Evaluating Senior Housing Options: A Checklist for CCRCs - Aging Wisely

Retirement considerations and senior living

There are a dizzying array of options for senior living. At Aging Wisely, we help many families with the decision process and transition to a senior living community. In this article, we will share some of our wisdom about CCRCs as a senior housing option.

What is a CCRC? A Continuing Care Retirement Community (CCRC) offers various levels of care within one campus. There are all types of set-ups for these communities and a wide array of price ranges, available services and styles. A typical CCRC offers independent living (some may even have villas/homes), assisted living and skilled nursing. Some may offer memory care as well.

CCRCs have traditionally been set up as “buy-ins”, where you pay an up-front entry fee to the community along with a monthly fee (plus possibly some a la carte fees). While this is most common, there are also CCRC style communities which offer all levels of care in a straight rental arrangement. This is fairly common in our area in Florida (Tampa Bay/Pinellas County) and can offer extra flexibility for “snowbird” residents who may not wish to commit long-term. The more traditional arrangement, however, is that one pays a large entry fee up front in order to have long-term access to the various levels of care as needed.

There are three basic types of contracts for buy-in CCRCs:

Life Care or Extended Contract: This typically requires the largest up-front fee, but offers unlimited assisted living and skilled nursing care.
Modified Contract: This contract offers a set of services provided for a period of time. When that time expires, other services can be obtained, but for higher monthly fees.
Fee-for-Service Contract: This comes with a lower initial fee but residents pay for assisted living and nursing services at market value at the time needed.

Many continuing care communities offer variations on these contracts and have different specifications and limitations.

Here is a checklist for evaluating Continuing Care Retirement Communities:

Know your budget and compare true costs. Read the fine print of the contract and consider your risk tolerance (i.e. someone with little risk tolerance who can afford it may feel more comfortable having the guarantee of a life care contract).
Find out about the stability of the ownership. Be prudent with your investment as financial issues or other problems could leave you in the lurch. Also, find out about your rights and protections if you choose to buy in to a community. Here is a great article on the Wall Street Journal about Assessing the Financial Stability of a CCRC.
Review all facilities and available services. When you tour, you will likely look at the independent living where you will probably start your stay. However, don’t neglect to see the assisted living, skilled nursing and any special care units. Find out, in particular, about the quality of care at the skilled nursing unit which you may need at some point at least for rehabilitative care. If that facility is poorly rated, some of the security you are paying for may not be worth it.
Think about the long-term. Will you be willing to move from what will become your home in to another apartment/section of the facility? While having options on one campus sounds great, it will still feel like a move to you. If you don’t take advantage of the additional care levels, will it be worth the money for a CCRC? What if you enter as a couple and one person needs a higher level of care before the other?
Involve key people in the discussion. Talk to your financial advisor when looking at your budget and what might be most logical for you. Consider how long-term care insurance plays in to this decision (if you have it). Consider having your attorney review any contract before you sign. Talk about the decision with trusted family members. Consider bringing in a professional advisor such as a geriatric care manager, who can give you access to the whole array of eldercare options that might fit your needs.

Of course, assessing the quality of any senior care facility is important and we at Aging Wisely are here to help. Our care managers assist Tampa Bay/Pinellas County elders and families with the senior care search and transition, with services from assessment and recommendations for facilities and financial assistance through the whole move process. You might also be interested in our Guide to Choosing the Best Senior Facility which offers steps to organize your search and considerations in locating quality options that make sense for you.

As eldercare professionals, we often share the advice that people typically wait too long to consider senior living options and could benefit from more proactive thinking. As I recently spoke to my 90-year old grandfather and friends from his CCRC, they echoed this sentiment. Most of their cohort only consider a retirement facility after health and care (or household management) needs have become problematic, when they could benefit from some of the positive aspects of retirement living sooner. It might be worth considering senior living options as a part of your overall retirement and healthcare planning, rather than thinking of it as a last resort.

Give us a call at 727-447-5845 if we can help with your search for assisted living or retirement communities in the Tampa Bay, Florida area. We’re here to help you determine what eldercare options are best, with expert input and solutions for YOU.

This list offers some top considerations about a CCRC. There are many additional details to consider and we will have additional articles on this and related topics. You can sign up to receive our latest blog posts via email. Leave us a comment if you have a question or topic you’d like to see us cover.

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