What Is a Continuing Care Retirement Community (CCRC)?

You’ve likely heard about various long-term care options. Home care is the most widely popular long-term care type, and others are usually familiar with options such as nursing homes and assisted living facilities. But what about a continuing care retirement community (CCRC)?

These communities are gaining traction in the world of long-term care as a unique alternative way to age in place. They’re a niche form of care compared to those above, but there are advantages to the CCRC model for many people.

Continuing care retirement communities offer multiple levels of long-term care living within the same community. This allows residents to remain living in the same environment regardless of their care needs. 

This article will explain what CCRCs are, what makes them different from other types of long-term care, and a few reasons they may be the right choice for you or your loved one. 

If you already know a continuing care retirement community is right for you or your loved one, you can use LTC News’s Long-Term Care Directory to search for CCRCs near you. This directory collects information from long-term care facilities all around the U.S. so you can compare and contrast the best options in your area. 

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What Is a Continuing Care Retirement Community?

A continuing care retirement community (CCRC) is a flexible approach to senior living. These communities offer a continuum of care for residents as their long-term care needs change over time. But what exactly does that look like?

There are several housing and long-term care options within a continuing care retirement community. These options include independent living, in which only a residence is required, not care. Other options include assisted living and skilled nursing care. However, some communities may also offer memory care sections.

• Independent living includes apartments, townhomes, or small houses where residents live independently with easy access to amenities and social gatherings.

• Assisted living is for individuals who need help with activities of daily living but not to the level of a nursing home. The most common option for assisted living is in a single or shared apartment.

• Skilled nursing is for individuals who need significant help with activities and skilled care. Individuals in skilled nursing sections may need round-the-clock care and medical attention.

• Memory care is for those with Alzheimer's or dementia. These sections offer extra supervision, security, and specialized staff to keep residents safe.

Residents are free to move from one level of care to the next as their long-term care needs change.

For example, an individual may enter the CCRC in the independent living section. After some time goes by, they may start to need help with activities of daily living. As a result, they may move to the assisted living section of the community to get the care they need.

Since all types of care exist on the same campus, residents can seamlessly move from one to another as their needs change. This integrated care approach takes the pressure off of individuals to find new types of care as their needs change. It allows individuals to live stress-free within the same community as they age.

What Services and Amenities Do Continuing Care Retirement Communities Offer?

Continuing care retirement communities offer comprehensive long-term care options for their residents. Here are some key services commonly found in CCRCs:

• Flexible living choices: Residents can choose between independent living, assisted living, skilled nursing, and sometimes memory care units. This flexibility lets residents live independently or with as much help as their care needs call for.

• Help with activities of daily living (ADLs): Help with daily activities of living, such as continence, eating, dressing, toileting, and more, is an essential aspect of long-term care. Residents have access to staff to help with these needs at any time.

• Meal services and access to restaurants: For those living within the assisted living or skilled nursing sections, the community will offer meal services. Some independent living sections may also offer meal services for those who wish to opt in. 

• Transportation services: CCRCs offer transportation services to help residents move around the community as well as leave for medical appointments. 

• 24/7 safety and security: Safety and security are a huge focus for CCRCs. These communities have 24/7 security personnel, emergency response systems, and advanced safety equipment to ensure residents' well-being and peace of mind. Many CCRCs are also gated communities, which helps control who enters and leaves. 

• Maintenance-free lifestyle: Staff at CCRCs take care of housekeeping and maintenance issues for most residents. The only exception would be those in the independent living section who may prefer to take care of household chores on their own. 

• Medical services: CCRCs offer skilled care and medical care within their skilled nursing sections. Some communities may also have physical or occupational therapists, dentists, or pharmacists on-site to help streamline access to care. 

Beyond long-term care services, continuing care retirement communities want all of their residents to enjoy a high quality of living. For this reason, they offer a wealth of amenities and activities designed to enrich residents' lives:

• Fitness centers and classes: Many continuing care retirement communities have fitness centers where they host exercise classes, like yoga. Some may also have pools for relaxation. These wellness areas promote physical health and improve mobility.

• Arts center and activities: Residents can participate in a variety of creative pursuits, including art classes, crafts workshops, and cultural events, fostering self-expression, relaxation, and social connection.

• Community and entertainment area: Games, movie nights, and themed events are a popular pastime for many seniors. CCRCs organize games, puzzles, and recreational activities to stimulate cognitive function, encourage social interaction, and provide entertainment for residents. 

• Community Outings: Regular group outings to local attractions, parks, theaters, and restaurants enable residents to explore their surroundings, connect with nature, and enjoy cultural experiences.

• Barber and beauty salon: Who doesn't want to look fresh? Many CCRCs have barbers and beauty salons within the community so that residents can keep their appearances sharp. 

• Retail and coffee shops: Some continuing care retirement communities have small coffee or retail shops where residents are free to shop and hang out. 

• Garden or nature trails: Connecting with nature is essential for physical and mental well-being. Some CCRCs have community gardens for residents to take care of and trails to explore. 

CCRCs are dynamic living environments that prioritize residents' comfort, safety, and engagement. 

How Much Do Continuing Care Retirement Communities Cost?

Determining how much a continuing care retirement community costs can be challenging. Price ranges and reports of expected costs vary for CCRCs. While it’s best to research CCRCs specifically in your area to get a sense of pricing, we can provide some general information that will give you some considerations as you explore the cost of CCRCs.

On average, in 2021, continuing care retirement communities cost $3,555/month; however, this answer can be misleading.

The monthly cost isn't the full story. Many CCRCs charge an upfront entrance fee ranging from $40,000 to over 2 million dollars. 

After the entrance fee, there's also a monthly fee; think of it like rent. These prices are based on a contract, meaning after prices are set, there's little to no room for increases. 

There are three main types of CCRC contracts. These contracts are complex and require the help of a lawyer or financial advisor. Here are the contract options in their most basic terms:

1. Life care contract (type A): This contract has the highest cost, but it includes coverage for all services available within the CCRC. Individuals will pay a one-time fee before moving in. Then, a predictable, discounted monthly fee for amenities and care. 

2. Modified contract (Type B): This contract charges an entrance fee and covers a limited range of services or benefits at a discounted rate. Residents who need more care than their limit allows will pay regular rates for the additional services.  

3. Fee-for-service contract (Type C): This is the lowest cost contract, where residents pay a lower entrance and monthly service fee. However, they'll be charged full price for any care services they may need. 

If you own Long-Term Care Insurance, make sure your CCRC knows this. Your contract may be modified in beneficial ways.

Some CCRCs may also offer alternative options like rental or equity contracts. Before deciding on any type of contract, it's best to consult with an expert. All CCRC contracts are complex, making it dangerous to jump right in without professional help. 

It's also worth mentioning that neither Medicare, Medicaid, or traditional health care insurance covers CCRCs. Long-Term Care Insurance can be used to cover any long-term care services provided within a CCRC. However, the entrance fee would not be covered. 

What Are The Pros and Cons of Continuing Care Retirement Communities?

Continuing care retirement communities offer unique benefits compared to other types of long-term care settings. However, these pros come with some drawbacks that may be hard for some people to ignore. 

Pro – A Wide Variety of Choices

Continuing care retirement communities offer several living arrangements for their residents, including small homes, townhomes, apartments, and more. 

Residents are free to move between these arrangements as their needs change. Those living in independent living sections may also have a choice of moving between a small home or an apartment. 

In addition to housing choices, residents have endless recreational choices throughout their days. With amenities like gardens, fitness centers, salons, and cafes for residents to explore, it's almost impossible to have a dull day within a CCRC. 

The best part is that, even with all of these options, residents are still within the same environment. There's no need to leave the community or make transportation arrangements just to get some fresh air or shopping done. 

Con – CCRCs Are an Expensive Financial Commitment

Continuing care retirement communities can be incredibly expensive. These communities are for individuals who have planned their retirement and have the savings or income to afford the upfront and continuous fees. 

Even individuals who plan with Long-Term Care Insurance are still not completely in luck. Long-Term Care Insurance may cover care received in a CCRC, but it does not cover any entrance fees. This acts as a huge barrier to entry for individuals who would've otherwise considered CCRCs as a care option. 

Pro – Easy Access to Flexible Care

Continuing care retirement communities provide a seamless continuum of care to all their residents. This flexibility isn't found in any other type of facility or even through in-home care. 

As resident's care needs change, they can move throughout the community to find a living arrangement that works best for them. Residents with spouses can also move to different sections of the community without worrying about being extremely separated because of their long-term care needs. 

In the event of an emergency or need for medical care, residents will have swift access to on-site medical personnel who are ready to help individuals make a quick recovery and continue life as before. 

Con – High Demand and Health Requirements

Many continuing care retirement communities are in high demand, and the services offered within them may even have waiting lists. 

CCRC contracts determine what priority level each individual has within the community. Some contracts do not guarantee priority access to different levels of care. 

In addition, some CCRCs may have requirements for individuals to meet before they can move into the community. These prerequisites can vary greatly depending on the community. 

Pro – A Supportive Social Environment

It's no secret that our interpersonal relationships are a key part of our health. CCRCs provide the perfect community for residents to get to know each other on a deeper level and make lasting connections. 

Between amenities, social activities, and living in the same community together, there are countless options for residents to get involved regardless of their care situation. 

Residents receiving intensive skilled care are in close proximity to those with less care needs, and since everyone lives in the CCRC, there's no concern of having to leave or move when care needs change. 

This creates a safe, permanent sense of belonging and community that may foster more connection and opportunity than other long-term care settings. 

Con – CCRCs Require Extensive Planning

Entering a continuing care retirement community can feel more similar to buying a new house than simply entering a care facility. 

CCRCs have complicated contracts. These contracts require the help of experts to decipher and negotiate. Entrance fees can also tie up money that may have otherwise resided in savings or assets. 

The decision to move into a CCRC carries significant weight, which may make individuals hesitant before jumping right in. 

State Regulation of CCRCs

An important thing to note is that regulatory standards for CCRCs vary by state and aren’t federally standardized. As of writing this, there are no federally mandated regulatory standards for CCRC.

To that end, here are some areas you should be asking about when you work with a CCRC:

• What regulations are in place on a statewide level?

• Is there a minimum level of financial reserve required for the CCRC?

• For higher levels of care (assisted living, nursing home, etc.), are there mandated care services at these facilities?

• Are there refunds for unused care expenditures if the resident leaves or dies prematurely?

You can read more about your state’s regulations at the National Consumer Voice for Quality Long-Term Care website.

An Overview of Continuing Care Retirement Communities

CCRCs provide a safe and familiar environment for seniors to age. They have options for independent living, assisted living, and skilled nursing care. 

Regardless of their changing care needs, residents have the peace of mind that they'll remain within the same community with easy access to any care they could need. 

While the price tag and commitment may make some people cautious, others see the social, safety, and long-term care benefits as unmatched by any other type of care facility. 

If you found this article helpful, check out some of our other resources on LTC News. 

• Find Long-Term Care Near You – LTC News’s Long-Term Care Directory can help you find a CCRC near you or your loved one.  

• How To Pay For Long-Term Care – This article explores different options to cover long-term care costs. 

• Who Needs Long-Term Care? – This article explains how you can tell when you or a loved one needs long-term care. This can be harder to decipher than one might think. 

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