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Reading Richard Quinn’s recent article on 55+ communities it seemed that some of people posting comments thought that a CCRC was where you went when you could no longer live independently. This is far from the case. In fact, if you wait that long a CCRC is highly unlikely to admit you.
The initials stand for Continuing Care Retirement Community, and that continuum of care is key. Although there are different models, a typical CCRC will offer Independent Living (IL), Assisted Living (AL) and Skilled Nursing (SN), and sometimes Memory Care. I just listened to a presentation at mine on the levels of care. and while occasionally someone might be admitted directly to AL, if there is more space available than usual, almost all residents begin in IL. Some never transition: three people in my building have died recently, and all were still in IL.
I hope to spend a long time in IL, where I am meeting some great people, and where there is more than enough to keep me occupied. I am glad to know that I can spend time in SN if I have surgery, and then come back to my apartment while having on-site PT.
Not all living arrangements are listed in the CCRC brochure.
Our new CCRC not far from us plans to open its first building in the Fall 2025.
My wife has assisted living now fully paid for by her LTC insurance policy.
Aides are permitted in independent living units as long as they not a live-in.
For us, it’s the best of all worlds.
I was reading Ruth Alvarez book on CCRCs. Page 67 says CCRCs normally take only Medicare supplemental plans and only a few are part of Advantage networks. Then any charges will be considered as out of network. Is this correct?
Glad you’re reading the book! Sadly, this question is an example of why it’s so difficult to generalize about CCRCs. Mine requires residents to “maintain Medicare Part A, Medicare Part B, and one supplemental health insurance policy or equivalent insurance coverage acceptable to [ ]” which includes Medicare Advantage. It also accepts Medicaid. There are CCRCs in my area that do not list acceptance of Medicare, and I believe it is somewhat unusual for those that do accept Medicare to also accept Medicaid.
Further, Medicare does not cover Assisted Living, and there are limits on the length of coverage in Skilled Nursing. The current cost of SN at my facility is $378/day, which is roughly equivalent to 12 hours of an in-home aid.
Good post Kathy. While CCRC’s are not “the home”, they are, both technically and practically, insurance and are regulated as such. They are a form of health, longevity and even social insurance. In a practical sense, they are also insurance for having one’s car keys taken away which something many people look forward to with a sense of dread. Between my wife and I can cite examples in the older generations of our families when the downside of one or more of these elements had poor outcomes by aging in place amongst other factors. They are not an inexpensive option but costs do vary by location and contract. As I have mentioned before in the comments on other HD articles, my wife and I are on 4 CCRC wait lists and we expect to wait 7-10 years, or more, until we begin being offered a spot, which is in part due to the fact we are choosing to wait for a villa or a home rather than an apartment as well as high and growing demand. I would encourage anyone with the slightest interest to do some research to learn more and even get on a wait list or two, which typically does not cost a lot and is mostly refundable.
I would say that my apartment is now my home. When I moved in existing residents greeted me with “Welcome Home” and I have come to feel that they were right. Of course, it helps that my study and bedroom are essentially unchanged, and I am using the same living room furniture.
In your CCRC is the entrance fee partially or wholly refundable and do they pay interest while it’s held?
I know you didn’t ask me, but the CCRC we are moving to has an 80% business model. No interest and 80% is returned if you never received any monthly assistance and none of the money was used to restore your unit to its original condition. However, they have a unique method of handling when you get your refund. When you release your unit, your name goes on a list. When your turn comes up you get your money. Your refund is not tied to your specific unit getting reoccupied. First come, first serve.
The CCRC my wife and I moved to last December has a 90% refundable fee that doesn’t earn interest (it was 100% refundable for our first 4 months). Our 10% deposit earned interest before we moved in but I am unaware of any CCRC that pays interest on entrance fees when residents die or move out. We did find one well-regarded facility that has a large entry fee that is 100% refundable but all of the others had refunds that ranged from 0% to 90%.
We did make a temporary interim move for seven months to a high-end for-profit facility that only has one-year leases and an entry fee of $7,500.
There are different systems at different CCRCs. At mine the entry fee is either 0%, 50% or 90% refundable, but the fee is considerably higher if it’s refundable. No interest that I’m aware of. This seems to be standard at nonprofits in my area. Also, when you first move in the fee is refundable except for 6% (I think it’s 6%) and then declines at 2% a month, so if you decide early that you made a bad mistake leaving is not too expensive.
Adding: some places don’t have an entry fee, just a monthly charge. However, that monthly fee is likely to be higher, and the property is unlikely to promise to keep you if you run out of money. It may be easier to find a vacancy at such properties.
The points made about the benefits of CCRCs make complete sense to me. Are there good independent brokers out there that can be relied upon for a search? No doubt I’d do my own education as well but maybe professional help in an important decision would make sense.
I know of one called “A Place for Mom”, but since it’s paid by the places it recommends I would steer clear. In NC the Dept. of Insurance regulates CCRCs, and it has a list on its website, along with the required Disclosure Statements. Still, the best advice I can give is to look for a non-profit that promises to keep you and has been in business for a while. You want a good Medicare rating for Skilled Nursing, and good financials. The acid test is a personal visit.
Unfortunately, some for-profit corporations have been buying up nonprofit CCRCs. Hopefully that’s not a growing trend.
I did not have a good experience with “A Place For Mom” when I was a caregiver for family a few years back. To me, they’re basically an aggregator – like those national home repair estimate websites – they share your info with multiple providers and will spam you with emails and other ads. I didn’t view them as helpful at all.
Good clarification. We recently looked at a community even though hopefully in the teens of years from needing one. You just never know, and we see being already at the top of at least one list as insurance.
I’m glad you have written so many articles about CCRC’s. I didn’t know what they were until I started reading your posts.
Your experience has led me to think a CCRC could be an option for me in the future. I don’t have children to take care of me in my later years and I do have longevity genes (my maternal grandmother lived to be almost 101 years old).
For now, my husband and I are happy living in our 55+ community. But I wonder if at some point in the future we’ll move to a CCRC.
Thanks for continuing to educate readers on this living option.
Thank you! I’m glad to know they’ve been helpful. Quite a few people moved to the new building at my CCRC from the same 55+ community.
Do you know if any attorneys are starting to specialize in CCRCs, able to vet contracts for clients?
It’s likely a consideration for me as well, but it’s a huge investment – and often one’s final RE purchase. (No pressure, right?)
The contracts are complex and varied from place to place, and as you mention, non-refundable in some cases, so due diligence is critical.
I’ve read of situations where things went south when a non profit CCRC was bought by a for-profit company or new leadership mismanaged finances.
Frankly, even reading books/guides, I’d be concerned I was missing some important “gotcha” in the legalese.
I did check w/one elder care attorney: he didn’t seem all that knowledgeable about them.
Sorry, no. My non-profit is merging with another non-profit, perhaps partly to look more formidable. If you have a choice of states I would look for one with good regulations, as CCRCs are regulated by the state. You also want resident representation on the board.
Another good post Kathy. My wife and I live in a 55+ community and we’ve certainly found most folks here don’t really understand what a CCRC is and how it differs from the other facilities available here. Depending on how our health goes, we plan to move into a CCRC in about 10 years. For us, we’re not looking forward to leaving our home. Plus, it will cost us more to live in IL in a CCRC than it cost to live in our current home. However, those con’s are more than offset by the pro’s if one of us develops a significant health care issue. Then the advantage of being in a good CCRC is huge. For us the tradeoff makes sense as we’ve seen firsthand how bad things can go and how long they can last. Also since I’m 5 years older than my wife it’s statistically likely she’ll outlive me for a significant period of time. It’ll be good to know she’ll be taken care of after I’m gone. So yeah, we’re definitely planning on moving into a CCRC at some point. We can’t say we really “want” to as we do enjoy our home, but big decisions in life have always been about tradeoffs and this is no different. Also, we believe that when we do make the move that if we go into it with the right attitude that it’ll be a much better experience than if we go into it with a bad attitude. So when the time comes for us, we intend to make the most of it and focus on the many positives. And yes, we’ve already starting looking with the intent of putting down a deposit to “get in line” at some point.
It sounds like we’re in a similar position. My husband and I live in a 55+ community now, but I do wonder if a CCRC will make sense for us at some point in the future. My husband is 13 years older than I am and I don’t have any children to look after me as I age. I could see a CCRC being a viable option for me in my later years.
Yep, I agree. My wife and I have started looking now so there’s no last minute frantic search involved later. Plus getting on a few waiting lists will be our next phase, probably in a few years.
I have yet to meet anyone at my CCRC who feels they made a bad decision. There are a few people who moved here from other CCRCs, but that is a reflection on the CCRCs in question, not on the concept. Choosing carefully is key, especially if the entry fee is non-refundable.
Thanks for raising this in Forum. I had recently organized a presentation on Assisted living/Memory care for our 55+ community. Surprised to see most residents have very little idea about services provided by Home Care, Assisted Living, Memory Care, Skilled Nursing Home, and Hospice. They are unaware of costs, levels of service, and payment options.
Yesterday I attended a virtual tour of a highly rated CCRC. It was an eye opener for me. Depending on individual situation, CCRC is certainly a good option to consider. I intend to collect more information and keep an open mind. Life is unpredictable, and time is limited. Good preparation mitigates misery and stress as one approaches end of life.
Good for you. If you’re looking for more information on CCRCs I highly recommend Ruth Alvarez’ book “Find the Right CCRC for Yourself or a Loved One”. Also, you might see if a local university has an OLLI class on CCRCs, or if your local senior center is offering one on senior living options.
Thank you so much!
Just as another data point, the facility my mother-in-law recently moved into is actually a CCRC, but she moved straight into memory care from home. We got lucky. There was an almost immediate opening, there’s no entrance fee (just the monthly rent, etc.), and it’s been a terrific fit so far.
Current residents in IL or AL or SN have priority for openings at more advanced levels of care, but as it turned out, she was able to get straight into memory care pretty quickly, within just a couple of weeks of submitting the application. It’s a nonprofit, church-owned facility, and by California standards pretty affordable, especially after her long-term care policy payment kicks in.
Dana, which CCRC did she move into? I live in California and have looked at different CCRCs. White Sands in La Jolla got good ratings by USNews.com.There is Piedmont Gardens in Oakland that got a good rating and is also owned by Human Good .
I’m so glad you were able to find a good place for your MIL. However, as you say, she got lucky. My CCRC had a lower than usual AL occupancy rate after Covid, and did admit a few people directly, but things are now back to normal. If you are admitted that way here you do pay an entry fee, although it’s lower than for IL. On the other hand, I believe the monthly fee is market rate as opposed to the discounted rate charged to residents. Of course, CCRCs differ, and the demand is likely higher in some areas than others.
Thanks Kathy. We have experience with CCRCs with family and friends. There is a large, luxury one near where we lived in PA. It is called Shannondell, and many of the residents liken it to a luxury cruise ship due to all the amenities. The IL is just like living in a 55+ condo community, but with lots of things to do. Yours and others warnings about long wait times have Vicky and I starting to discuss where, what, and when. our next move might be.
Rick, I do think it would be prudent to start looking seriously. I got lucky with my timing, but I’m leading edge baby boom. It’s possible wait lists aren’t as long where you are, my area seems popular with retirees. Finding an unusually short one would require more investigation!
For those who want to read more about CCRCs, here are some posts that are worth reviewing:
https://humbledollar.com/2024/04/gift-to-myself/
https://humbledollar.com/2023/02/continuing-care/
https://humbledollar.com/2022/03/life-care-compared/
https://humbledollar.com/2024/03/getting-in-line/
Thank You. I was looking for this.