Continuing Care Retirement Communities Explained

Active retired people, two senior men playing chess at parkContinuing Care Retirement Communities, also known as CCRCs or continuing care, offer residents the ability to ‘age in place’ with the knowledge that a move will never be required for health reasons. Whereas most retirement communities offer independent living and assisted living only, CCRCs provide a continuum of care that includes independent and assisted living, secured memory care for residents with Alzheimer’s or dementia and skilled nursing care. For this reason, CCRCs are often referred to as Life Care Communities. Each level of care is provided in a separate building or area of a campus and nearly all residents move in to the community living independently.

What type of housing is available at CCRCs?

Continuing care communities allow seniors the ability to choose whichever housing option suits them best. Independent living options usually include apartments or freestanding cottages. They are meant for seniors who are independent and do not need constant care or supervision. Residents can come and go as they please, and enjoy active lifestyles.

Assisted living residents generally live in small apartments with shared dining and common areas. Residents are assigned one or more staff members to attend to their daily needs and help with common chores such as laundry, bathing, basic hygiene and light housekeeping. Recreational activities and programs are scheduled for the enjoyment of the residents.

Skilled nursing care is provided on site to treat residents recovering from short-term conditions. The facilities are also equipped with medical personnel and accommodations to support residents who require long-term, intensive, round-the-clock medical care as well.

Services available at CCRCs

Residents of CCRCs enjoy the same services that are provided at traditional retirement communities, often with additional flexibility. Meal plans are usually limited to one meal per day or 30 meals per month and independent living apartments offer fully-equipped kitchens. Additional fees are charged for extra meals, guest meals, or those served in the apartment due to illness.  Housekeeping and maintenance are also included in the monthly fee, although residents can often choose the frequency of cleaning services, whether weekly or bi-weekly. Typically attracting a younger age group and thus more active residents, the campuses usually include more amenities such as putting greens, swimming pools/spas and sport courts. Transportation is provided for activities, shopping and medical appointments; however, residents at CCRCs frequently keep their cars and continue driving as part of their active lifestyle.

Paying for CCRCs

Unlike traditional retirement communities, which charge a monthly rate and do not require a long-term agreement, CCRCs typically require a substantial deposit known as a ‘buy-in’ up front. This deposit is usually 70-80% refundable and the refund becomes part of the residents’ estate upon death. The buy-in fee also acts as insurance in that, if a resident outlives their finances, the community will cover all necessary expenses.

In addition, residents pay a monthly fee that is determined by factors including: size and location of the unit, the amount of their initial deposit, level of care, and single vs. double occupancy. To learn more about paying for CCRCs, visit our Overview of the Costs of Joining a CCRC page.

The advantages and disadvantages of Continuing Care Retirement Communities

Advantages of CCRCs include:

  • aging in place‘ greatly reduces premature decline often associated with change in living environment in advanced age
  • the ability for spouses requiring different levels of care to live within close proximity
  • security in knowing care needs will be met until the end of life and children will not be ‘burdened’
  • greater involvement in the operational decisions made by management due to an active resident council and greater financial investment

Disadvantages of CCRCs:

  • financial commitment required by investing in the ‘buy-in’ fee upon move-in
  • greater stigma associated with higher levels of care due to the lack of integration among residents of independent living and assisted living
  • residents are encouraged to move in when they are independent so the monthly fee for those moving directly into assisted living, Alzheimer’s care or skilled nursing is typically higher

Written by gerontologist Sara Shelton.