All About Continuing Care Retirement Communities
Continuing care retirement communities (CCRCs) – or life plan communities as they are sometimes called – are unique because they offer a full range of living arrangements for their residents. CCRCs are comprised of independent housing, assisted living/adult care facility, and nursing home services – all within one community. This arrangement allows a person to enter the community as an independent housing resident, and, as his/her needs change, the services provided in the CCRC can change so that the person does not have to move out of the community. Within CCRCs, the independent housing options typically range from small and large apartments to townhouses and cottages. Assisted living options can include Enhanced programs, which allow residents to remain in that level of care longer as their needs increase, as well as Special Needs programs that offer memory care services. Some CCRCs are looking to expand options to offer CCRC at home services for people living in their own homes in the community, as well.
In addition to providing living arrangements and a range of health-related services and supports, CCRCs also provide their residents with the amenities and comforts of a community. Residents often have access to health clubs, swimming pools, conference centers, medical suites, dedicated worship centers, convenience stores, beauty salons and a choice of dining options. CCRCs host organized social events, provide recreational activities and offer transportation to venues outside of the community. They may also offer guest quarters for visiting family members and friends.
CCRCs provide housing and health-related services for their residents under an agreement effective for the life of the resident or for a specific period. There are three main types of agreements or contracts within CCRCs. “Type A” contracts, also known as “life care” agreements, include housing, residential services and amenities and unlimited long term care without substantial increases in periodic payments. Modified (“Type B”) contracts cover housing, residential services and amenities and limited nursing home care without any substantial increases in periodic payments. Fee-for-service (“Type C”) contracts include housing and residential services and amenities. Residents are guaranteed access to health care services by paying prevailing rates. Essentially, residents only pay for health care services used in this model.
Payment:
Residents pay an entrance fee – most often from the sale of their home – and monthly charges out of their own funds and/or from long term care insurance benefits. In exchange, they have guaranteed access to the entire range of services provided in the community. CCRCs are an attractive alternative to many older adults, since they provide security in knowing that their future health care and other needs will be met by the same organization and that their monthly fee will remain predictable even if the level of services needed changes. This allows the older adult to more readily budget for the cost over time.
Questions:
When deciding on a particular CCRC for services, consider asking the following questions:
• What types of contracts does the CCRC offer (i.e., life care, modified, fee-for-service), and what are the entrance and monthly fees associated with each?
• What are my current living expenses vs. the costs of living at the retirement community?
• Is there a policy that allows a refund of the entrance fee if I leave the community?
• How long has the CCRC been in business? How about the organization that operates it?
• What services are included in the monthly fee? What services are offered for an additional charge?
• What kind of health care is available on-site (physicians, dentists, clinic, etc.)?
• What activity programs, educational opportunities and transportation services are available?
• What opportunities are there for involvement through resident councils and committees?
Resources:
How to Select a Continuing Care Retirement Community
Consumer Guide to Life Plan Communities: Quality and Financial Viability
Financial Ratio Medians for Not-for-Profit Entrance Fee Continuing Care Retirement Communities
Financial Soundness Handbook for Residents and Prospective Residents of CCRCs
New York State Department of Financial Services CCRC Year-End 2018 Financial Update
New York State Department of Health CCRC Resource Page