Continuing Care Retirement Community (CCRC)
A continuing care retirement community (CCRC) offers multi-level care for seniors, from independent living to assisted living and more — all in one accessible area. You could start living in a CCRC with little to no assistance, but if your health changes, more help is readily available. Having access to different levels of care is appealing to most seniors, but it's best to understand costs and services to determine if it's right for you.
What Is a Continuing Care Retirement Community?
A continuing care retirement community, also known as a CCRC, offers a wide range of long-term care services and facilities all within one senior living community. These include independent living options with skilled nursing care available, assisted living, memory care and short-term rehabilitation.
To live in a CCRC, you must first be able to live independently, then you are permitted to move to other living options within the community that have more personal or medical assistance if your health declines. Keep in mind that most CCRC have a minimum age requirement between 60 to 62 years old.
Having ample health care, personal care assistance and a community does come with a hefty cost with a CCRC. There is an entrance fee along with a monthly fee.
The entrance fee has a wide range, from $40,000 to $2 million. On average, the entrance fee for a CCRC ranges between $200,000 to $500,000. If you have a home that you’re looking to sell in order to move into a CCRC, you could use those funds to cover the entrance fee.
Monthly fees vary depending on the type of CCRC contract you choose. With an extended care contract, your monthly fee will likely be around $3,500 a month.
If you want access to different levels of care for your retirement lifestyle, and it’s within your budget, a CCRC may be a beneficial option. Be sure to explore all services provided by a CCRC to ensure it’s a good fit for your needs.
What Services Does a CCRC Provide?
A CCRC offers most essential services you’d need in one community — from health care, such as an onsite dentist and nursing services, to commercial services like a coffee shop or housekeeping, and community services such as a golf course or greenhouse.
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Having an abundance of health care options, along with social events and community services makes a CCRC a popular option for seniors. According to an article from the National Investment Center, CCRCs commonly have a higher occupancy compared to other senior housing options.
Learning more about each service can help you decide if a CCRC will cater to your specific needs for retirement.
Professional Health Services
All CCRCs have professional health services available, from nursing care, assisted living care to memory care, therapy and more. Even though you need to be able to live independently when you first arrive at a CCRC, you can utilize the health services any time.
For example, you could move into a CCRC in good health and live independently at first. Later on, you could require assisted living care for several months due to a back injury. After you are healed, you are welcome to move back to independent living housing within the community. There is not a fixed schedule with health services, you can simply move from one facility to another due to your health status.
At any level of care, you will always have access to the professional health services available, such as an onsite pharmacy or dentist.
Commercial services offer assistance in and outside of your home. Home repairs and housekeeping services are available, as well as transportation services to take you to retail and food options within the community.
Other common businesses within a CCRC include a postal office, banks, salons and coffee shops.
Having access to a CCRC;s social community services, like a golf course or art studio, promotes socialization and helps battle loneliness and depression in your golden years. According to the Centers for Disease Control and Prevention, older Americans are more at risk for depression.
While there are roughly 1,900 CCRCs nationwide, not all of them have the exact same community services available. If there is one or several community services you want, contact the CCRC you have in mind to confirm it is available at your desired location.
Levels of a Continuing Care Retirement Community
There are four levels of care within a CCRC — independent, assisted, memory care and skilled nursing care. You can switch between these levels of care within the CCRC.
- Independent Living
- If you live independently, you should not require medical assistance or constant supervision. Most of these seniors enjoy a CCRC for its social events and close-by community services.
- Assisted Living
- Assisted living is the next step from independent living if you can no longer perform household tasks, like cooking and cleaning or if personal care has become difficult. You should not require around-the-clock care, but those in assisted living at a CCRC could benefit from part-time help.
- Memory Care and Skilled Nursing Care
- Memory care and skilled nursing care are similar. Both typically require 24-hour surveillance and skilled medical assistance. However, memory care is specialized for those with memory issues like dementia or Alzheimer’s. If you choose to live at a CCRC, you can lock in a fixed monthly fee and have every level of care available.
Understanding CCRC Contracts
There are three types of standard CCRC contracts, classified as Type A, B and C. The contract you choose will determine the fees for enrollment, as well as the services and treatment you will receive at the CCRC.
- Type A
- Also known as an extensive life-care contract, Type A has the highest fees but offers the widest range of services at little-to-no cost. This means your assisted living costs, medical treatment and skilled nursing care could be free with contract Type A. If you are at high risk to require costly services, you could benefit from this option.
- Type B
- Also known as a modified contract, Type B offers limited services compared to Type A. If you require services not included in this contract, you will have higher monthly fees.
- Type C
- Also known as a fee-for-service contract, Type C has a low enrollment fee, and you only need to pay for the specific services you require. This includes assisted living, skilled nursing or memory care. Meaning, if you do not need any of these services, you do not need to pay for them at all.
Some, but not all CCRCs, will offer contracts Type D and E. Type D is a rental contract, and Type E is an equity agreement to purchase a share of your unit instead of an entry fee.
With every CCRC contract, you’re likely to pay a large sum of money. It’s best to run your contract by a lawyer before signing.
What to Consider When Choosing a CCRC
When selecting a CCRC, there are several factors to consider, such as costs, quality of care and services provided.
- Most older Americans turn to Medicare and Medicaid when considering health care costs. It’s important to note that Medicare and Medicaid don’t cover independent living at a CCRC.
Medicaid is known to pay for assisted living and nursing services under certain circumstances, However, Medicaid is for those with low income. If you can afford the monthly cost of living at a CCRC, you likely don’t qualify for Medicaid coverage.
You should also consider the cost of the entrance fee, which is $200,000 to $500,000 on average. If you don’t have a home or asset to sell, paying for the entrance fee could be difficult.
- Quality of Care
- Before signing the contract of your choice and moving into a CCRC, you should tour the CCRC and try to speak to current or past residents. There, you can learn the quality of care that is received.
If you are unable to visit the CCRC in person, compare online reviews instead.
You can also check your state consumer and regulatory affairs department to see if complaints have been made. Moving to a CCRC is a big financial step to a secure retirement. Ensuring sure you’re receiving a high quality of care should be priority.
- Services Provided
- If you have your heart set on living in a community with golf course access, a beauty salon nearby or a pool, confirm with the CCRC before making any assumptions. Not every CCRC has the same services available for leisure activities.
All CCRCs should have access to the same medical facilities and treatments, but it doesn’t hurt to confirm this information as well.
If you’ve considered all these factors and found it to be a good fit, the government affiliated Eldercare locater can help you find a CCRC near you.
Frequently Asked Questions About CCRCs
8 Cited Research Articles
- Howley, E. (2022, March 2). What’s the Best Age to Move Into a CCRC? Retrieved from https://health.usnews.com/wellness/articles/whats-the-best-age-to-move-into-a-ccrc#:~:text=Actuarial%20consulting%20firm%20Milliman%20reports,80%20to%2085%20years%20old
- American Association of Retired Persons. (2022 January 27). How Continuing Care Retirement Communities Work. Retrieved from https://www.aarp.org/caregiving/basics/info-2017/continuing-care-retirement-communities.html
- Peck, L. (2021, May 21). CCRC Care Segment Performance Trended Lower But Better Than Non-CCRCs in 1Q 2021. Retrieved from https://blog.nic.org/ccrc-care-segment-performance-trended-lower-but-better-than-non-ccrcs-in-1q-2021
- Centers for Disease Control and Prevention. (2021, January 6). Depression Is Not a Normal Part of Growing Older. Retrieved from https://www.cdc.gov/aging/depression/index.html
- Department of Health & Human Services. (2020, February 18). How Much Care Will You Need? Retrieved from https://acl.gov/ltc/basic-needs/how-much-care-will-you-need
- Florida Institute of Certified Public Accountants. (2011, November 3). Deducting Future Medical Expenses for Seniors…Now. Retrieved from https://www.ficpa.org/publication/deducting-future-medical-expenses-seniorsnow
- Colliton, J. (2010, July 6). What Happens With a CCRC When You Run Out of Money. Retrieved from https://collitonlaw.com/what-happens-with-a-ccrc-when-you-run-out-of-money/
- Eldercare Locator. (n.d.). Find Help in Your Community by Entering Your Zip Code or City and State. Retrieved from https://eldercare.acl.gov/Public/Index.aspx