Continuing Care

Choosing the right continuing care retirement community




Seniors should carefully review a facility's services, before signing a contract with a Continuing Care Retirement Community. Know what you will be getting.

Photo By Daniel Oines

A Continuing Care Retirement Community (CCRC) offers 360-degree care in residential community for seniors, with a full menu of services and living situations. Residents at a CCRC may move between independent living, assisted living and nursing home care, depending on their individual, changing needs. Seniors electing to live in a CCRC (also known as “Continuing Care Retirement Facilities,” “Life-Care Facilities” and “Life-Care Communities”) contract with the community in advance for a lifetime commitment to provide care, regardless of their future health and needs. They then live in the residential community for the remainder of their lives, and are placed within a living situation appropriate to their needs and abilities.

Seniors or family members of seniors who are concerned about future security find CCRCs a safe bet, addressing any worries about future health problems down the road and alleviating any concerns about hidden costs along the way. A Continuing Care Retirement Community generally offers seniors a contract or contracts that provide a continuum of care that includes access to housing, services, and health care for more than one year, or the balance of their lives. Usually, it is a wise idea for seniors to move into a CCRC sooner rather than later, as most CCRCs require that new residents be capable of living independently when they first move in.

There are a number of contract options offered by CCRCs to seniors and their families. An extensive care contract is the most expensive, but affords the least risk, providing unlimited long-term nursing care at little or no additional cost for as long as nursing home services are needed by the client. A modified care contract comes with medium financial risk, and provides long-term health or nursing services for a specified period of time, after which, the senior or their guardian is responsible for the additional cost. A fee-for-service contract offers an a la carte approach, requiring that residents pay separately for all health and medical services provided by the facility, as well as long-term care. While a fee-for-service contract is the least expensive contract, it does have the highest risk, as costs can run very high for seniors who require unanticipated extensive care later in life.

The most common element in a Continuing Care Retirement Community contract is an entrance fee, where regardless of whether the contract is an extensive, modified or fee-for-service contract, the resident pays a lump sum entrance fee, plus monthly fees thereafter. Another CCRC contract option may require an equity agreement where seniors purchase a condominium or co-op apartment on the property instead of paying an entrance fee. Less commonly found are Continuing Care Retirement Community contracts where residents pay monthly fees only. Seniors and their families are advised to be sure to read the fine print on the contract carefully to ensure that they are signing an agreement that guarantees the lifetime of services and support over an extended period of time that they are looking for. There are so-called copycat senior-care residences that claim to offer all the benefits of a Continuing Care Retirement Community, but in reality the services guaranteed by the actual contract fall far short of the claims made by management.

Before signing a contract with a Continuing Care Retirement Community, seniors should conduct a thorough review of the facility’s services, operations and finances, and determine that the CCRC is appropriate to their needs, lifestyle and expectations. It’s also a good idea to ask a family attorney or accountant to review the contract as well. If the contract is found agreeable, ask to spend at least one night and two days at the facility, to test drive the community and make sure it is a good fit. Some points to consider include:

• Are pets allowed in your residence?

• What social, recreational and cultural activities are offered?

• Is food prepared onsite? If so, how is it?

• Are there fitness facilities onsite?

• Is the staff friendly and knowledgeable?

• What healthcare and personal care services are available?

• What preparations have been made for handling medical and evacuation emergency situations?

CCRCs are an excellent option for those who are independent and in good health, but might need some assistance with daily living needs or require skilled nursing care. The variety of housing offered by CCRCs is varied as well, ranging from ultra-urban high-rise apartment communities to cottages, townhouses, duplexes or even single-family homes located in a beautiful, natural setting.

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