What is a Continuing Care Retirement Community?

A continuing care retirement community (CCRC), also known as a life plan community, allows residents to enjoy independent living, a feature-rich lifestyle, and access to all levels of healthcare in one setting. CCRCs offer seniors the opportunity to live as independently as possible for as long as possible and provide the peace of mind that more care and assistance will be available if and when residents need it. 

Modern CCRCs have something for every resident, from amenities and activities to satisfy a variety of interests to a full continuum of care that ensures their health needs are met. As seniors’ needs change, CCRCs allow them to transition to a different level of care without having to move to a new community. 

CCRCs promote a lifestyle free from endless to-do lists and home maintenance chores. The communities manage home maintenance and yard work services, including housekeeping, laundry, landscaping, and lawn care so residents don’t have to. Seniors can leave behind the tedium of doing household chores and yard work and have more freedom and time to do activities they enjoy.

Most seniors want to age in place, but living at home is oftentimes not the most practical or safest option. CCRCs offer an appealing alternative by encouraging an independent lifestyle with various housing setups like studios, condominiums, duplexes, etc. This enables seniors to live independently, but they know they can count on care and support when needed.

Seniors living at home are prone to feelings of isolation, depression, and loneliness, which can result in poorer health down the line. CCRC residents have access to a community of people in the same age group with shared interests. These communities offer a wide range of social activities like game nights, hobby clubs, mixers, organized trips, and more. Residents can participate in and enjoy these activities with their neighbors while maintaining a private living space.

CCRCs have many amenities and services to help seniors stay healthy and active, including fitness centers, exercise classes, spa services, swimming pools, and more. The on-site staff ensures that residents receive routine screenings and acute health care services when needed. In addition, CCRCs encourage spiritual and emotional wellness with hobbies, worship activities, and volunteerism.

Falls are the number one cause of injury for older adults aged 65 and older. CCRCs ensure the safety of residents by providing appropriate living arrangements and experienced staff members. In case of health emergencies, the on-site staff can deliver timely care. With 24-hour security and personal alarm systems, seniors and their families can have peace of mind.

The cost of living in a CCRC is two-fold. Most senior communities will ask for entrance or buy-in fees and monthly payments.

Before moving in, incoming residents must typically pay substantial entrance fees. This fee can vary by facility, but expect to pay as low as $20,000 for a rental or non-purchase agreement to $500,000 or more, depending on the size, location, and type of housing you choose.

Some continuing care facilities may also ask for a buy-in fee, also called an “ownership fee.” In a buy-in situation, the resident would own the unit, which means a more expensive upfront cost than standard entrance fees. Depending on the facility, entrance, and buy-in fees may or not be fully or partially refundable if the resident leaves or passes away.

CCRC monthly fees range from as low as $500 to $3,000 or more depending on factors like the facility, level of care required, housing type, and contract type. Monthly fees cover healthcare and housing costs but are not fixed and are subject to inflation. These fees may also change when the resident moves between housing arrangements and level of care.

Some facilities use a pay-as-you-go model in which you only pay the monthly fees. It’s essentially a rental agreement but is drastically more expensive than other payment structures, especially if healthcare is involved.

Most senior living communities offer one or two levels of care. In contrast, CCRCs often provide three or more types of care for a continuum of options, including:

• Independent Living: This community type is ideal for seniors who want to live independently but without the hassles that come with home ownership, like chores, home maintenance, and yard work. Instead, seniors can focus on doing what they love and develop an active lifestyle.
• Assisted Living: This community is designed for seniors who need assistance with activities of daily living (ADLs), such as bathing, personal hygiene, and eating. Residents require a higher level of care than those in independent living.
• Memory Care: This special care unit is designed to provide a safe and structured environment for seniors with Alzheimer’s, dementia, and other types of memory loss conditions. Memory care staff helps residents with basic daily tasks and is trained to meet the unique needs of seniors with memory issues.
• Skilled Nursing: These facilities provide short and long-term care for seniors after a hospital stay. On top of delivering the highest level of medical care with on-site licensed nurses and other medical professionals, skilled nursing also provides personal care services such as assistance with ADLs.

Both CCRCs and life care communities provide seniors with a wide range of healthcare and lifestyle accommodations, including those discussed above. However, the primary difference between the two is that all life care communities are considered CCRCs, but not all CCRCs offer life care.

Simply put, life care is a descriptive term for a specific CCRC contract type, also referred to as a Type A contract. In concept, lifecare contracts work similarly to long-term care insurance in the sense that seniors pay more expensive monthly fees while living independently with a continuum of care. Seniors will receive full health care, supportive services, and housing for as long as they live. However, life care communities also require entrance fees, but monthly payments are guaranteed not to increase regardless of the level of care provided or changes in the senior’s needs or accommodations. Learn more about the different types of CCRC and life care contracts. 

CCRCs provide residents with a lifetime continuum of care by combining different levels of senior care and housing options on one campus. Seniors can move into a community while they’re still healthy and independent and progressively transition to a different community setting with a higher level of care as their needs change (e.g., from assisted living to skilled nursing). As a result, residents can live independently for as long as possible and receive personal and medical care as needed in one location without being forced to leave the community they know and love.

More often than not, CCRCs require the residents to be reasonably healthy and independent for admission. Before admission, the resident’s level of care will be evaluated and should be clearly described in the contract. Typically, the resident’s care requirements will be assessed by family members, medical advisors, and facility managers. While living in a CCRC, residents may undergo regular evaluations or be re-evaluated after an incident like illness or injury to determine the appropriate level of care. 

Below are the things to look for when choosing CCRC for seniors:

• Contract clarity and costs: Request for a sample contract and financial disclosure. This senior living option is often the most expensive, so take note of what’s included in the contract and the associated costs.
• Quality of staff: Are the staff members trained and certified? Does the facility conduct background checks? What is the staff-to-resident ratio? What’s the state of staff turnover? Ask these questions when visiting a CCRC facility.
• Community and culture: Some CCRCs will allow residents to stay overnight or for a few days. This exposure enables seniors to determine if the community and culture fit them well. Speak with the residents to learn valuable insight into the community’s day-to-day lifestyle.
• Amenities and features: While touring, ask about the facility’s amenities and features, such as health centers, spas, wellness programs, swimming pools, juice bars, etc. Determine the needs and preferences of your loved ones, and look for a facility that can meet them.
• Advanced care: Ask how the facility will handle its future obligations. Do they have the capacity to accommodate residents that may require advanced care? For instance, some communities have dedicated memory care units for residents with Alzheimer’s or other forms of dementia.

Don’t wait until you need assisted or skilled nursing care before considering moving into a CCRC – it may be too late. If you wait too long, you may not qualify for a life care or Type A contract. As mentioned, most continuing care communities have a health qualification process in place to ensure residents are in good health and can live independently.

Most CCRCs offer various transitional assistance services, which translates to enormous resources and support to make the transition process much easier for seniors. For example, some communities have move-in coordinators that can help seniors decorate their new living space and work closely with a relocation company. With extensive planning and pre-work, transitioning into a CCRC becomes a less overwhelming and more comfortable experience for the senior.