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Life is filled with unexpected challenges, especially as we age. When you or an aging loved one faces changing circumstances — whether it’s a need for additional health care services, physical support or memory care — the transition can feel overwhelming. That’s why many seniors opt for continuing care retirement communities (CCRCs), which are created with shifting needs in mind.
“A continuing care retirement community allows residents to stay in the same general location as their health needs change,” says Christopher Norman, a board-certified geriatric nurse practitioner with the National Council on Aging. The goal, he adds, is to provide a place where residents can transition between different levels of care without needing to move to a completely new facility.
CCRCs offer a number of benefits, but the amenities and services also come with a high price tag. Read on to learn more about what a continuing care community is, common services you can expect and how to decide if it’s the right choice for yourself or a loved one.
Key takeaways
- Continuing care retirement communities work by offering different levels of care within the same community.
- A continuing care facility can support residents with a variety of needs, from independent and assisted living to memory care and skilled nursing.
- CCRCs are among the most expensive senior living options, typically requiring both an entrance fee, which can range from $100,000 and up, and a monthly fee to cover maintenance and other expenses.
What is a CCRC?
“CCRCs work by offering different levels of care within the same community, often in separate buildings,” Norman explains. “For example, a resident may start out in independent living, then transition to assisted living and later move to long-term care, all within the same community.”
The goal of CCRC senior living is to reduce the stress of adapting to new circumstances by allows seniors to transition smoothly between different levels of care. There are approximately 2,000 continuing care communities in the United States, according to a report by Newsweek. However, they are not the most well-known care option, and many people are unaware of how these communities can assist them. Additionally, financial barriers may limit who can access CCRCs.
What is the purpose of a continuing care community?
James Bowdler, founder of PrimeCarers, notes that for many people, the biggest perks of CCRCs include:
- Multi-stage support with an easy transition. Residents can stay in the vicinity while receiving necessary care.
- Cost efficiency. Residents avoid the financial burden of moving to different facilities as healthcare needs change.
- Independence and security. Residents maintain independence while having the security of available support.
“The availability of socialization opportunities is often a big plus at CCRCs. Plus… maintenance of the building and grounds you share with others, cooking for most meals and housekeeping services are included.”
— Christopher Norman, geriatric nurse practitioner
Another significant advantages is that differently-abled partners can stay together. “This is often appealing for aging couples that may have different health needs but would like to remain together in the same community,” says Norman.
Other specific perks, services and amenities vary between facilities, but often they include:
- Meals and snacks.
- Transportation support.
- Housekeeping and laundry services.
- Emergency support.
- Fitness centers.
- Social activities designed to enhance daily living.
Each of these helps ease care transitions by providing an opportunity to age while remaining active and connected to your community. Additionally, CCRCs often offer shared dining spaces for communal meals, activity centers with facilitated events, social engagements and outings.
“The availability of socialization opportunities is often a big plus at CCRCs,” Norman adds. “Plus, you don’t have to worry about maintenance of the building and grounds you share with others, cooking for most meals and housekeeping services are included.”
The different levels of continuing care
CCRCs are occasionally called other names, such as life care communities, life plan communities, lifetime communities, continuing care facilities and active adult retirement homes. Regardless of what they’re called, CCRCs generally provide several tiers of care to accommodate the varying needs of their residents:
- Independent living. For seniors who can live independently but may enjoy community services such as dining, housekeeping and recreational activities.
- Assisted living. For those who need help with activities of daily living, like bathing, dressing and medication management, while still enjoying community amenities.
- Memory care. Specialized support for those with cognitive impairments, such as dementia, providing a secure environment tailored to their needs.
- Skilled nursing care. In-patient services, occasionally short-term, where patients receive rehabilitation services and medical treatment.
As with most senior living facilities, the specific levels of care offered — and the specific dwelling structures, like houses, townhomes, duplexes and more — may vary based on cost and location.
How does a CCRC work?
Here’s what you can expect if you’d like to join a continuing care retirement community.
1. Residents must sign a continuing care agreement
Before you or your loved one commits to a CCRC, you’ll likely be required to sign a continuing care agreement. The contract should address many topics, including, but not limited to:
- Residences.
- Fee schedules.
- Health care coverage.
- Cancellations and refunds.
- Services provided.
- Insurance and other requirements.
A CCRC agreement should also include the conditions for transfer within the community to other levels of care, plus a description of the CCRC’s responsibility should a resident become unable to pay fees.
The experts we spoke to recommend hiring a lawyer or financial advisor to review this document prior to signing. “Despite the price tag, amenities and marketing of CCRCs, the ability to ‘age in place’ at a CCRC is not always a guarantee,” he explains. “I encourage people to understand the fine print before signing a contract. Legal representation is often helpful in negotiating this process — another expense that not everyone can afford. These are all things to consider when choosing a CCRC.”
“CCRCs are often very expensive to buy into, and even when you’re in, the contracts can be very complex.”
— Christopher Norman
2. There’s a required entrance fee — and monthly expenses
Residents join a CCRC by paying an entrance fee, Bowdler notes. Depending on a variety of factors, entrance fees can range from $100,000 to over $1 million. Further, there’s a monthly fee assessed to cover community maintenance costs, like upkeep and medical services, after the initial fee. The amount of care you need and the size of your residence within the community will also help determine this monthly charge.
“The services [in a CCRC] are designed to make your daily life easier, and the amenities encourage you to interact with other residents and be active,” Bowdler notes. “You can use the community’s facilities and services, which frequently include housekeeping and exercise centers, by paying the entry fee.”
It’s important to note that, with the exception of your personal property, you are typically considered a renter at a CCRC, not an owner, Norman adds.
3. Residents must meet certain health requirements
“People often must meet physical and cognitive standards to be admitted and to stay within a CCRC,” Norman explains. These standards are determined by state regulations and the facility itself, so they will vary greatly between communities.
“CCRCs are often very expensive to buy into, and even when you’re in, the contracts can be very complex and will include stipulations whereby a person can be evicted from the CCRC,” says Norman. It’s important to make sure you understand all of the terms and stipulations before choosing this care option.
Questions to ask when considering CCRCs
When deciding if a particular CCRC, or any CCRC at all, is right for you or your loved one, it’s important to ask specific questions. LeadingAge, a national organization representing nonprofit and government providers of aging services, recommends asking the following as you assess CCRCs:
- Are you a for-profit or not-for-profit facility?
- What is included in the monthly fee?
- How will you help me maintain my freedom and independence?
- How is aging in place supported?
- What kind of emergency response systems do you have?
- How do you measure resident satisfaction? Can I see your last two surveys?
- What are your community’s five most popular programs?
- Who decides what programs and events are scheduled?
- Can I review your residency agreement?
Additionally, you can visit the federal government’s online Eldercare Locator or call 800-677-1116 to get contact information for your local Area Agency on Aging, which can provide more detailed information about the CCRCs in your area.
Find a retirement community.
Alternatives to a continuing care facility
While CCRCs offer dynamic, flexible and fairly comprehensive aging support, considering alternatives is OK. CCRCs may not be for you if you have financial concerns, prefer care that involves more family and loved ones or are interested in a more individualized aging experience.
According to Norman, alternatives to CCRCs that offer similar services include:
- Stand-alone assisted living.
- Nursing homes.
- Home care services.
“Some people may also consider 55+ communities combined with external care options as a flexible alternative,” Norman adds.
Lastly, depending on your individual needs and situation, you might consider aging in place. “Aging in place in the comfort of your own home could be a wonderful option if you have the means,” Bowdler says. “It would mean that you would still be independent and in a place you know well, surrounded by things you love and the memories you built over the years. You can also avoid the hefty fees that many senior living facilities impose.”
