Continuing Care Retirement Communities (CCRC)

What are the pros and cons to CCRC?

Pros to CCRC

• Continued Care Without Moving: Your loved one’s care needs can be managed as their needs increase from one stage to another. This happens without having to make a big move or adjust to a new facility.
• Familiar Social Network: Familiar friends and staff will always be with your loved one.
• Access to Medical Services: CCRCs typically have many levels of around the clock access to medical services.
• Partners Can Stay Close: Spouses or partners with different care needs can live together or nearby. They get to enjoy meals and social activities together.
• Peace of Mind: Relief for family members, knowing that your loved one is in a place where they can stay comfortable and well cared for as the years go by.

Cons to CCRC

• Expensive Entry Fee: CCRCs are the most expensive form of senior living. Most require a non-refundable entrance fee, plus a monthly maintenance fee ranging from a few hundred dollars to thousands of dollars a month.
• Requires In-depth Financial and Personal Planning: The expense of CCRCs means families have to do careful financial planning. This requires projecting their future income and expenses to determine if they can afford a CCRC for their loved one’s lifetime.
• Long-term Commitment: Your loved one may not be ready to commit to a health and living commitment that may last a long time.

What services do CCRCs offer?

Continuing care retirement communities offer a range of long-term care solutions. These include the services that any independent living, assisted living or nursing home offers. Click the options below to learn what each wing of the CCRC may offer for your loved one’s needs:

• Independent Living Services
• Assisted Living Services
• Nursing Home (Skilled Nursing) Services

How much does CCRC Cost?

CCRCs typically cost more than senior living facilities that specialize in a certain area of need.

• Most CCRCs require an entrance fee that can range from tens of thousands of dollars to nearly a million dollars with the average being near $329,000.
• CCRCs also have monthly maintenance fees which range from $2,000 to $4,000 per month.
• The few CCRCs not requiring an entrance fee and/or rental model typically have a fee ranging from $3,000 to $6,000 per month.

Most CCRCs have three different payment contracts you can choose from:

• All-Inclusive Extensive Contract (Type A): At this level of care, residents have unlimited access to skilled nursing, assisted living, and other services with no increase in monthly maintenance fee.
• Modified Contracts (Type B): At this level of care, residents have limited access to health care and additional services. Residents are required to pay for needed additional services, often at a discounted rate.
• Fee-for-Service Contracts (Type C): At this level of care, residents have to pay the full price of health care and services every time those are needed. While this is the cheapest option at the start, the healthcare costs can make it more expensive in the long run.

CCRC contracts can be complex. If possible, review the document terms with a lawyer or financial advisor before signing a contract. Important questions to answer and understand are:

• Is there a clear breakdown of all fees, annual price increases, and payment schedules?
• Are the services in the entrance fee listed in detail?
• Are the services in your monthly maintenance fee also listed in detail?
• What are the fees for services not included in the monthly maintenance fee?

Questions to ask about CCRCs include

Based on which wing of the CCRC your loved is more likely to live in, it may be helpful to review our checklists below:

• Assisted Living Checklist
• Nursing Home Checklist

Questions to ask to gather important information are:

• Is it for-profit or not-for-profit?
  • For-profit facilities are more likely to be sold and have a higher likelihood of someday going out of business.
  • Consider how both situations would affect your contract with the facility.
  • Does the facility’s contract include refunds if they go out of business?
• Is it accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF)?
  • Getting accredited is difficult and allows for people and consumer advocates to look into the organization’s financial health.
• Is there a memory care unit that offers special services for residents with dementia and Alzheimer’s disease?
• What happens if a unit is full and a resident needs to move to a higher care unit?
• What is their policy when a spouse or partner needs a different level of care before the other?
• Can any part of the entrance fee or monthly maintenance fee be refunded when a resident dies or leaves the CCRC?

How to pay for CCRC?

• Entrance Fee: Most individuals have to pay the entrance fee out-of-pocket by selling an asset like a house or using savings.
• Continued Maintenance and Care Costs: For CCRCs that accept Medicare or Medicaid, they can be used to pay certain services a resident might receive while living in the community.
  • Government programs may help with costs based on your loved one’s needs and the wing they live on. To learn more, click on the link that matches the unit your loved one is in:
    • How to Pay for Assisted Living
    • How to Pay for a Nursing Home
    • How to Pay for Hospice

How do I find the best CCRC near me?

FindContinuingCare.com has a directory of CCRC facilities searchable by zip code.