As I often discuss in my blog posts, among the advantages of picking a continuing care retirement community (CCRC, also known as a life plan community) over other types of senior living communities is the contractually guaranteed provision of housing and services along the continuum of care, typically ranging from independent living to assisted living to skilled nursing care. Seniors who make the decision to move to a CCRC (as well as their loved ones) are provided the peace of mind that comes with knowing they will receive the type of care they need in the future, while living a maintenance-free lifestyle today.
During my years of working within the senior living industry, I’ve visited over a hundred CCRCs across the country. My impression is that the vast majority of these communities are doing an outstanding job of providing services to their residents, and the residents I talk with seem very happy, speaking highly of their community, the staff, and the relationships they’ve developed.
So, while most CCRCs are following through on their commitments to their residents, like all industries, some CCRC providers are better than others.
You may have heard about extreme examples of senior neglect or facility maladministration on the news, and these issues definitely aren’t unique to CCRCs. There are stories about other types of providers delivering less-than-satisfactory care and services—assisted living communities that are bankrupted by financial mismanagement; nursing homes that are neglecting or abusing residents; even abuse or theft by caregivers in seniors’ private homes.
The difference, of course, is that CCRC residents are usually making a bigger commitment—financially and otherwise—thus most would agree that they are entitled to expect a higher-level of service and care for life.
So, let’s tackle these two key questions:
- How do I choose a CCRC that I can feel confident will follow-through on its commitment to provide me with a continuum of care for life?
- What can a CCRC resident or their family do if a CCRC doesn’t adequately deliver on its promises?
Choosing a reputable CCRC
As with so many things in life, an ounce of prevention is worth a pound of cure when it comes to the quality of the CCRC you choose, and that is why it is so vital to do your due diligence and research BEFORE you move to any CCRC.
When you are considering various CCRCs, there are a number of things you can do to learn more about their quality, reputation, and long-term financial stability.
Review their scores
There really is not one central location that independently rates or ranks CCRCs, unfortunately. However, there are places where you can find different data to inform your CCRC decision. Some examples:
- The Commission on Accreditation of Rehabilitation Facilities (CARF) is an independent, non-profit organization that rates CCRCs (though pursuing accreditation is voluntary on the part of the CCRC). It’s also important to understand that CARF doesn’t accredit based on whether a community meets a specific set of requirements. Instead, it is based on whether the community exhibits consistent progress toward improved efficiency, fiscal health, and service delivery.
- If the community is Medicare/Medicaid-certified, the Centers for Medicare and Medicaid Services (CMS) offers ratings based on its inspections and reporting on the healthcare center within the CCRC.
- About two-thirds of states have some level of CCRC regulation; click hereto learn which ones, the agency under which they’re regulated, and the financial reserve requirements, where .
Review the financials
You can learn a lot about a community by reviewing their financial data from the past few years, and a community that is well-managed should be more than happy to provide this information to you. Is there positive cash flow from operations? Are financial covenants being met? myLifeSite also gathers communities’ audited financial statements and provides five key financial ratios on each of the hundreds of CCRCs we profile. You can even sort your search results from best to worst based on communities’ debt service coverage and net operating margins.
>> Related: How Do I Know If a CCRC is Financially Viable?
Talk with the local ombudsman
Your local long-term care ombudsmen act as volunteer advocates for people living in care facilities, providing residents and their loved ones a way to file a formal complaint against a facility and then working to resolve the grievance or regulatory violation. I highly recommend finding the ombudsman in your area and inquiring about any regulatory violations or complaints lodged against the CCRCs you are considering. For most ombudsmen programs, obtaining this information will require a phone call to the agency, but it is worth your time and effort.
Spend time on-site
There is a lot to be said for getting personally acquainted with a community to get a feel for what it is really like to live there. So, visit the CCRCs you are considering; visit often; visit at different times of day. Many communities have guest suites, so stay on the campus for a few nights. Eat in the dining facilities. Talk with people who live there to get their first-hand accounts about their experiences. If applicable, talk with people you know who have had loved ones who have lived there, especially if they received care in the healthcare center. This may be one of the best ways to learn about a community!
Fortunately, most communities are well-managed and should be responsive if any issues arise. But when making a major life decision that impacts your finances, health, and happiness for years to come, it can be devastating if contractual guarantees about care and services are not met.
So, what can CCRC residents or their families do when a CCRC doesn’t deliver on its promises?
Should an issue arise, the first thing I suggest is contacting the community’s management staff. Most CCRC directors should be eager to listen to feedback from residents in an effort to address any concerns and continuously improve their community. If you are not satisfied by the response from management, contact the community’s board of directors to notify them of the issue or dispute.
Notify your local long-term care ombudsman
As discussed above, long-term care ombudsmen are volunteer advocates for those who live in care facilities, including CCRCs. They are able to address issues related to things like residents’ rights, unsatisfactory services or facilities, management-related issues, financial disputes, and more. Contact your local ombudsman to find out the proper process for lodging a complaint.
Inform the state
Again, this is only applicable in about two-thirds of states, but if your CCRC is in a state that regulates the industry, contact the appropriate oversight agency to find out the process for filing a complaint. You can use this list to help you get started.
Consider your options
If you are interested in learning more about CCRCs in your area, visit the free online community search tool on myLifeSite. You can research information such as entry and monthly fees, contract options, healthcare services provided, and much more!
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