There are many different types of senior living options available today, but the most comprehensive are continuing care retirement communities. With a wide range of care levels, these facilities act as a one-stop shop for seniors planning for their future needs.
Here, we’ll break down exactly what CCRCs are, who they’re for, how they work, how much they cost and how to find the right one for your situation.
What Is a CCRC Facility?
Also referred to as life plan communities, CCRCs are a senior living option that offers “a continuum of care designed to meet residents’ changing needs,” explains Brian G. Lawrence, CEO of FellowshipLIFE, an aging services provider based in New Jersey.
With CCRCs, the idea is the senior — who is often still self-sufficient — moves onto the campus and then transitions seamlessly through different levels of care as needed without having to move to a new location. This approach creates a “stress-free and supportive hospitality environment for aging in place,” Lawrence adds.
CCRCs are designed for seniors who:
— Have the financial wherewithal to pay the hefty entrance fees
— Don’t want to manage multiple moves later in life
— Want access to a variety of amenities and activities
— Want social interaction with other seniors
— May be healthy and able to live on their own but anticipate they’ll need more assistance in the future
— Want more predictability regarding expenses as their care needs change
Qualifications for CCRCs
To enter a CCRC, you must meet certain qualifications. These can vary by property, but generally include:
— Health status. Most CCRCs accept new residents who are still reasonably healthy.
— Financial status. You must meet certain financial eligibility standards to be accepted into a most CCRC properties, and some may require long-term care insurance.
— Age. Most CCRCs have an age minimum, such as 55 or 62, before you can enter.
CCRCs must be accredited to house and care for seniors by the state in which they’re located, but specific requirements vary by state. As you’re looking into potential CCRCS, make sure to confirm that they are accredited by the appropriate state agencies and meet the mandated minimum operating standards.
[READ: Active Adult Communities: What They Are and How to Choose One.]
Services and Living Arrangements Provided by CCRCs
CCRCs offer different living arrangements and services that are tailored to residents’ individual needs. Common services include:
— Nursing and health care services
— Assistance with activities of daily living, including toileting, personal care and medication management
— Meals and dining options
— Housekeeping, laundry and property maintenance
— Outings and social activities
— Exercise classes and/or fitness facilities
— Security and emergency assistance
Living arrangements can also vary by property as well as the level of care provided. Common options include:
— Apartments or condos
— Bungalows or cottages
— Townhouses
— Single or shared rooms in a nursing home-style setting
[READ: Assisted Living Communities: Types of Rooms]
The Different Levels of Care in CCRCs
CCRCs are fundamentally different from other senior living options in that they offer a range of care options all within the same campus. By contrast, a stand-alone nursing home might offer only skilled nursing care and wouldn’t be an appropriate place for a healthy senior who can still live independently.
Below, we explain the types of living options available in most CCRCs.
Independent living
Independent living is for seniors who are still healthy and well enough to look after themselves but who want to have access to benefits like dining options, housekeeping services and other amenities. Within a CCRC, this is usually the entry level for most residents and offers the least hands-on care and support.
Assisted living
Over time, many older adults are less able to care for themselves and could use assistance with activities of daily living, such as preparing meals, using the toilet, managing their living space and keeping track of medications. That’s when it’s time to transition into this second level of care within a CCRC. Assisted living provides more direct, hands-on help but still has limited health care services.
Skilled nursing
As your health care needs escalate, you may need round-the-clock skilled nursing care. Within a CCRC, this third level of care provides more intensive, hands-on assistance and care and includes support from nursing staff and other medical professionals. This is the kind of care you would receive in a stand-alone nursing home.
Memory care
For older adults with Alzheimer’s disease and other types of dementia, memory care is another care level that includes assistance with activities of daily living and specialized support. These units are usually separate from the main CCRC community, as safety and security can become a big concern for those with dementia. Staff in this section of the property also have specialized training to care for people experiencing cognitive decline.
Short-term rehabilitation
Some CCRCs also offer short-term rehabilitation care for residents who are recovering from an acute illness, trauma or surgery. Services can include medical care and physical therapy to help you regain some level of independence or to restore lost mobility, strength or stamina. As the name suggests, this level of care is usually deployed for a short time period — days or weeks in many cases, sometimes months.
[READ: When’s the Right Time to Move Into a Continuing Care Retirement Community?]
Benefits of CCRCs
CCRCS promise a number of benefits to seniors, and many experts say the earlier you move in, the more you can capitalize on the amenities, activities and social opportunities.
Generally speaking, CCRCs can provide seniors with these perks:
— A safe, secure place to live, potentially for the rest of your life
— Access to memory care, skilled nursing care and rehabilitative services if you need them
— Ways to socialize with other seniors
— Fitness classes and other activities that keep seniors active and engaged
— Accommodations for spouses with different care needs within same community
— Care tailored to changing needs
— A maintenance-free lifestyle
— Meals and healthy dining options
— Predictability of expenses despite how needs change, depending on how the contract is worded
Limitations of CCRCs
While CCRCs can be an excellent option for some seniors, this approach may not be best for everyone. Some of the limitations and potential drawbacks of CCRCs include:
— Cost. Upfront and monthly fees can be steep and aren’t covered by Medicare. Medicare, however, “may cover skilled nursing care when that care is rendered in a CCRC, in some circumstances,” says Bob Rees, chief sales officer with eHealth, Inc., a health insurance broker and online resource provider headquartered in Santa Clara, California. Medicaid pays for some assisted living but only in limited circumstances.
— Complex contracts. Contracts are complicated and should be reviewed by a financial consultant and attorney to protect your interests.
— HOA restrictions. There are often rules about how you decorate or take care of your home. Residents also usually have limited opportunity for input when it comes to changes or major decisions about the community.
— Financial risks. To some extent, you are vulnerable to the financial well-being of the facility owners, especially if you don’t have an equity contract and don’t own the unit you live in. And this challenge runs both ways — if you run into financial hardship, some communities do not offer any charity or benevolence care.
How Much Do CCRCs Cost?
. With an entrance-fee model CCRC, incoming residents pay a large entrance fee, often between $100,000 and more than $1 million, sometimes coupled with monthly service fees. With a monthly rental model, on the other hand, you’ll pay a much smaller upfront fee as well as rent. The average rent in a CCRC is $3,450 per month, according to the National Investment Center for Seniors Housing & Care.
CCRC contracts
As noted, the contract you sign as an incoming resident to a CCRC stipulates the benefits you’ll receive and your financial responsibilities for those services during your time living in the community.
There are several types of contracts that CCRCS offer, including:
— Type A — Life care contracts. Also called exclusive or life care contracts, type A contracts are the most comprehensive and usually include the residence, assisted living services, skilled nursing care, memory care and all other anticipated health care needs. These contracts lock in your health care services rate at the start of the contract — before you need them — so you have a predicable monthly payment for the duration of the contract.
— Type B — Modified life care contracts. Also sometimes called modified fee-for-service contracts, type B contracts offer many of the same provisions as type A contracts but include only some of your anticipated future needs, not necessarily all.
— Type C — Fee-for-service contracts. These contracts usually include entrance and monthly fees, but cost-of-care fees are charged separately as they’re needed. The upfront or monthly costs may be lower than with Type A contracts, but there’s less predictability in what your monthly payments will be as your care needs escalate.
— Type D — Monthly agreements. Not all CCRCs offer monthly agreements, but some do, and these are similar to paying for an apartment on a month-to month cycle. Health care services as well as other benefits are usually charged separately at the time they’re rendered.
— Type E — Equity contracts. For those buying the home or condo within the community, an equity contract may be offered. These contracts charge a monthly service fee, homeowner’s association fee and property taxes. Services such as meals and caregiving are usually charged at market rate at the time they’re rendered.
The contract will govern how you engage with the property during your time there, and because many CCRC residents live in the facility for years at a time, it’s important that you understand your rights and responsibilities and have appropriately planned for contingencies.
For instance, contracts sometimes include stipulations wherein you could be evicted from the CCRC if you no longer meet the physical and cognitive standards outlined by both state regulations and the facility itself, says Christopher Norman, a Jamesville, New York–based board-certified geriatric nurse practitioner with the National Council on Aging.
Which is why Norman strongly recommends that you fully “understand the fine print before signing a contract — legal representation is often helpful to negotiate this process,” he says, adding that not everyone can afford that kind of help.
How to Find the Best CCRC Facilities Near You
Finding the best CCRC facility near you can take some time, and you’ll want to follow these steps:
— Begin your search as early as possible.
— Research facilities to find a few that fit your budget while matching your needs and preferences.
— Tour each community you’re considering.
— Ask lots of questions.
— Talk with residents and staff at each facility.
— Ask about staffing levels and how care needs are assessed and addressed, along with safety, hygiene, infection control and other protocols that impact health and safety.
— Review the contract carefully and engage a trusted advisor to help you understand the nuances.
Explore Top-Rated CCRC Facilities with U.S. News
You can start your search for top-rated CCRC facilities with U.S. News’ Best Continuing Care Retirement Communities of 2024.
U.S. News created this rating using data from nearly 400,000 resident and family survey responses at more than 3,500 senior living communities across the country in 2024. Questions assessed resident and family members’ satisfaction with all aspects of care across the spectrum of senior living options.
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What Is a Continuing Care Retirement Community (CCRC)? originally appeared on usnews.com
