Continuing Care Retirement Communities (CCRCs): An All-in-One Senior Living Option

CCRCs incorporate accommodations for independent living, assisted living, and nursing home care, meaning an aging adult can spend the rest of their life in the same setting, even if the level of care they require fluctuates. This can minimize stress for seniors and families, as well as empower older adults to form close, long-term bonds with community residents and staff.

“CCRCs are great for people who only want to move once,” says Kyla Jones, regional manager at A Place for Mom. “They do have to move to a different area, but it’s ultimately the same place.”

When choosing a CCRC, it’s important to consider available services, costs, and benefits to determine if this all-in-one senior living approach best fits your loved one’s lifestyle and needs.

To be considered a CCRC, a retirement community must offer independent living, assisted living, and nursing home care all in one campus, allowing residents to move between care types if their health or ability to be independent changes. Acute care services, such as short-term physical therapy and rehabilitation following an injury, typically takes place at nearby hospitals.

You may hear one of these other terms used to describe a CCRC:

• Life care communities
• Life plan communities
• Lifetime communities
• Continuing care communities or facilities
• Active adult retirement homes

As one of the most personalized types of senior living, life plan communities vary significantly. Living spaces can include houses, cottages, clusters, townhouses, duplexes, and apartments.

Despite these different settings, most CCRCs share the following common amenities and features:

• A dining room for communal meals
• Activity centers
• Gyms
• Outdoor recreation, including swimming pools
• Social events, like outings to theaters and museums

Let our care assessment guide you

Why choose a continuing care facility for yourself or your loved one?

In addition to offering an engaging, community-centered lifestyle and many senior living activities, continuing care can be a particularly helpful option for couples with different medical needs. Spouses may not be able to live in the same apartment unit, but they’ll be nearby and can eat and socialize together.

While monthly maintenance contracts differ based on a senior’s specific retirement community, most CCRCs provide several services older adults need and value, such as:

• Nutritious meals and snacks
• Transportation
• Lawn care and gardening
• Garbage and snow removal
• Regular housekeeping
• Laundry
• Some utilities
• Health monitoring services
• Emergency call monitoring
• Security and supervision

However, life plan communities aren’t right for everyone. Determining health care options for the rest of your life and committing to lifelong financial obligations is a big decision, one some families might not be ready to make. Residents need to be comfortable with both the health care continuum and the monetary responsibility of living in a CCRC.

Due to their commitment to care for seniors at various stages in the aging journey, CCRCs can come with different costs than other types of senior living. For instance, communities typically require a large entry fee, with amounts ranging from as little as $10,000 to as much as $500,000.

“CCRCs are more expensive than other types of senior living and often start with a large buy-in,” Jones says. “They will also sometimes advance people up to a higher level of care, like assisted living to a skilled nursing facility, sooner than a community that doesn’t offer skilled nursing.”

Residents must also pay a monthly maintenance fee, which can range from roughly $200 to more than $2,000. A contract between the resident and the CCRC spells out what the monthly maintenance fee covers, as well as health care coverage and costs.

When you commit to a CCRC, you usually sign a continuing care agreement. A lawyer or financial advisor should review this document first, as it’s a legal contract between the resident and the CCRC. The continuing care agreement should cover:

• Residences
• Fee schedules
• Health care coverage
• Cancellations and refunds
• Services
• Insurance requirements
• Conditions for transfer within the community to other levels of care, plus a description of the CCRC’s responsibility should a resident become unable to pay fees

There are typically three fee schedule options at a CCRC:

1. Extensive contracts. This is the most expensive agreement, and it gives residents access to all health care services available on campus with little or no increase in the monthly maintenance fee. Though this contract has a high up-front cost, it can save a family money if their senior loved one has a chronic condition that requires frequent monitoring and treatment.
2. Modified contracts. This contract offers residents access to all health care services available on campus, but residents pay for needed health care through monthly maintenance fee increases. Life plan communities often offer care at discounted rates.
3. Fee-for-service contracts. Residents pay for all health care costs separately. Although this can initially be the least expensive contract, it can become quite costly if a resident eventually has extensive health care needs.

CCRCs may also offer residents a certain number of skilled care days each month without raising the monthly maintenance fee. This is sometimes part of the modified contract schedule option.

Based on these high entry costs, CCRCs may appear more expensive on the surface. However, they can reduce common senior living expenses, including repeated moving costs, move-in fees at multiple communities, and the price of some health care services. Ultimately, these life care communities can provide peace of mind for seniors wanting to find a safe, long-term home.

Talk with a Senior Living Advisor

Beyond the continuing care agreement, potential residents should fully explore the details of each continuing care community they’re considering.

When visiting CCRCs, ask about these factors:

• Staff. What training do employees receive? Does the community conduct background checks? What is the staff-to-resident ratio?
• Culture. Does the community’s general atmosphere match your loved one’s personality? Is it formal, or more casual? Are residents more reserved, or social and eager to get involved?
• Amenities. Since your relative may live in the community for several years, it’s extra important to make sure it fits their interests. For example, if your parent loves to read, does the CCRC have a library? If they’re religious, does it have a chapel?
• Safety. What security features does the community have?
• Dementia and Alzheimer’s considerations. Does the continuing care facility have a memory care unit?
• Accreditation. Is the community accredited? Some life plan communities receive accreditation from the Commission on Accreditation of Rehabilitation Facilities, which renews this credential every five years.
• Contingency planning. In rare cases, certain units in a CCRC — such as its nursing home — may be full. How will the staff handle this potential challenge? For instance, does the CCRC have a reciprocal agreement or partnership with nearby communities?

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A Place for Mom’s 400 local experts can share information about CCRCs and other senior living options in your area. They can also help assess your family’s specific situation to figure out the right fit for your loved one — all at no cost to you.

Sources

AARP. “How Continuing Care Retirement Communities Work.”

The Aspen Institute. “The True Cost of Caregiving.”