It is a bit ironic that when you move to a continuing care retirement community (CCRC, or life plan community), you hope to never need one of its defining characteristics: the onsite healthcare center. But as we wrote about a few weeks ago, the odds are that at some point, you will require some level of care services, ranging from assisted living to full-time skilled nursing care. So, how can you be sure the healthcare center for the CCRC you are considering will meet your expectations?
Researching for yourself
The healthcare center at a CCRC is effectively a nursing home within the CCRC’s campus (or in some cases, at a contracted off-site location). CCRC residents living either temporarily or permanently within the healthcare center are cared for by a team of licensed practical nurses (LPNs), licensed vocational nurses (LVNs), as well as registered nurses (RNs).
As a CCRC prospect, there are a number of ways that you can do your own research to determine the quality of the care you might expect to receive should you ever need to spend time in the CCRC healthcare center.
CMS quality rating
The first and simplest place to look for details about the healthcare center is to review their Center for Medicare and Medicaid Services (CMS) quality rating, if they have one. Medicare’s Nursing Home Care Compare website gives each nursing home a rating of between 1 and 5 stars. You also will find information about staffing ratios, safety inspections, and any fines or citations they have received.
(Note: This is only applicable if the CCRC’s healthcare center is Medicare-certified [versus private pay only], and being Medicare-certified, or not, isn’t necessarily an indicator of quality.)
Long-term care ombudsman records
The long-term care ombudsman for the state where the CCRC operates can be an excellent source of information about any issues with a CCRC’s healthcare center. Long-term care ombudsmen are volunteer advocates for residents of nursing care facilities. They provide residents and their loved ones a formal process for filing complaints against a facility. They also respond to consumers’ inquiries about any regulatory violations or complaints that have been lodged against a particular facility.
Thankfully, complaints against CCRCs are not common; most provide excellent care to their residents, whether they are living independently or in the healthcare center. However, you can (and should) ask the community directly if they maintain a list of any complaints that have been lodged by residents of the healthcare center, or their loved ones. The community’s transparency on this topic can speak volumes.
Staff satisfaction and turnover
The average turnover rate for the nursing home industry is high — around 30 percent. Again, along the lines of transparency, ask CCRC management about their healthcare center’s staff tenure. If the CCRC’s is higher than average, it could suggest that the staff is unhappy or poorly managed, which can result in subpar care. Generally speaking, if management is eager and proud to share details about their healthcare services, it is a good indication of their quality. Avoiding talking about the topic can be equally revelatory.
Take a look for yourself
Although many people prefer not to think about their potential future care needs, it is wise for prospective CCRC residents to take a first-hand look inside the community’s healthcare center. Even a quick tour can be quite revealing. Notice if the nursing staff seems happy and engaged, if the facility appears clean and free of unpleasant odors, if the environment is comfortable and welcoming, and if the residents seem well cared for.
There’s nothing quite like a first-hand account to learn about nearly any product or service! If you know someone who has received care in the CCRC’s healthcare center, or whose loved one has, ask them about their personal experience. It can be one of the best, least biased ways to get a handle on the care you might expect to receive there, should you ever need it.
>> Related: How Does Nursing Home Billing Work?
Questions to ask about the CCRC healthcare center
As you consider your CCRC options, bear in mind that one of the things you will be paying for is the peace of mind that comes with having access to a full continuum of care services, should you ever need them. That’s why you want to be sure you’re getting what you’re paying for when it comes to the CCRC’s healthcare center.
Here’s a list of healthcare center-related questions you will want to consider during your CCRC decision process:
- Is there an on-site medical doctor? If yes, are they full-time or part-time?
- Are there any on-site medical and/or preventive care services available to independent living residents? (e.g., routine physicals, dental exams, etc.)?
- Is there an on-site pharmacy? If not, is there a regular delivery service?
- Are skilled nursing and rehab services offered? If so, is it on-site or off-campus?
- If skilled nursing is offered off-campus, will regular transportation back and forth be available for visitation by a spouse or other residents? How often?
- Are private rooms available in the healthcare center? Is there an additional cost for a private room?
- If you require temporary care in the healthcare center, do you retain the right to move back to your independent living residence? For how long?
- In the case of a couple, if placement in the healthcare center is deemed permanent for one resident, can the other resident move to a smaller, less expensive unit?
- What is the healthcare center’s CMS star rating? (Again, a rating will only be available if the facility is Medicare-certified.)
- Are healthcare and personal care services limited or reduced on the weekends?
- Are assisted living residences separate from skilled nursing residences, or in the same building?
- How does the community’s ratio of CNAs, LPNs, and RNs compare to the legal minimums for each?
- How does the CCRC attract and retain healthcare staff?
View and download our Ultimate CCRC Checklist to learn more about choosing the CCRC that is right for you.
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