If you have looked at options for where to live as you age, you may have considered continuing care retirement communities (CCRCs). Here’s what to know before moving into one:
A CCRC typically offers different tiers of living situations, from independent to assisted living to nursing care and, sometimes, a separate Alzheimer’s or dementia wing — all within the same campus. As a resident becomes less independent and more in need of services, she can shift from one level to another.
The U.S. Department of Health & Human Services estimates that 52 percent of Americans turning 65 today will develop a disability serious enough to require long-term services and support in the future, though most will require it for less than two years.
Applying for Admission
When admitted into a continuing care retirement community, residents are often evaluated to make sure they are healthy and independent.
Consumers should carefully review the terms of the residence and care agreement they intend to sign with the CCRC, since that is a legal document.
— Susanne Matthiesen, CARF International
“Some CCRCs may require a health screening at the time of admission,” said Susanne Matthiesen, managing director of aging services at CARF International, a Tucson-based organization that accredits services for older people, including CCRCs. “Some facilities may require the applicant’s health records and a physical exam.”
Why Choose a CCRC?
Individuals who opt for a continuing care retirement community may no longer want the responsibility for maintenance and repairs on their own home. Others may want the advantages of a community and the activities that come with it.
“This is an opportunity to continue to learn, grow and find new social aspects of life rather than waiting until a life event” that pushes you into the situation, said Jeff Petty, CEO and president of Wesley Enhanced Living, which operates several nonprofit CCRCs in Pennsylvania. Most people “want that social connection,” he added. “They want to be part of a community.”
Adult children sometimes initiate an older parent’s move to a CCRC, said Shelley Ballet, senior vice president of Wesley Enhanced Living. Other times, one spouse is declining — for example, can’t walk the stairs anymore — and that triggers the move.
How to Suss One Out
Visiting during a CCRC’s open house, lunch or another activity is a good way to begin learning more about one. “It’s a process,” said Ballet. It may take two or more years to decide which CCRC is right for you and to complete all the research.
The Downside: A Steep Price
How do you know if you can afford a CCRC? The price depends on the region of the country, and costs tend to be commensurate with the median housing prices in the area, Petty said. Typically, residents pay an entry fee upfront and a monthly fee afterwards.
Entry fees often range from $50,000 to $200,000 or more depending on the CCRC, according to Petty. Indeed, in more expensive parts of the U.S., the entry fee can be substantially higher: The senior living referral service A Place for Mom estimated in April 2015 that it can be as much as half a million dollars. Typically, residents sell their home as a way to finance the entry fee, and there are several types of contracts.
In addition to weighing the initial expense, prospective residents should look into the financial health of a CCRC: some have become insolvent. And knowing what is included in the contract is vital, Matthiesen said.
“Consumers should carefully review the terms of the residence and care agreement they intend to sign with the CCRC, since that is a legal document,” she said.
Matthiesen advised having a legal or financial adviser review the agreement prior to signing and to explore its provisions concerning potential negative situations.
“Consumers should also check with the Department of Insurance in the state where the CCRC is located regarding how that department licenses the CCRC and what consumer disclosure provisions and other protections are in place,” she added.
In addition, Matthiesen said, ask when the CCRC conducted its last actuarial study because “this type of study can help to identify potential financial risks to an organization as the population being served ages in place and may require more services.”
What to Ask About
CARF International also recommends you check into these items:
- Which services are available, which are included and which cost extra
- What amenities are offered
- What kind of contracts are available, ranging from the most extensive services to lesser services
- The fees for each type of contract
- Inspection reports you can review
- Whether any part of the entry fee is refundable when you move or pass away.
Finally, make sure a community among peers for the years ahead is right for you, and that you will feel comfortable in the setting.