Choosing the right continuing care retirement community (CCRC) is a major decision that can shape the next chapter of your life or that of a loved one. CCRCs offer everything from independent housing, such as cottages or apartments and assisted living to skilled nursing care and memory care options. How do you find a right place that meets your needs?
Our U.S. News checklist is here to simplify the process. From evaluating care options and financial considerations to assessing the community environment and knowing which questions to ask, we’ve got you covered. With careful planning and the right resources, you can find a continuing care retirement facility that is the ideal place to call home.
Finding the Best CCRC Facility Takes Time: Start Early
Major cities often offer a variety of continuing care retirement communities (CCRCs) to choose from, while smaller towns and rural areas may have fewer options and might not provide the full range of care, from independent living to assisted living to nursing care and memory care. Even if you plan to stay in your home for a while, it’s wise to start exploring different communities early to see what options are available.
“I’ve met many people over the years who moved to senior living communities and often say they wish they had made the move sooner,” says Anshu Raina, executive director of the Villages of Victory Lakes, a CCRC based in Lindenhurst, Illinois. “Residents quickly form a sense of community by seeing each other in the corridors, during regular activities and coming together for meals. There’s a strong sense of belonging with many new friendships that form.”
[READ: When’s the Right Time to Move Into a Continuing Care Retirement Community?]
Our Checklist to Find the Best CCRC Options
Relocating an older parent or loved one into a continuing care facility is a significant life event that can stir strong emotions. Leaving a family home and familiar neighborhood can take an emotional toll since building new social connections takes time.
“For some people, especially if they are moving by themselves, it may take time to adapt to a new environment,” says Cindy Robinson, senior vice president of Capri Communities in Waukesha, Wisconsin, which offers independent living and continuing care communities throughout the area. “Some older adults may struggle at first when they move, but generally we find that residents become more socially active in these communities and realize that they were isolated when they lived in their own homes, only seeing family and a handful of friends.”
[READ Talking to an Aging Parent About Assisted Living]
Here’s our checklist to learn what to look for in a CCRC.
1. Consider your preferences
Not all retirement communities come in the same size and shape. Some communities are relatively small with only a few apartments and limited services while others feel like a college campus with multiple buildings, housing options and a robust list of daily activities.
A small to medium-sized community would normally include about 40 independent homes, 100 apartments, 45 assisted living suites, 20 memory care rooms and more than 100 nursing home beds.
If you prefer to stay close to family, friends and established social connections, consider the 55+ or 65+ communities in your area. Communities with faith-based programs are common, so also consider explore those options.
“Smaller communities offer a more intimate environment where it’s more neighborly,” Raina says. “They also have a smaller set of staff, so residents see the same people all the time and really get to know them. You develop relationships with the staff as well as your neighbors.”
2. Consider your care needs
Whether care needs are more immediate or farther in the future, it’s essential to consider the continuum or next level of care needs for you or a loved one. Older communities may offer only independent housing options for seniors and no long-term care services. However, within the past two decades more communities have begun offering a continuum of care. These CCRCs include a range of living and care needs, including:
— Assisted living
— Nursing and rehabilitation care
— Memory care services
“CCRCs are a great option if an individual anticipates increasing medical care needs, as this setting allows individuals to easily transition to higher levels of care when needed within the same community,” says Rachel Reeves, senior vice president, public affairs at the American Health Care Association/National Center for Assisted Living in Washington, D.C.
3. Consider your finances
Many decisions will be guided by the overall costs of each community and how much you expect to earn in retirement from Social Security, pensions, retirement savings and other investments and assets.
The nicer the facility, the higher the monthly fees and added services will be. Studio accommodations are less expensive than one-bedroom accommodations, and the overall size of the unit can also affect the cost. Look for the flexibility to select the amenities and services that are important when choosing housing options. More intensive health care needs, such as physical therapy, rehabilitation or medication management, will lead to higher monthly costs. Some communities may offer add-ons for an additional expense, including parking, salon services, medical care and meal plans.
[READ: Assisted Living Costs and How to Pay]
4. Research facilities that match your preferences, needs and budget
Once you determine your budget, housing and location preferences, build a short list of communities that match your requirements and preferences. Whether you’re staying in your town or moving to a new area, a good place to start research is through U.S. News rankings of CCRCs.
“If consumers aren’t sure where to begin, the internet?can be a helpful tool and starting point; however, consumers should not rely on the internet exclusively when choosing a community,” Reeves adds. “Ask family members, neighbors, work colleagues and members of your faith communities for suggestions on which communities they recommend.”
Experts recommend using the following sources of information to find potential communities in your region:
— Local or state aging agency. These agencies can tell you if your state has a searchable database of communities. To find your nearest Area Agency on Aging, use the federal government’s Eldercare Locator website or call 1-800-677-1116.
— U.S. News rankings. This resource provides ratings on hundreds of CCRCs, evaluating factors such as overall resident satisfaction, value, dining, costs, activities and more. Find out more at USNews.com.
— American Seniors Housing Association, a trade association focused on companies involved in the finance, development and operation of housing and services for seniors, offers searchable listings to help you find senior community options.
— LeadingAge. An association of aging-related organizations, LeadingAge has an online Aging Services Directory to search for facilities in your area.
— Word of mouth. Relatives, friends, neighbors and your health care providers, such as doctors, dentists, chiropractors and therapists are also good sources of information.
5. Tour your favorite options
After narrowing down your list of communities, scheduling a visit is the best way to learn about the specific services provided, whether the staff is friendly and if you or your loved one would feel comfortable living in the community.
“Touring communities is extremely important in the selection process to ensure families and residents get a good idea of what to expect, meet staff, and see first-hand what a loved one will be experiencing,” Reeves says.
Ask questions of the staff and residents and learn about payment options, Reeves suggests. “Each community is unique, and it is important for the consumer to understand what they are looking for in order to have their needs met and feel comfortable and confident in their decision.”
When exploring CCRCs that you’re considering, it’s a good idea to tour their facilities. The tour can offer a real-world view of what living in that CCRC would be like and help you answer questions such as, do you like the atmosphere? Is the staff friendly? Do the residents look happy? Is the facility clean? Speak with current residents and get their input on what it’s like to live there.
If you live out of state and have difficulty taking a tour of a CCRC that you are interested in, contact the facility and ask if they offer virtual tours or if they can live-stream a tour with you. With the increased technology available now, some CCRCs have options for interested individuals who are unable to take an in-person tour.
When visiting a facility either in person or virtually, it’s always a good idea to ensure that it can provide the services, care and support needed not only today but also in the coming years.
6. Gauge resident satisfaction
Resident satisfaction is a key indicator of the effectiveness of a community and the well-being of its residents. It reflects how well the facility is meeting the needs and expectations of community members, and good ratings indicate that residents are engaged in activities that maintain social connections.
“Oftentimes, you’ll learn the most by speaking directly to residents and receiving an unvarnished answer with the pros and the cons of the community,” says Lance Slatton, a certified senior care manager and founder of All Home Care Matters podcast based in Livonia, Michigan. “Second, most CCRCs conduct surveys on resident satisfaction. When contacting the CCRC or during your tour, ask when the last resident satisfaction survey was conducted and if you would be able to review it.
Talking to current residents is one of the best ways to collect feedback, but it’s also valuable to read online reviews, which can often be found in local Facebook groups or other social media platforms like Nextdoor.com that discuss the pros and cons about communities.
7. Get to know the staff: staffing ratios, training and tenure
During your tour, you will likely meet with the executive or assistant director, head of sales and maybe the nursing director. While these meetings are important for getting a general sense of the community, it’s also essential to have informal hallway chats with the facility staff, such as nursing assistants, medical aides, the activities director and the food service team. It’s usually during these discussions when you get a true picture about the community in comparison to the sleek marketing messages delivered by the management team.
Questions to consider when you’re talking to the direct-care staff:
— Do you like working at this place?
— How long have been working here?
— What’s the staff turnover rate?
— What training is provided to the staff?
— How would you describe the level of support and care provided to residents?
— Would you want one of your own family members living here?
Staffing ratios play an important role when individuals transition from independent living to assisted living or nursing care. Nursing home facilities are required to meet minimum staffing standards in each state. In New York, for instance, these minimum standards require daily staffing hours equal to 3.5 hours of care for each resident each day by a certified nurse aide, licensed practical nurse or registered nurse. These minimums vary from state to state. To learn more about staffing levels at nursing homes visit Medicare’s Nursing Home Care Compare.
8. Explore the types of units available
Most communities offer a variety of living options that are tailored to different budgets, needs and preferences. Independent housing may offer stand-alone cottages with one to two bedrooms, two bathrooms and one or two-car garages. More common are apartment options that offer studio, one bedroom or two bedrooms with or without patios and terraces. Assisted living places mainly offer studio apartments only, but some facilities like Saint Catherine Commons in Kenosha, Wisconsin, on Lake Michigan, offers one or two bedrooms in its assisted living property.
“When scheduling a tour, be sure to view the different housing options to decide if they would be a good fit for you or your loved one,” says Cindy Robinson, senior vice president of Capri Communities in Waukesha, WI, which offers independent living and continuing care communities throughout the area.
9. Dig deep into costs and fees
For those considering independent living, it’s critical to get a full picture of the costs and fees to help create a monthly budget. Some communities charge an application fee and others require an upfront, non-refundable fee to join the community. Most housing options are monthly rental arrangements, but some places also offer an entrance-fee model where you put money down for a cottage or apartment and then get 80% to 90% back upon moving out.
Regardless of the type of contract, you’ll pay a fee or rent each month. On average, rent for a CCRC was $3,450 in 2023, according to the nonprofit National Investment Center for Seniors Housing & Care, known as NIC. By comparison, the average cost of assisted living is $4,500 a month.
Many communities offer comprehensive amenities included in the rent. These often cover daily meals, housekeeping, maintenance, transportation, gym and various activities. The all-inclusive approach is a significant draw for many individuals looking to balance independence with convenience.
During any tour, get specific information in writing about the cost structure and what they consider extra fees, which often include laundry services, additional meals and health care services such as nursing aides and therapists.
While there is no government assistance available for independent housing within CCRCs, Medicaid can help cover the costs of long-term care needs once a person qualifies. Additionally, some individuals use long-term care insurance to manage expenses. To find out if a community accepts Medicaid payments, it’s best to speak with them directly.
10. Understand the health care options
In independent living, there are usually limited health care options. Sometimes there is a part-time nurse on staff to handle minor health care needs or questions, but generally residents need to handle their own needs through their doctor or other health care providers.
Health care services increase as people move into assisted living and long-term care facilities. Consider these different levels of health care services:
— Assisted living: This option is best for individuals who need help with activities of daily living, such as bathing, dressing, medication management and meal preparation.
— Skilled nursing care: This is for residents who need more intensive medical and personal care support, including eating assistance, getting out of bed or moving around in a wheelchair or walker.
— Memory care: This type of care is for those living with dementia or Alzheimer’s disease who need consistent care and help with most health and personal care needs.
— Private duty care: Within many communities, private duty health aides are available for a set amount of hours to provide help with cleaning, cooking or regular companionship. Aides are available either through the community themselves or through an outside health staffing agency.
— Rehabilitation services: To help residents recover from falls or injuries, rehabilitation services, such as physical and speech therapy, are usually done over a certain number of weeks with the goal of helping an individual return to independent or assisted living settings.
— Pharmacy services: Most communities do not offer on-site pharmacy help, but many will contract with a pharmacy consultant who can help residents manage their prescription drugs, side effects and medication options to improve overall health.
— Dental care: Some larger communities provide on-site dental services for routine check-ups, broken partials, dentures or fillings. Major dental work, including X-rays, is done at an off-site office.
11. Learn about activities and enrichment opportunities
Communities often boast on their websites and brochures about the many enrichment programs offered to residents — everything from arts and crafts, book clubs and music programs to day trips and activity clubs. It’s not unusual for communities to offer special events with motivational speakers and book authors.
Like many communities, the Capri communities across Wisconsin are helping keep their residents stay engaged by giving them the chance to form their own activities and clubs and support charitable groups in the local area. Some members manage and run general stores in certain locations. They have also started to offer travel and excursion options. One facility partnered with a travel company to plan two future trips to Italy and New York. Each of the Capri communities do charitable work.
“We aim to ensure they live their fullest life by providing activities and events that offer engagement and continuous learning with a focus on wellness and spiritual needs,” Robinson says.
12. Talk transportation
Depending on the location of the community, transportation services can help residents feel more independent. Urban communities are often near public transportation, such as bus lines, making it easier for residents to get around. In contrast, those living in suburban and rural areas may need a car for daily activities. Increasingly, many communities provide shuttle and van services to local stores, shopping malls and doctor appointments. These services can typically be scheduled or reserved through the main desk or may run on a regular schedule throughout the day.
13. Ask about emergency protocols
When considering a CCRC, it’s crucial for families to understand how facilities plan to handle crisis situations and emergencies, such as elder abuse, theft, or environmental disasters such as hurricanes, earthquakes and wildfires. Every community is required to have an emergency protocol in place, following federal, state and local regulations. Fire safety is governed by the local fire department, but emergency exit routes, fire extinguishers and other safety regulations are determined by the Occupational Safety and Health Administration. Additionally, federal rules mandate that skilled nursing care facilities serving Medicare and Medicaid patients train their staff on how to protect residents and themselves during emergencies.
Emergency protocols must be made available to residents and their families upon request. When visiting a CCRC, ask about the specific plans for evacuating residents, especially those with health or mobility challenges. Also ask how frequently the facility conducts evacuation drills with both employees and residents to ensure preparedness.
14. Ask how the facility handles resident safety, hygiene, and infection control
The pandemic prompted many CCRCs to reassess their health and safety protocols, particularly for COVID-19, flu and other infectious diseases. In response, these communities now strictly adhere to guidelines set by their local health departments, which outline the required precautions and procedures. When considering a move to a CCRC, be sure to ask how the facility manages outbreaks and the specific protocols they have in place to protect residents.
“We now have a better understanding of how to manage these situations,” Raina says. “Our knowledge about proper personal protective equipment and infection control has significantly improved since the early days of the pandemic.”
Explore Top-Rated CCRC Facilities with U.S. News
Choosing the right CCRC involves careful planning and research. It’s important to start your search early, especially if you live in an area with limited options. When evaluating a CCRC, consider the range of services offered, from independent living to nursing care, and how they align with your current and future needs. Touring communities is a crucial step; it allows you to assess the environment, meet the staff and speak with current residents to gauge their satisfaction and the quality of care. Look for communities that offer a broad range of activities and social events, fostering a sense of community and engagement among residents.
Financial considerations are also key when selecting a CCRC. Assess your budget and the costs associated with different levels of care and amenities. Understand the various types of contracts and fees involved and explore options for financial assistance if needed. Utilize resources like the U.S. News rankings to compare facilities and use word-of-mouth recommendations to find reputable communities. Ultimately, visiting the communities in person will provide valuable insights and help ensure that the chosen CCRC aligns with you or your loved one’s lifestyle, health care needs and financial situation.
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A Checklist for Choosing the Best CCRC Facility originally appeared on usnews.com
