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 an older person's life. A person usually begins living in the independent living units of a CCRC. The person moves to assisted living units or the nursing facility as more help is needed. Services and housing can change as the person's needs change over time.

CCRCs are also called life-care communities. Typically all the types of housing and services are on the same grounds. Most CCRCs now require an upfront fee (an endowment) plus a monthly charge for rent and services. Another option is to pay an entrance fee plus monthly charges and be guaranteed a place to live with nursing care for life. You may also rent 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. They may have cottages, apartments, townhouses, and individual homes. They may offer services such as shopping areas, activity centers, fitness and recreation areas, beauty shops, and theaters.

A person usually starts living in the independent living units of a CCRC. The person moves to assisted living units or the nursing facility as more help is needed. Many CCRCs have special living units for people with Alzheimer's disease. Short-stay rehab units may be a part of a CCRC for residents coming home from the hospital who do not need long-term care in a nursing facility.

How do CCRCs differ 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. Living units may be purchased, rented, or leased.

How do I choose a CCRC?

Asking friends and relatives about housing options for retired persons 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 address is:

American Association of Homes and Services for the Aging
901 E Street, NW, Suite 500
Washington, D.C. 20004-2037

CCRCs are usually regulated by the state insurance commission. Call that 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. Questions may include:

• What is the cost to enter the CCRC?
• 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?
• What other services are offered? Beauty shop, laundry, drug store, grocery store, transportation?
• Do residents have a say in 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 considering a CCRC.

What kind of contract is there 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 in to 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 home care is provided and at what cost). Payment options, which vary with each CCRC, may be included in the contract. You may have one 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 can't live in your apartment, how long the apartment will be held?
• What items you will need to purchase for your room (such as carpet, drapes, or a refrigerator)?

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

For more information, see Resource List: Housing.