What Is a Continuing Care Retirement Community?

Continuing care retirement communities (CCRCs), also called life care communities or life plan communities, are residential care communities that offer independent living, assisted living, and nursing home care in one campus, allowing residents to move between care types as their health or ability to be independent changes.

CCRC living spaces can include houses, cottages, townhouses, duplexes, and apartments, and typically include features such as:

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

Some CCRCs have an onsite medical center, and amenities such as high-quality restaurants and proximity to a golf course.

A CCRC may be a good fit for a senior who wants to stay in one place that will provide care as needed, who enjoys high-quality amenities, and has the finances to pay a substantial entrance fee. “A CCRC provides stability and a security that the community will take care of a resident through end of life,” says Jeni Wallace, Senior National Account Manager at A Place for Mom.

In a CCRC, seniors can get help with activities of daily living (ADLs), rehabilitation services, skilled nursing care, and 24-hour supervision, as needed.

A continuing care community can be a helpful option for couples who have 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.^[01]

When a CCRC may not be the right choice

A CCRC may not be the right choice for seniors who aren’t able to pay the entrance fees, who prefer flexibility in choosing where they live as they get older, or whose need for medical care is short-term.

Let our care assessment guide you

CCRCs involve both upfront and ongoing costs, which can vary widely depending on the community, contract type, and level of care provided.^[02]

• • Entrance fee. CCRCs typically require a one-time “buy-in” of $100,000 or more, with some luxury communities costing $500,000+. In some cases, this fee is non-refundable.
  • Monthly costs. Residents also pay a monthly fee, typically $3,500 or more, which typically includes:
    • Rent and housing
    • Meals
    • Maintenance and utilities
    • Amenities and services

Types of CCRC contracts

CCRCs offer different types of contracts:

• • • Type A or extensive
    • Type B or modified
    • Fee-for-service

Contracts that require higher entrance fees typically cover all or most of the care that the resident will ever need. “The more you pay up front, the more care that is covered down the road,” says Wallace.

Extensive

“The Type A or extensive contract has the highest entrance fee and the most care covered,” says Wallace, 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.

Modified

The modified or Type B contract requires a smaller entrance fee, but the monthly fee could increase as they require more care, explains Wallace. However, some communities offer care at discounted rates.

Fee-for-service

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.

What affects the cost of a CCRC?

Several factors influence the cost of living in a CCRC, including the level of care needed, the type of contract, and the location of the community.

Level of care needed

For many seniors the actual cost of a CCRC will depend on the degree of care they require while living there; the more care they need, the higher their costs may be.

Contract type

For seniors who choose a Type B or fee-for-service contract, the total cost will be determined by the amount and type of care they need. Those who choose the Type A contract pay a higher entrance fee but pay fewer care costs over time.

Location

Location influences cost, with CCRCs in areas with a higher cost of living charging more. Of all senior residence choices, CCRCs are only a small percentage, says Wallace, so it may be difficult to find a CCRC in a senior’s preferred area.

Assisted living is one type of care that’s provided in a CCRC, which also provides independent living and skilled nursing care on the same campus.

CCRCs compared to other types of senior care

Consider both benefits and limitations of a CCRC when evaluating whether this is the best fit for yourself or a loved one.

Benefits of CCRCs

Key benefits of a CCRC include:

• The ability to age in one place, without having to change location
• Predictable care that’s provided as needed
• A sense of stability for couples if one needs more care than the other

Limitations of CCRCs

CCRCs do have limitations, including:

• High, and potentially non-refundable, upfront cost
• Long-term commitment to living in one location
• Less flexibility if a senior wants to change where they live

Talk with a Senior Living Advisor

In addition to the various contracts offered by a CCRC, potential residents should fully explore the details of each continuing care community they’re considering.

When visiting CCRCs, ask about the following:

• Staff. Ask about employee training requirements, whether the community conduct background checks for employees, and what the staff-to-resident ratio is.
• Culture. When visiting a community, ask yourself if the community’s general atmosphere matches your loved one’s personality and take note if residents seem reserved, or more social and eager to get involved.
• Amenities. Since your relative may live in the community for several years, it’s 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. Ask if the continuing care facility has 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.^[03]
• 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, and does the CCRC have a reciprocal agreement or partnership with nearby communities?

If you’re exploring options for yourself or a loved one, compare the costs and care provided in a CCRC with those of an independent living and an assisted living residence to get a clear sense of whether a CCRC is the right choice.

If you need to find a senior community immediately, talk to one of A Place for Mom’s Senior Living Advisors who can help you understand what kind of care your loved one needs and help you find a community that’s a great fit. This service is free to use.