Questions & Answers About Continuing Care Retirement Communities

Moving from place to place can be a hassle, especially for seniors. As they age, often the required level of care increases. With increased care, many elders are forced to relocate to a senior care facility that can accommodate their needs. If your senior parent wishes to live their life in one place, a Continuing Care Retirement Community (CCRC) may be an ideal option for them.

What Is a Continuing Care Retirement Community?

A continuing care retirement community (CCRC) can be either a single building or an entire campus devoted to the continuum of care for seniors. Care level options include independent living, assisted living and skilled nursing. Elders usually have the luxury of living in the same apartment or house while living independently or in assisted living; however, once the elder moves into skilled nursing, they usually move to a different part of the building or campus.

What Services Are Offered?

Like most senior living communities, CCRCs offer meal and dining plans, transportation, activities, and health and wellness services. Some communities offer additional living services for residents including rehabilitation programs, adult day care and memory care units to accommodate all residents as their needs change.

Rehabilitation programs are usually confined to the skilled nursing section of the community and aim to allow an injured resident the luxury of recovering at home. Rehabilitation is confined to nursing because patients require an extensive amount of care, including personal and medical. A resident living independently may get injured and need rehabilitation. During recovery, the resident may need assistance with daily living activities like bathing and dressing, in addition to the required medical care. Medical care in rehabilitation includes wound care and physical, occupational and/or speech therapy.

Adult day care and memory care units are usually offered within the assisted living section of a CCRC. Adult day care is reserved for memory impaired elders, such as those with Alzheimer’s or dementia, who cannot be by themselves during the day; the community provides a private duty caregiver for the day. Most residents that use adult day care have spouses who care for them in the evenings. In contrast, memory care units differ in that they provide around the clock supervision for memory impaired residents. Residents live in the unit and do not leave the unit without an escort; this is done for their safety. Most residents who live in memory care units do not have a spouse and therefore need 24 hour care from the community’s staff.

How Do Services Change?

The services elders receive change when they need more care. All residents, no matter what level of care they receive, have access to dining options, housekeeping, activities and transportation. The changing services are primarily in the health and wellness departments. Here is a summary of the services provided by CCRCs.

  • Independent Living 
    Residents receive general services such as housekeeping, transportation if needed, meals and activities.
  • Assisted Living
    Residents also receive general services. Additionally, they receive mobility assistance and daily personal care including bathing, dressing, grooming, toileting, and eating.
  • Skilled Nursing 
    Residents living in skilled nursing (nursing homes) cannot take care of themselves and have extensive medical needs. This care level provides the same services as independent living and the same personal care services as in assisted living, but also includes medical care. Medical care for residents living permanently in skilled nursing includes treatment for specific conditions or diseases, such as Parkinson’s disease care or hospice care.

What Are the Costs of a CCRC?

Upon moving into a CCRC, residents pay a refundable entrance fee usually somewhere between $200,000 and $300,000. This is called “buying in.” This entrance fee covers some of the additional costs associated with higher care levels.

In addition to the entrance fee, a monthly fee is required. This monthly fee is sometimes called “rent.” When care levels increase, the monthly fee increases. Monthly fees can also increase annually because of inflation; most communities limit the annual increase to no more than 10%.

If an elder wants to live in assisted living without “buying in” to the CCRC, they can certainly do this. Monthly fees are higher for those who are not a part of the CCRC.

Does Medicaid and/or Insurance Cover CCRC Costs?

Residents living in a CCRC pay privately when living independently or when in assisted living. There is an exception to this; some states offer a waiver for low-income seniors in assisted living.

Medicaid and insurance will pay under certain circumstances. If an elder needs rehabilitation, Medicare will pay a percentage of the cost. When a resident moves into skilled nursing, the CCRC conducts a financial review. This means that the community reviews the resident’s finances to decide when to apply for Medicaid. When the resident runs out of money, Medicaid will pay for the cost of long-term nursing care.

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