Continuing Care Retirement Communities (CCRCs)

What Is a Continuing Care Retirement Community?

A continuing care retirement community (CCRC), also known as a life plan community, delivers independent living and an amenity-rich lifestyle with access to onsite higher-level care should medical needs progress. This continuum of care ensures residents have the stability of remaining in the place they call home.

What Services Does a CCRC Provide?

Continuing care retirement communities offer a wide range of amenities and services. These are some popular options:

How Are CCRCs Different From Other Retirement Options?

The most important difference here is that CCRCs recognize that many seniors want to live as independently as they always have. For example, let’s say you're an older adult who lives alone. You can still live independently, but you spend more time alone than you’d like. To remedy this, you can move into the independent living component of a CCRC. There, you can maintain the same hobbies and interests you enjoyed previously while also living close to those who can help when there is a need. You’ll establish a community for yourself as you get to know the area, the people, and your neighbors.

As you get older, you may find that tasks like cutting the grass or mopping the floors are a bit more challenging to do. This is when moving into or utilizing the assisted living components of the CCRC is a good option. Unlike in a traditional assisted living community, you’ll already know the community and the people; you’re not moving to a new community, just into a different area (in some cases) or getting a bit more help when you need it.

When you do have the need, you can move into the onsite nursing facility component. Again, you maintain the same quality of life and stay in familiar areas.

Usually, this type of location offers customizable services to fit the individual’s needs at that point in their life. This ensures the very best level of care is always available.

Is a Continuing Care Retirement Community Right for Me?

A CCRC delivers a multitude of benefits in one location. In addition to comparing contracts and weighing the pros and cons of a CCRC, ask yourself these questions:

1. Am I ready to spend the rest of my life in a continuing care retirement community?
2. Do I have the financial resources available to “buy into” a CCRC?
3. Am I able to move past the emotional attachment of selling my current home?
4. Do I feel isolated in my current home due to my spouse’s passing or the lack of family nearby?
5. Would maintenance-free living improve my quality of life?

The Levels of a Continuing Care Retirement Community

Levels of care can vary greatly by CCRC. Below are the most common types of continuing care offered. As you assess each community, ask what care levels are included in your contract.

• Independent living: This often is the first step in a resident’s life at their CCRC. Active, healthy older adults enjoy the CCRC amenities and maintenance-free benefits, all while living unassisted in their choice of residence.
• Assisted living: If a senior’s level of care needs increase, assisted living provides 24/7 access to medical and custodial care. While residents are encouraged to be as independent as possible, staff members are available to help with activities of daily living, such as bathing, dressing, or medication management. Assisted living may take the form of private or semi-private apartment-style accommodations.
• Memory care: Seniors struggling with memory loss due to dementia, Alzheimer’s disease, or other cognitive impairments can transition to the CCRC’s on-campus memory care facility. Specially trained staff provide personalized care with a focus on keeping residents comfortable, engaged, and safe.
• Skilled nursing care: Similar to assisted living, skilled nursing care includes 24/7 medical and custodial care. However, skilled nursing focuses on short-term care and rehabilitation. For example, residents needing post-surgery wound care, physical or speech therapy after a stroke, or intravenous medication administration would reside in the CCRC’s skilled nursing care unit.

What to Consider When Visiting Continuing Care Retirement Communities

With around 1,900 CCRCs available across the United States, there are plenty of options to fit your current and long-term needs.2 Comparing CCRCs can be quite challenging, as no two are alike. As you research potential continuing care retirement communities, be sure to fully understand these 10 crucial questions:

1. What services (medical, social, and residential) are included in each contract option?
2. What services are offered at an additional cost?
3. What is the occupancy level in each area of care?
4. Has there been a major annual fee increase over the past five years?
5. Is there an assurance that care will be available, even if you outlive your financial resources?
6. Is benevolence care available if you do run out of money?
7. Is all or a portion of the entrance fee refunded due to relocation or death?
8. Is the CCRC’s skilled nursing care a Medicare-certified facility?
9. How safe is the community, and is it a gated community?
10. Is the CCRC a nonprofit or for-profit retirement community?

How Much Do Continuing Care Retirement Communities Cost?

According to CBRE Group, a U.S. commercial real estate firm, the average CCRC entrance fee is $402,000.2 Monthly charges can range from $3,000 to $5,000 but may increase as needs change.3

The entrance and monthly fees seniors pay in a CCRC guarantee housing and medical care. In comparison, older adults choosing to age in place in their current homes may face unexpected and exorbitant healthcare costs. CCRCs provide peace of mind that aging in place at home does not.

Why Do Continuing Care Retirement Communities Charge an Entrance Fee?

Moving into a CCRC is an investment in your future. The entrance fee is a contractual upfront cost (like a down payment on a home). An entrance fee guarantees housing and medical services throughout your lifetime.

Part of the CCRC’s entrance fee may be based on the location, size, and type of residence. For example, an oceanfront single-family cottage in an expensive ZIP code will be priced higher than a standard studio apartment in a town with a lower cost of living.

As entrance fees can be pricey, many residents sell their existing homes to finance the entrance and monthly fees associated with a CCRC.

Does Medicare Cover Continuing Care Retirement Communities?

Medicare does not cover “room and board” costs such as residential housing, meals, and nonmedical care within a CCRC. However, there are specific instances when Medicare may cover medically necessary skilled nursing home care. As you interview prospective CCRCs, discuss when and how your Medicare coverage will be utilized.

Understanding Your CCRC Contract

There are four main types of CCRC contracts. It’s important to understand the differences between them, what you’re signing up for, and which contract makes the most sense for your lifestyle and needs.

Type A Contract: Also known as an extensive or full life care contract, the Type A entrance and service fees are the costliest of the four CCRC contracts. Type A comes at a greater cost because all health-related services are prepaid, ensuring a full range of higher medical care is included. For example, the contract will cover your assisted living, medical treatment, and skilled nursing care with little or no additional cost.2

Type B Contract: Also known as a modified life care contract, the Type B entrance and service fees include partial prepayment of future medical care (not full care). The monthly service fee may increase when a higher level of care is necessary. For example, should a resident need to move from independent living to skilled nursing, a Type B modified contract covers only a portion of the care cost.

Type C Contract:Also called a fee-for-service contract, the Type C upfront entrance fee and monthly service fee tend to be the lowest. Instead of prepaying for all medical costs as in Contract A or a portion of medical costs as in Contract B, residents pay for medical expenses as needed. For example, if a senior requires assisted living or memory care, this will be an out-of-pocket expense.

Type D Contract: A Type D contract, also known as a rental agreement, is offered by some CCRCs, but not all. You can think of this contract as a pay-as-you-go option. There is no entrance fee, and you only pay for CCRC services as needed.

How to Find a Continuing Care Retirement Community Near Me

Oftentimes, people don’t realize there are CCRCs close to them. That’s a good thing because it means the location is doing a fantastic job creating a modern, residential area that looks and feels just like a traditional home. However, most communities do offer CCRCs. Because they can cost a bit more than other types of senior living care, they are often found in communities with a higher net worth or in areas with a larger population of older adults.

From the outside, CCRCs look like larger developments. Many offer a one-stop-shop type of living setup, which means you may notice single-family homes or townhomes alongside nursing facilities or assisted living areas. If you or a loved one are considering moving to a CCRC, search our database for senior care providers in your neighborhood.

It’s important to protect yourself and your finances. Contact your state’s Department of Community Affairs and the Administration on Aging (AoA) long-term care Ombudsman program for information on what statutes and regulations are in place for CCRC consumer protection.

For more information on CCRCs and how they compare to other types of senior living, watch the video below with our editor-in-chief, Jeff Hoyt.

>> Related Reading: Best Retirement Communities in the U.S.