dad’s gone fishing
A few months back I had some friends over for brunch. They were all baby boomers coming up soon on retirement age. One of them, Mark, encouraged me to write a post about all the continuing care retirement communities (CCRCs) that are sprouting up and what people might want to know about this type of living arrangement. This is a broad topic, especially for us boomers who love to exercise our independence and self -expression. Let’s face it, the medical-model of the nursing home, or SNF (skilled nursing facility) as folks in my line of work are prone to call it, is no longer the predominant model of infirm or old-age care. Some would argue whether it ever occupied that status. This post is about considering options.
Many of us are by nature planners, and retirement planning and estate planning go hand-in-hand, just as does disability or life-care planning. Maybe there are too many hands here. . . ! My point is that the disability aspect comes into play as a result of increased longevity in our country. While we are lengthening our days considerably, we have no way of knowing whether our retirement savings will outlast us, nor do we know whether we will need any assistance from others – family members or hired professionals – to help us pay our bills and assist with our day-to-day living. This topic is huge, so I am narrowing it to just the FAQs about CCRCs.
The American Association of Homes and Services for the Aging defines a Continuing Care Retirement Community (CCRC) as “an organization that offers a full range of housing, residential services, and health care in order to serve its older residents as their needs change over time.” The focus is not on the medical needs of older persons but rather on helping people maintain a sense of independence and community. There are still many people who cling to the idea that the only way to maintain their independent lifestyle is to live on their own is a house that may be difficult and even dangerous for an older person to maintain. The growth of independent living, assisted living and CCRC-type communities attest to the relaxation of that otherwise inflexible approach to an independent lifestyle.
Well, these CCRC’s have been around for many years, even if many of them fell on some pretty lean times over the last decade or so. Belt-tightening seems to be easing and optimism often appears less guarded these days. Here’s a recent post about the market boom of a boomer market in assisted living developments.
Many families are undoubtedly going to continue with their multigenerational living arrangements, and you can read my blog post about that topic here. In the Denver metro area of Colorado, there are several CCRCs. Each one has different arrangements for how to enroll, pay rent, buy into, and generally become a member of the community. For the vast majority of us who have little or no long term care insurance, these living arrangement can provide a certain amount of peace of mind. Check out the AARP’s article about CCRCs here.
What is a CCRC?
A CCRC is a community which is designed for people aged 60+ (the age often varies) and provides a continuum of residence-based care. Beginning with independent living, one can expect private, low-maintenance housing – as in an apartment or cottage home along with a built-in community. The “continuing care” part comes into play in the event a person needs or wants additional services like housekeeping, transportation, and security. You can expect community attracting spots like a fitness center, performing arts center, along with various dining venues. There are also plenty of activities to keep people socially engaged like classes, field trips and the like.
What about the “care” in CCRC?
As far as the care part goes, this often encompasses on-site care that including assisted living, memory care, skilled nursing, and rehabilitation services. It is by nature a continuum, designed to offer services in the event they are needed in a nearby setting. These care include in-home services, assisted living, memory care, skilled nursing, and rehabilitation services. This can simplify things especially for a spouse of life partner of a person who needs more care and services.
How does someone go about finding an appropriate CCRC?
CCRCs began to crop up as not-for-profit based communities, often sponsored by faith communities or other similar affiliations for people. Many CCRCs have cropped up in more recent years that are for-profit institutions. There is a listing of many of these types of communities under the guise of the Commission on Accreditation of Rehabilitation Facilities, and another acronym is CCAC for Continuing Care Accreditation Commission (in case you might have wondered about the nature of “rehabilitation” in the facility) along with important standards to consider. Keep in mind that there are many types of CCRCs and many homes are not yet accredited and there are different types and levels of accreditation.
Why are the location and setting of a CCRC important?
CCRCs can offer a full-service lifestyle right on campus. This can be very important for a couple to maintain an independent lifestyle but still allow a spouse who may suffer from health challenges to receive care within the community while providing support for a caregiver spouse. Many residents appreciate having easy access to greater community amenities such as cultural, recreational, spiritual, and retail offerings. Additionally, residents often choose a location that allows them to maintain close ties with family and friends.
Do I have to rent or can I own a home at a CCRC?
Some CCRCs offer equity, but most do not involve a real estate transaction. If you are looking carefully at these options or considering them for another, read the contract very carefully. There is no “standard” type of contract for these living arrangements. Many communities offer an entrance fee plan, guaranteed by a contract or residency agreement that entitles residents to occupy their chosen cottage or apartment and use the common area amenities, programs and services. The one-time entrance fee – which is usually partially or fully refundable – also assures residents access to the on-site continuum of health care. I am familiar with one local facility that had a $10,000 “fee” chargeable to a resident’s move from a two-bedroom unit to a more affordable (from a monthly rent standpoint) one-bedroom unit after the spouse passed away. Keep in mind there are typically monthly service fees that come into play as well, depending on one’s circumstances. If you are considering a move to a CCRC, for yourself or a loved one, please take the time to carefully read the contract so that there are no surprises.
CCRCs are a relatively recent development in living arrangements that are designed to encompass different living arrangements in a single community, thereby obviating the need for someone to move to a different residence or facility as their care needs increase. It will be interesting to see how they evolve in the coming years.
©Barbara Cashman www.DenverElderLaw.org