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Continuing Care Retirement Communities (CCRCs)

Ken Teegardin Written by Ken Teegardin
SeniorLiving.Org Expert on Chief Editor | Caregiver

For seniors with the financial means, a Continuing Care Retirement Community (CCRC) may be the ideal senior living option to "age in place." CCRCs are a combination independent living, assisted living, and nursing home.

Continuing Care Retirement Communities

Services offered include health services, meals, personal care, housekeeping, transportation, and emergency help. In addition, the communities are chock full of social and educational activities.

Because CCRCs are an "all-in-one", there is a greater level of comfort for residents. And children of the parents enjoy a greater piece of mind knowing that all their parents' needs from housekeeping to medical care are taken care of.

Types of CCRC Contracts
In general, CCRCs have three main types of contracts with a fourth (rental) occasionally available.

  • Extensive or Life Contracts (Type A) are the priciest because they generally include unlimited assisted living and health services with little or no extra fee.
  • Modified Contracts (Type B) provide similar services to Type A except that only some health services are included in the initial monthly fee. If a resident's needs exceed those fees then they are charged market rates for services.
  • Fee-for-Service Contracts (Type C) offers a lower initial enrollment fee, but residents pay market rates for health care services on an "as needed" basis.
  • Rental Agreements (Type D) usually require no entrance fee but guarantee access to CCRC services on an "as needed" basis.

What CCRCs Cost
By far, a CCRC is the most expensive senior living option. There are a number of costs to consider when looking at CCRCs. According to an article in the Wall Street Journal, the "average entrance fee for each unit is $249,857."

The U.S. Government Accountability Office studied the CCRC industry and found these ranges of fees:

Type A
Entry Fee: $160,000 to $600,000
Monthly Fee: $2,500 to $5,400

Type B
Entry Fee: $80,000 to $750,000
Monthly Fee: $1,500 to $2,500

Type C
Entry Fee: $100,000 to $500,000
Monthly Fee: $1,300 to $4,300

Type D
Entry Fee: $1,800 to $30,000
Monthly Fee: $900 to $10,700 depending on level (assisted, nursing, etc.) of initial care

All of these fees will depend on a number of factors such as the type of housing (single family home, condo, apartment); whether they rent or buy; size of the facility; kinds of services; type of contract.

Evaluating CCRCs
Request a weekend or even weeklong stay at a CCRC. This will give you or your loved one a complete picture of the community. Consider the following whether you visit for the day or the week:

  • Does the facility feel like home? Is there a community feel?
  • Talk with the residents. How do they like living there? How are the services? How is the care? How attentive and professional is the staff? Is there anything missing? Is the community a good value? Do the residents seem like people you'd want to get to know better? Do the residents interact with one another?
  • Talk to the staff. Do they seem to genuinely care? Do they seem concerned?
  • Ask to see licensing, inspection reports, and any complaint investigations.

Other CCRC Considerations
Because it costs so much to run CCRCs and consequently, to live in one, it's important to know the financial health of the company. In order to survive, these communities must operate at or near full capacity. If they don't, then some resident services may be cut.

Start by asking for the facility's audited financial statements. Here are some things to look for:

  • Consider the facility's cash-to-debt ratio. This should be about 35%.
  • What is the facility's cash on hand? CCRCs with "one campus average 306 days of cash on hand; those with multiple sites average 281," according to an AARP article.
  • "Watch out for facilities that rely heavily on investment income, donations or entry fees, which may signal an inability to run on income from operations," says an article in the Wall Street Journal.

CCRCs are the best of all senior living options because they allow residents to "age in place". This gives both the resident and the resident's loved ones added piece of mind. However, CCRCs are the most expensive retirement option. There's a lot to consider before making the step to CCRC living.

To compare CCRC living with other retirement options, read our "Senior Retirement Lifestyles" article.


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