Continuing-Care Retirement Communities

What is a continuing-care retirement community?

A continuing-care retirement community (CCRC) is a place that offers care for the rest of your life. Usually you move first to an independent living unit of a CCRC. Then you move to an assisted living unit or the nursing facility when you start needing more help. Services and housing can change as your needs change.

CCRCs are also called life-care communities. Typically, all of the types of housing and services are on the same grounds. Most CCRCs now require an entrance fee plus a monthly charge for rent and services to guarantee a place to live with nursing care for life. You may also rent from month to month and pay for health services as they are needed.

What types of CCRCs are there?

Housing options vary from one CCRC to another. There may be cottages, apartments, townhomes, and individual houses. Services offered may include shopping areas, activity centers, fitness centers, recreation areas, beauty shops, and theaters.

Many CCRCs have special living units for people with Alzheimer's disease. Short-stay rehab units may be available for residents coming home from the hospital who do not need long-term care in a nursing facility.

How are CCRCs different from other retirement communities?

Active adult or independent living communities are other kinds of retirement communities. They are designed for older adults who are active, healthy, and able to live without assistance. These retirement communities do not provide different levels of care over a lifetime. They do not provide health-related services. The living units may be purchased, rented, or leased.

How do I choose a CCRC?

Asking friends and relatives about their experiences with retirement housing is a good way to start collecting information about CCRCs. Good experiences with a CCRC by someone you know is the best recommendation you can receive.

The local Area Agency on Aging or a senior center can also provide information about CCRCs. Your local library has access to information or can direct you to references. You may also contact the American Association of Retired Persons (AARP) for information.

The American Association of Homes and Services for the Aging (AAHSA) sponsors a commission that has set accreditation standards for CCRCs. This group can provide you with a list of CCRCs nationwide or in a particular region of the country. Their contact information is:

American Association of Homes and Services for the Aging

Phone: 1-202-783-2242

Web site: http://www.aahsa.org

Address: 2519 Connecticut Avenue NW, Washington, DC 20008-1520

CCRCs are usually regulated by the state insurance commission. Call this agency for information about a particular CCRC.

When deciding which CCRC is the place for you to live, develop a list of questions to ask at each facility. Examples of questions are:

• What is the cost to enter the CCRC? Is some of the entrance fee refundable if I don't stay?
• Are there monthly fees? If so, what are they and what do they include?
• How often do the rates increase?
• Are meals provided or available for an extra fee?
• What health services are available? Is there an extra fee for this?
• What other services are offered? Beauty shop, laundry, drugstore, grocery store, transportation?
• Is there a resident council that takes recommendations and concerns to the management?
• Is there a religious connection? Does everyone belong to the same denomination? Are there churches nearby?
• Can I stay at the CCRC for a trial visit?

The AAHSA can provide a more extensive list of questions to ask when you are considering a CCRC.

What kind of contract is needed to get into a CCRC?

You will be expected to sign a resident agreement before moving into a CCRC. This agreement is similar to contracts for buying a home or a car.

The contract should state the amount of money required to get into the CCRC. Check the contract for specific monthly fees and how the facility decides to set or raise fees. The contract must also state how much healthcare is covered (such as how many days of nursing facility care is provided and at what cost). Payment options, which vary with each CCRC, may be included in the contract. You may have 1 monthly bill for your rent and all services or you may have separate bills for your rent and each service you have used.

Other items that may be spelled out in the contract are:

• If you are ill and cannot live in your apartment, how long the apartment will be held?
• What items will you need to provide for your room (such as carpet, drapes, or a refrigerator)?

It is a good idea to have an attorney go over the contract with you so that you understand it completely. You want to be sure you know what you are buying.