What is a Continuing Care Retirement Community?

There are different types of continuing care retirement communities, but all provide increasing care without the stress of moving. Learn the basics in advance.

A continuing care retirement community, (or CCRC), is a residential setting that offers a variety of amenities and levels of service. Housing ranges from independent to assisted to skilled nursing. Many locations also feature memory care. This broad spectrum provides everything one might need as they age, with the convenience of staying in the same complex, or “aging in place.”

How to Know When It’s Time

The decision to leave your home and move into a CCRC is a very personal one. For some, it’s a choice made when the care of your home or yard becomes burdensome. Others may be enticed by the activities, meal options, or social opportunities.

While no one can decide for you, you may want to consider the opinions of those closest to you. Include your spouse, partner, or children in the process. Have them accompany you when you visit. Allow them to ask questions as you take tours of each community. Many residents prefer to enter while still living independently. This allows time to get comfortable before reaching a more vulnerable stage where help is needed bathing or getting dressed.

Waiting Lists

One of the most important timing tips is to plan in advance. Don’t expect to be able to move in right away. This isn’t always possible. Many locations have waiting lists. That’s why looking ahead is important. In the event of an injury or illness, you’ll already know your options and be prepared to make a decision. People often advise getting on several lists. This increases your odds of being near the top of at least one when the time comes.

Essential Questions to Ask

Make the most of your site visits by having a list of questions ready to go. Check out each community’s website to better familiarize yourself before arriving, so you can get right down to business once there. Here are some things you’ll likely want to know.

1. What Are the Costs? Know their entrance fee and monthly rates. Ask to see their contract. Take a copy home with you, if possible. Be sure you’re clear on which services are included and which will be billed separately. Ask about any increase in fees over the past few years.
2. Will My Insurance Cover Any of My Expenses? Some policies only kick in at higher care levels.
3. Can You Accommodate My Spouse, Too? What happens if your partner needs more or less care than you? How will that affect cost and living arrangements?
4. What Type of Medical Care and Support Do You Offer? Ask to meet with a member of their healthcare staff to address any concerns you may have.
5. What Recent Inspections or Audits Can You Show Me? Ask which agencies regulate CCRCs in your state. Request their most current reports. Do they have any resident satisfaction surveys they can share with you?
6. How Are You Different From Other Nearby CCRCs? Let them point out where they shine, or point out features you may not find elsewhere.
7. What is Your Process For Moving Between Care Levels? Do they allow short periods of increased care, if needed?

Money Matters- Entrance Fee, Monthly Rate, and Extras

There’s more to consider than just the monthly rate. Roughly two-thirds of CCRCs also charge an entrance fee, or “buy-in”, and it can be significant. Some offer a lower non-refundable entrance fee. Refundable fees are higher, a large percentage of which is returned when you move, or paid to your heirs upon your death. Determine what is and isn’t covered by your monthly fee. Postage, dry cleaning and having guests join you for dinner can add up if you’re not careful. Anticipating these expenses allows you to plan wisely.

What Can I Expect From My CCRC?

Services and amenities vary as much as pricing, so don’t take anything for granted. Know as much as possible before you sign on the dotted line. Common services include:

• ‍Medical Care (From basic care and medication assistance up to fully staffed clinics)
• Meals (One per day up to full service)
• Recreation (Pickleball, tennis, indoor/outdoor pools, and more)
• Social Events (Think singalongs, guest entertainers, outings, games, movie nights, etc.)
• On-Site Extras (These run the gamut from hair and nail salons to ice cream parlors and gift shops)
• Transportation (What hours does this run? How far will they go? Will the driver wait for you while shopping or seeing a doctor, or will you need to call for your return ride?)

Show Me the Savings

We’ve talked about the expenses, now let’s look at potential savings. You’ll no longer need to pay for certain items included in your new home’s contract. This could be landscaping, housekeeping, most groceries, and entertainment. Don’t forget bills like homeowner’s insurance and utilities. If you will no longer need your car, you won’t be paying for gas, maintenance, or insurance.

Food, Glorious Food

If possible, arrange to dine at the facility during your visit. This won’t tell you everything about their cuisine, but it will help.  Ask about how they accommodate dietary preferences or food allergies. WIll you have a microwave and mini-fridge, kitchenette, or full kitchen in your new home?

Who Decides When I Change Levels?

While there’s no “one size fits all” arrangement, you’re likely to find some or all of these care levels at any CCRC.

• ‍Independent Living - more freedom, less care.
• Assisted Living - mostly independent, but help is available for meals, bathing, and medication.
• Skilled Nursing - higher level of care, including personal and medical services.
• Memory Care - specialized support and security for those with progressive memory impairment.

Each community will address changing from one level to another in their contract. You’re likely to find language that provides for a collaborative decision-making process, meaning they will discuss any potential changes with the resident and possibly their family, physician, and attorney in advance. In the end, however, the CCRC makes the decision. Most contracts make it clear they have the last word in this area.

Are All CCRC Contracts Alike?

In a word, no. Even those with many locations have clauses and policies unique to each community. Help weed out what will and won’t work for you by getting the answers you need in advance. Online chats and virtual visits are widely available, making those hard questions a bit easier to ask. You may also choose to have an attorney review your contract before you sign.

Oscar Wilde said,

“I’m a man of simple tastes, I’m always satisfied with the best.”

I think Mr. Wilde would have been quite comfortable in a resort-style CCRC.

Here are a few surprisingly high-end features you might find at some of America’s most luxurious properties.

• ‍Enjoy the gourmet dining, sprawling grounds, and impressive neighborhood (next door to Stanford University) of Vi, in Palo Alto, CA. They offer so many activities and services that some describe it as “a docked cruise ship.”
• Join your fellow residents at The Clare in Chicago’s Gold Coast neighborhood for a night at the opera, just one block away. Design your own living space to suit your needs, complete with views of Lake Michigan or the Chicago skyline.
• The Regal Palms of Largo, FL boasts its own library, computer center, holistic spa, and admission to neighboring recreation complexes. Security features include 24-hour staffing and emergency call system, all in a lush, green setting with no buy-in fee.
• If you can’t imagine retiring without oceanfront views and beach access, then White Sands at La Jolla, CA has you covered. Added perks include pet-friendly housing and daily limo service to La Jolla Village.
• The options seem to be endless at Philadelphia’s Watermark at Logan Square. Sign up for classes at Watermark University or take advantage of the creative arts studio before heading out for a night at the theater. Their cuisine has been described as “extraordinary”.