Continuing Care Retirement Communities (CCRCs):
Continuing care retirement communities, also sometimes called life care communities, offer the opportunity to "age in place" on one campus, no matter what future health problems may arise.
A resident can move from an independent apartment to assisted living when the need develops for some basic help with everyday activities. Dementia care is almost always available for those with Alzheimer's Disease or other cognitive problems. And, of course, nursing home care is also provided right on campus if long-term medical care becomes necessary.
When a retiree wants to plan ahead, a CCRC would seem to offer everything. At an initial investment commonly between $100,000 and $500,000, "buy-ins" can be substantial. Whether a CCRC is a good financial investment is a subject for a qualified financial planner and a CPA. Whether they are a good care option is the subject at hand today.
The idea of aging in place without ever having to move again is attractive to many seniors and their families. However, when it comes to CCRCs, there are four little known truths that bear a closer look:
You'll Never Have to Move Again
To a senior, moving is a relative thing. Whether the move is across the country, across town, or to another section of a CCRC campus, a move is a move. CCRC residents who move from a spacious independent living apartment to an assisted living apartment will be giving up substantial space and "downsizing" again. They will no longer be taking their meals in the independent living dining area, so they will see less of their friends. While the need to search for a good assisted living residence may be avoided, there will still be the physical and emotional trauma of the move itself. Residents of life care communities do not "age in place," because they still face the probability of several traumatic moves as they age.
What You See Now May Not Be What You Get Later
Like all real estate, continuing care communities can and do change ownership or management. When owners or managers change, there will inevitably be changes in staff, quality of the food, recreation and entertainment, and maintenance. Some of these changes may be positive, some may be negative. Residents who have purchased a life care contract may find themselves caught in a living situation they no longer like. Unfortunately, selling an apartment in order to move elsewhere will usually be controlled by the community, not the resident.
The Nursing Home Has Deteriorated
When prospective residents tour a CCRC they see the lovely independent apartments and they eat a meal in the elegant dining room. They may visit the assisted living building. Rarely do prospective residents visit the nursing area, and if they do they really don't know what to look for beyond the decor. Many a life care retirement development is highly regarded in the community, while the state inspectors are finding violation after violation in the nursing area. All prospective residents or their families should check the Medicare Nursing Home Compare data early in the decision process. Unfortunately, this data will not reveal what may happen in the future. Residents who need nursing care are in no position to shop around if the nursing home in their CCRC has gone downhill.
Management Has The Last Word
The fine print of a continuing care contract will almost without fail give the community management the last word about whether a resident will be forced to move to a higher "level of care." If a resident requires too much attention in the dining room or needs home health services for more than a few weeks, many CCRCs will require that resident to move to assisted living. Assisted living residents are often required to move to the nursing home when they need a wheelchair. Although the contract will usually have provision for an appeal, the facility almost always has the right to make the final decision.
CCRCs make shopping for future senior care seem easy because every possible level of care is available on one campus. However, residents are not protected against future decline in the quality of care and services provided. "Aging in place" will still require moves that are hard on the elderly, and residents may not have the right to decide when or where these moves will occur. Individuals considering buying into a continuing care retirement community should read the contract very carefully and have it reviewed by both an experienced attorney and a financial professional before making a purchase commitment.