do not charge entrance fees, but do charge monthly rental fees per your individual choices.
Obviously, there is a wide range of services, amenities and accompanying fees available to you. Much is negotiable. Be patient, ask a lot of questions, and read everything carefully. “Includes access to health care services” is not the same as “includes paid health care services.”
3. What are the advantages of living in a CCRC?
Two important words: lifestyle and security. CCRCs are typically luxurious communities that are more like high-end neighborhoods, or, in some cases, posh hotels. With that comes a lively social scene, and a sense of freedom and independence that makes the move to senior living a relatively smooth transition for your psyche. There is a full array of activities for everyone, and the amenities are second-to-none.
The security comes from relinquishing the expense and tribulations of home ownership, and the knowledge that your present or future health care condition can be accommodated within this setting you have so intelligently chosen.
4. What are the financial pitfalls?
If you choose poorly, increasing monthly fees may become unwieldy. If you or your partner move to a different level of care, you may be asked to pay additional or separate monthly fees. If part or all of your entrance fee is refundable, any bankruptcy of the CCRC may endanger those funds. Ask for and examine audited financial statements and investigate the ownership structure. And, by all means, take a look at how monthly fees have risen in the past.
Financial pitfalls can be avoided. And, if you do the math, you may well find that when you take into account the cost of home maintenance and repairs plus the cost of health care, moving to a Continuing Care Retirement Community is the best financial decision you could ever make.
5. Will I enjoy living at a CCRC? It’s such a momentous decision.
Yes, but…visit, visit, visit. Don’t just talk to the marketing team. Have some meals in the dining room, walk around and talk to the residents. Do this more than once. Don’t just tour the independent living section. Tour assisted living, memory care and skilled nursing. Do these areas seem residential or do they become more institutional as the level of care increases? What is the occupancy level of these living sections? If you should need to move to assisted living, will there be room for you? What is the alternative plan that the CCRC has in place? What is the average age of the residents? Does there seem to be a peer group in which you would be assimilated, or do you immediately feel like an outsider? If it's the right community, you will feel welcome and right at home.
Most CCRC residents that have done their research and chosen wisely have no regrets about moving to a CCRC. They have discovered new lifestyle options and joyful experiences they would not have found anywhere else. It’s your life, make the most of it. A CCRC may be just what you’ve been looking for.