Continuing Care Retirement Communities (or CCRCs) offer multiple housing options for seniors in one location. Typically, these long-term care options include independent living, assisted living, and nursing homes. CCRCs allow seniors to age in one place, providing different levels of care as their needs change. As the US population continues to age, these life-care communities are expected to assume an increasingly prominent role in the later life landscape. Are you considering a long-term care retirement community for yourself or a loved one? If so, keep reading. We discuss the typical structure of the CCRC, admission requirements and types of contracts. We also cover the costs and provide some ideas on where to get the funds. Finally, we discuss how to find the perfect CCRC for you or your loved one.
What is a Continuing Care Retirement Community?
A long-term care retirement community is a facility focused on the lives of seniors. It accommodates seniors based on their various care needs. Also called a "living care community," each CCRC allows seniors to structure their retirement by planning for the levels of care needed for the rest of their lives. CCRCs allow seniors to age in place, providing them with ongoing care as they age. As residents' needs change, so do the services they receive. Because CCRCs allow seniors to plan for the rest of their lives, some facilities have renamed themselves "life planning communities." This revised name reflects the focus on each resident's ability to live a rich and vibrant life while still being able to provide senior care services. Continuing Care Retirement Communities offer multiple on-site housing options, each with different levels of care. Center staff continually reassess each resident's needs to determine if a higher level of care is needed. As residents' needs change, they will move to a different facility within their home community. Upon admission to the CCRC, most residents qualify for independent living. As they move up the continuum of care, they transition to different on-site care facilities. Regardless of the care option they receive, all residents have access to emergency medical care.
A new resident's CCRC experience usually begins in the independent living complex. These complexes usually have large common areas and outdoor facilities. Some of CCRC's features may include swimming pools, restaurant-style dining rooms, fitness classes, and numerous on-site and off-site social activities. Withregular social activitiesand departures, independent CCRC residents enjoy quality retirement. Residents in independent living facilities enjoy a lifestyle often found in upscale seniors' communities. Accommodations include houses, duplexes, cabins or apartments. CCRC's detached housing complex is often well landscaped with outdoor patios, walking trails, and landscaping. Additionally, the CCRC community takes care of all home maintenance issues, allowing residents to enjoy a vibrant, independent lifestyle.
living with assistance
As residents' needs change over time, they are likely to move from a self-contained living unit to a CCRC assisted living facility. In the assisted living section, seniors receive home care services along with assistance with activities of daily living (ADL).assisted living residentsEnjoy private rooms or apartments. Benefit from transportation to and from health appointments. In addition, immediate assistance is available 24/7 via an emergency call button. Although assisted residents need different levels of medical care, they continue to maintain a rich quality of life. Residents enjoy walks and outings to shopping and social activities, often accompanied by family members. In addition, community college classes, community group performances, and special events are held on the nursing home's premises.
Specialized nursing center
As a loved one's health care needs increase, they may transition to CCRC's skilled nursing facilities. This higher level of care often includes around-the-clock help with ADLs and medication management. Skilled nursing services are always available for residents' health needs, and licensed physicians are onsite. Residents at this long-term care facility live in private or shared rooms, and a resident's emergency call button will quickly call for help. Nursing homes also function as short-term rehabilitation facilities for recently hospitalized patients. Speech, physical and occupational therapies are provided by qualified professionals under the supervision of a physician.
Many nursing homes include a designated ward for patients with dementia and Alzheimer's. These specialized nursing care facilities provide memory and Alzheimer's care residents with health services that meet their specific needs. Each self-contained unit has staff trained to provide residents with varying levels of memory care. The memory care sections also include more staff oversight and stricter safety protocols help ensure the safety of residents. Residents' families have peace of mind knowing that their loved one is safe and their medical and home care needs are being met.
CCRC Resident Eligibility Criteria
Long-term care retirement communities have very strict admission requirements compared to other types of long-term care facilities. The first criterion is that applicants must be in good health and able to live independently.
To apply to become a CCRC resident, applicants must be within a certain age range. In most cases, long-term care retirement communities require residents to be at least 55 years old. However, many CCRCs limit enrollment to people between the ages of 55 and 65. And, according to the center, some CCRCs are even more restrictive, only allowing applications from people aged 62 and over.
Each CCRC applicant must provide their complete medical history along with relevant family medical history details. During enrollment, they undergo a complete physical exam and may undergo a mental health exam.
Financial Eligibility Requirements
Each applicant must provide proof of sufficient financial assets to cover their current care needs. They must also show that they can afford a higher level of care in the future.
Affiliate CCRC Approval Criteria
Certain religious, ethnic or cultural organizations may operate their own retirement assistance communities. A group's admission criteria may require applicants to be members of that organization. However, it's best to check with the specific organization to find out their requirements.
Submission of legal documents
Senior care centers tend to require applicants to provide specific legal documents. These documents are called “advance directives”. They provide legal instructions for your health care preferences if you are unable to make these decisions on your own. Physicians and caregivers will rely on advance directives for legal guidance in making health care decisions. Each CCRC's advance directive requirements may differ; however, they will likely ask for a "power of attorney" and a "living will".
This widely used legal document allows you to nominate a person or organization to manage your affairs if you are unable to perform those roles. There are several different types of power of attorney. Each gives your agent (the person who will make decisions for you) different levels of control.
A living will specifies the medical treatments you would like to use to stay alive. It also details the treatments you don't want to use. A living will can also include your preferences regarding other medical decisions.
The benefits of living in a CCRC
A well-run continuing care retirement community provides its residents with many different benefits. Together, the CCRCs allow residents to enjoy the best possible quality of life as their needs evolve.
Provide care as needs change
When a resident first enters a CCRC, they are generally in good health and have a high degree of mobility and independence. Over the years, the resident's health may deteriorate and necessitate transfer to the CCRC assisted living community. Eventually, they can transition to the complex's nursing home.
Provides a family community
As a resident moves through the CCRC continuum of care, staying in their family community can provide a sense of comfort and security. In addition, staff who know a resident's personality and lifestyle habits can easily detect changes that may indicate an emerging physical or mental problem. The resident's family can rest easy knowing that their loved one's needs will continue to be met.
Accommodates couples with different care needs
Many CCRCs are designed to accommodate couples with different care needs. For example, a spouse who meets the institution's independent living criteria may share a living space with a partner who needs some assisted living services. Or, if one of the spouses moves into the nursing home at the facility site, their partner can easily visit.
Sharing the CCRC complex with other residents helps build relationships based on shared values and interests. Lasting friendships can start in classes, outings, services, or elsewhere. Even if one party's care needs to change, the friendship can continue as long as both parties remain on CCRC property.
How much do long-term care retirement communities cost?
When evaluating the costs of long-term care retirement communities, understand that a CCRC costs more than other long-term care options. This higher cost results from CCRC's all-inclusive monthly fee structure.
Subscription fee and monthly fee
All CCRC residents who enter pay an entrance fee in addition to their regular monthly fee. This entrance fee is directly related to the size of the community, along with the resident's living arrangement and their use of services and amenities. Note that a greater need for services increases the resident's monthly fee accordingly. Ask if any fees are refundable if the resident does not use these services.
Contract types and resident tariffs
Long-term care retirement communities use three types of care contracts that determine residents' monthly fees. These types of contracts include an all-in option along with two modified contracts.
Type A: Extended or Lifetime Contract
This all-inclusive contract carries the highest price and entrance fee. A Type A contract includes all amenities along with housing and services related to the home. The resident has unlimited access to assisted living and medical care services at no additional cost.
Type B: Modified Contract
Compared to a Type A contract, a modified Type B contract contains a reduced enrollment fee and an initial monthly fee. The resident enjoys many of the same services as a Type A resident. However, under a Type B contract, the resident can only access limited health services. Additional health services require additional costs. If the resident needs services outside the scope of the contract, their monthly fee will increase.
Type C: Fee-for-service contract
With a Type C lease, residents enjoy low entry fees and low initial monthly costs. However, this type of contract is a fee-for-service contract. This means that the resident must pay the market price for all the health services they access.
How to pay a CCRC
Because CCRCs are more expensive than other long-term care options, funding can be an issue. Prospective residents and their families are often looking for ways to meet CCRC funding requirements. The following are some possible funding sources.
Personal funding sources
CCRC residents frequently turn to retirement savings to finance the lives of their seniors. If the resident owns stocks and/or bonds, liquidating these investments will provide additional capital. Family members can also help, depending on your financial situation. Additionally, proceeds from home sales are a popular way to raise funds for CCRC entrance fees. However, before the sale of the house can proceed, the contents of the house must be settled and removed from the premises. This is usually done through an estate sale. It is here that oneprofessional real estate sales companycan help as they will take care of everythingprocess of selling goodsfrom start to finish.
long term care insurance
Long term care insurance policies usually cover assisted living costs. If the resident has existing long-term care insurance, check your policy for details. Also, keep in mind that the policy may place restrictions on funds used for activities of daily living (ADLs). If this is the case, and depending on the type of contract sought, the resident may have to seek other funding for the remainder of the CCRC.
state health insurance
Medicare does not provide coverage for community long-term care expenses. Although,some health-related servicesmay be covered by the resident's Medicare Beneficiary Agreement. The care must be considered medically necessary and a Medicare participating provider must perform the services.
If you or your loved one meet the low-income criteria and have very limited financial resources, the Medicaid program may be able to provide some relief funds. In most cases, the beneficiary must have less than $2,000 in assets, not including your home or vehicle. The beneficiary must also meet functional eligibility requirements. Most CCRC residents do not qualify for Medicaid assistance. Therefore, they must use their own financial resources to pay the installation fees.
If a CCRC resident has served in the military, he or she may be eligible for US Department of Veterans Affairs (VA) benefits that cover some long-term care expenses. The resident must go through the VA to access these benefits. Because this is a complex process, the resident may wish to enlist the help of a geriatric planner.
Finding the right CCRC installation
Finding the best CCRC for your situation is key to a successful long-term care experience. Three online resources provide up-to-date information about facilities in your geographic region.
The US Elderly Care Locator
from the federal governmentsenior locatorprovides a list of local long-term care retirement communities. They also have information about seniors' rights, housing options and insurance benefits. We suggest you bookmark this site for verified help with all your elderly care questions.
LeadingAge, a not-for-profit association of senior caregivers, offers aSenior Services Directory. You can search for CCRCs in your area based on your state, city or zip code. Also, you have the option to search for a specific community.
Online referral services
Also, try online referral services such asCaring.comoSeniorLiving.org. They provide easily accessible resources.
Before signing on the dotted line, take a deep dive into CCRC's offerings as it pertains to your needs or those of your loved ones. Develop a list of "must-have" services and amenities and decide if you're willing to forgo other offerings. Remember this is where you or your loved one will spend the rest of your lives, so take your time and carefully evaluate each CCRC.
Determine CCRC's proximity to doctors, specialists and hospitals. Consider the facility's distance from grocery stores, pharmacies, and other frequently accessed businesses. Also, consider whether the resident needs to be close to family and loved ones.
Review the different floor plans of the facilities and see if the homes have safety enhancements such as grab bars and non-slip floors. Determine whether assisted living facilities and nursing homes offer private rooms with bathrooms. Make sure common areas are clean and well-maintained, and make sure outdoor spaces are easily accessible. Finally, ask about sprinklers, fire escapes and other safety measures.
Ask about different types of meal programs and find out if residents with special diets can meet their nutritional needs. Ask to see recent menus as this will help determine the range of entree options and meal combinations.
Determine whether independent residents can also get occasional assistance with ADLs. Ask about on-site services like beauty salons and places of worship. Find out if transportation services are available to meet residents' scheduling needs.
Confirm which health services residents can access at each level of care. Make sure the facility has safe housing for residents with dementia and Alzheimer's. Ask if there is an on-site pharmacy staffed by qualified pharmacists and pharmacy technicians.
Social and recreational activities
Learn about social and recreational activities for different levels of care and ask to see weekly and monthly activity schedules. Take a look at the common areas and find out if residents can access TV, movies and games. Find out if the facility offers activities like on-site fitness classes and off-site tours.
Learn staff credentials and observe their behavior when interacting with residents. Ask if administrators are generally available during business hours.
Continuing Care Retirement Community Resources
When objectively evaluating CCRCs for you or your loved one, the following tools can help you during each facility visit. Be sure to write down all relevant information, record your questions, and note any observations.
CARF International Consumer Guide
CARF International is a recognized national accreditation organization for health and human service providers. The CARF offersdownloadable consumer guidefor all things CCRC. Get details on fee structures, CCRC contracts and company financial performance.
Nonprofit Explorer Facility tax returns
If you are considering a non-profit CCRC, review your tax returns to help you determine the financial health of the business. ProPublica, an investigative news organization, operates the information sectornon-profit scoutsearch location
AARP printable worksheet
The American Association of Retired Persons (AARP) offers an easy-to-print formatLong Term Care Worksheetthat you can do on your tour of the facility. Please review it regularly and make changes during the CCRC selection process.
Legg Mason's visit sheet
Financial services company Legg Mason created aCCRC installation guidefor your tour of the facility. Topics include location, configuration, and services provided.
make the right choice
Finding the right long-term care retirement community is not a spur-of-the-moment decision. Take the time to research area facilities online and speak with the admissions coordinator at each complex. Then schedule a leisurely tour of the campus. As you walk around the grounds, talk to several residents and ask how they enjoy their living space and quality of care. Then record your impressions of the facility and compare it to other long-term care retirement communities in the area. So choose the CCRC that offers you or your loved one the most nurturing environment for the future.