4 Key Factors of the CCRC Decision Process

Making a decision about senior living is among the biggest choices you will make in your life…It’s way up there on the list anyway! Perhaps you have already decided that you want the long-term security of a continuing care retirement community (CCRC, also called a life plan community), but there are so many things to consider when looking at different providers. It is understandable if your head is spinning and/or you feel overwhelmed with the options.

But there is a way to simplify the decision about which CCRC is right for you. I recommend breaking down the decision into these four buckets: lifestyle, healthcare, financials, and contract details. Let’s take a look at each of these four key factors.

Lifestyle

While all four categories are important, this may be the most important one. After all, the CCRC is where you will live. And it isn’t a decision you want to have to make again. Therefore, it needs to be a place where you will be happy and comfortable. It should not only accommodate, but also foster, your lifestyle preferences so that you can live the life you want to live.

If wellness and fitness are important to you then you should ask a lot of questions about the wellness program. Does the community offer a comprehensive wellness program for residents, including mind, body, and spirit? Ask to talk with the wellness or fitness director to see if they appear passionate about healthy living for residents.

Or maybe you prefer intellectual stimulation and reading. Ask what sort of educational classes take place and how often. Are there lifelong learning classes onsite or nearby? Do residents get involved in inviting speakers in? Is technology utilized for continuing education among residents?

There are many other things to consider, including, but not limited to: the flexibility of meal plans and dining choices, location, size of residence, vitality of the residents, and involvement in projects outside of the community.

These are the types of things that will impact your daily living experience, so it’s important to think through what each day might look like for you. Many communities will even let you stay a night or two to get a feel for what it might be like to live there.

Finally, there are a growing number of “affinity communities,” which cater to groups that share common lifestyle preferences, interests, or hobbies, including LGBT-focused providers. Affinity communities aren’t a new concept since many CCRCs were founded by religious organizations, but today’s communities go beyond the spiritual to embrace everything from golf-lovers and motorcycle enthusiasts, to the arts and continuing education. There are even communities that focus on environmental conscientiousness–an increasingly popular trend as the Baby Boomers reach retirement.

Healthcare

The availability of an on-site healthcare facility is one of the biggest draws of many CCRCs; it offers a tremendous amount of peace of mind for residents to know that care will be available if and when they need it. So, you want to be sure that the type of care provided is the type you would expect to receive should you need it down the road.

On the CCRC campus, residents typically are provided with services spanning the entire continuum of care, from independent living through skilled nursing care, and many offer specialized memory care units. So, when you visit a community, I encourage people to tour the healthcare facilities. Does it look clean and is it free of odors? Do employees look well-kempt, happy, and productive? Is the sales rep proud to talk about their healthcare services, or do they shy away from the topic? If you know others who have received services in the healthcare facility, be sure to talk with them or their family members.

If the community is Medicare-certified (as opposed to private pay only), be sure to check out the CMS rating for the on-site healthcare facility on the Nursing Home section of Medicare.gov. You also may be able to find out if there are any complaints about the facility at the long-term care ombudsman program for the state in which the CCRC is located.

Financials

This bucket is two-fold: You should consider both your own financial situation and the financial viability of the community.

When it comes to your personal finances, you must look at both the entry fee and the monthly cost of living in various CCRCs to determine if you have the necessary funds. According to the MyLifeSite CCRC database of over 500 providers across the country, entry fees average from around $100,000 on the low end to over $400,000 on the high end (across a blend of contract types). Of course, prices can vary dramatically from the averages based on a variety of factors, including the geographic region and size of the residence. Average monthly service fees range from around $2,000 to over $4,000. It’s important to understand what is included in the monthly fee versus what is extra. It’s also important to understand how your monthly fee might adjust if you require assisted living or nursing care services. (See the next section for more on this topic.)

The other important factor is the financial viability of the CCRC you are considering. You want to ensure the organization is financially positioned to meet their long-term commitment to you. I strongly encourage you to read this related blog post, How Do I Know If a CCRC is Financially Viable?, in which I list eight specific finance-related questions to ask the CCRCs you are exploring.

Also, if the community is located in a state that regulates CCRCs, I suggest contacting the appropriate regulatory agency to ask about the financial requirements and oversight process for CCRCs, as well as any record of bankruptcy of CCRCs located within the state. Remember, however, that just because a CCRC is located in a state that is not regulated does not necessarily mean that it is not well-managed or financially viable.

Contract details

This is a biggie, mainly because 1) it impacts your wallet and 2) each community has different contract types and specifications. In the simplest terms, there are five main types of CCRC contracts: Type A (“Extensive” or “Lifecare”), Type B (“Modified Fee-for-Service”), Type C (“Fee-for-Service”), Rental, and Equity/Co-Op. Each has pros and cons to consider; here’s a great explainer of the CCRC contract types.

In theory, each type of CCRC contract should be actuarially equivalent. In other words, all other things being equal, one type of contract should not be financially advantageous over another, if the contracts are priced appropriately and all of the same statistical assumptions are used. Yet, different communities may use different methods to “price” their contracts, so this theory will not always hold true when comparing one community to another.

Making a decision

Once you gather this information on the communities you are looking at, consider your findings; you may begin to see a clear winner, or alternately, it may make it easy to rule out some contenders. Either way, you will have a big-picture look at the important aspects of your CCRC decision process, enabling you to make an educated, well-informed choice about your senior living options.

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