Considering a Continuing Care Retirement Community? Moving Sooner Rather Than Later May Be the Best Approach
Aging in place may be the stated desire of the vast majority of retirees ( about seven out eight seniors, as we said here last week). Yet while growing old at home is often a good idea, it might not be the best choice for everyone. Healthy seniors who plan carefully have several housing options available to them, one of which – the continuing care retirement community, or CCRC – can offer a good compromise between living independently and enjoying the benefits of living in a group setting.
Moreover, there’s another big attraction, say the proponents of CCRC living: moving into one of these facilities can be the last move you’ll ever need to make. That’s because CCRCs promise various levels of care that increase as your needs change.
CCRCs have been around for years but they don’t get a lot of attention. For a closer look at pros and cons of CCRC living, we turn to this recent article from U.S. News. Reporter Elaine Howley not only discusses whether to consider a CCRC but also at what age. As it turns out, if you’re considering a continuing care retirement community, moving sooner is often the best choice. Let’s take a look.
Seniors Have a Spectrum of Living Options
Most of our readers are no doubt familiar with the various residential options available to seniors as they age, mainly independent living, assisted living, and nursing homes. But less well known, perhaps, is the CCRC, or continuing care retirement community.
UCLA geriatrician Dr. Susan D. Leonard explains CCRCs this way: “Typically, they include a combination of independent living, assisted living and nursing home care levels. This allows seniors to age in one location and transition to a higher care level as their care needs change – such as due to functional or cognitive decline – without having to move away.”
In other words, the main difference between CCRCs and other options is that everything is under one roof. Sue Johansen, senior vice president at Seattle-based A Place For Mom, explains, “Because CCRCs allow seniors to age in place, [without disrupting their living situations or communities,] those seniors are able to develop friendships and communities that remain intact even as the level of care they require changes.”
Living in a CCRC – Another Form of Aging in Place?
Howley writes, “CCRCs operate under the concept of ‘lifecare,’ which is designed to care for seniors from retirement through the end of life. This type of care is also known as aging in place. CCRCs cater to seniors who don’t want to worry about moving or finding new care as they age and the level of care they need increases.”
Johansen adds, “When seniors join a continuing care retirement community, they are usually making a decision to spend the rest of their lives as a part of the community.” This adds an extra layer to the decision to move to a CCRC: where would you like to spend the rest of your life?
CCRC Cost is an Impediment for Many Seniors
CCRCs are not only a long-term commitment; they are also a significant financial investment and can be very expensive. Johanson explains, “CCRCs usually require an up-front investment, known as a ‘buy-in.’ Up-front fees can range from the low six-figures to more than $1 million. These buy-ins do not include the monthly fees that CCRCs charge. However, once a resident has paid their up-front fee, the monthly rates are locked in at a predetermined level, no matter the type of care required.”
While initially expensive, this “locking in” can actually be a wiser financial decision, as nursing facilities can vary in cost over the course of a resident’s time there. Howley notes, “ Genworth Financial’s 2021 Cost of Care Survey notes that skilled nursing in a private room costs $108,405 annually on average.”
What’s the Ideal Age to Move to a CCRC?
The proper age to move to a CCRC can vary (the average age is currently around 80 to 85), but while it’s tempting to wait until you need to make the change, experts say that moving in sooner rather than later can be very beneficial.
“There are clear advantages to moving into a CCRC as a ‘young’ senior. One major one is financial – you are locked into a fixed monthly fee after your buy-in costs, no matter the level of care you might need in the future,” Johansen says.
Howley adds, “The financial specifics vary by community, and your monthly rate will depend on where the facility is located, what the buy-in rate is and many other factors that will be wholly specific to your situation.”
Social Advantages to Retirement Community Living
“Another advantage to joining a CCRC sooner rather than later is the opportunity to form relationships with other community members,” Johansen says. “This helps seniors maintain an active life and limit the sense of isolation that often comes with retirement and aging.” This is especially beneficial for seniors who are widowed, and can help with the grieving process and preventing loneliness.
Since CCRCs are often big, highly social settings, they can be a great fit for any senior who enjoys a community feel and easily accessible social activities.
Also, the CCRC experience is highly customizable, able to be modified over time to adjust to a person’s needs. It removes the uncertainty about where the next stage of care will come from, and the sooner a person adjusts to the setting the more fulfilling their experience can be.
How to Choose the CCRC That’s Right for You
Experts agree: before choosing a CCRC, it’s crucial to do plenty of research and ask as many questions as you can. Visiting different locations is also a good idea, or even asking if a facility will allow a trial weekend or week-long stay. While there, be sure to talk to staff and other residents and ask plenty of questions.
Howley also provides the following list of things you should consider in a CCRC:
- Can you see yourself living here for the rest of your life?
- Do the residents you meet seem like the type of people you’d enjoy living with or around?
- Can you envision being friends with them?
- What sorts of activities are available on the campus and do they sound appealing?
- Can the staff accommodate particular requests or personal preferences?
- What are their licensing and standards requirements?
- Do they have inspection reports available?
- Are there any other outstanding issues or concerns regarding the property or how the business is being run?
Finances and Fine Print: Get the Right Advice!
Once you’ve chosen a CCRC, then the decisions begin, especially the financial ones. Johansen says, “Many seniors opt to pay for their care in a CCRC by selling their home. There might be tax advantages to selling your home the year before you pay the up-front fee. Additionally, you may be able to deduct part of that fee as a pre-paid medical expense.”
While the up-front sticker shock can be tough for some to swallow, it’s important to keep in perspective that the monthly fee is fixed and your rate will not change, something that other senior living options might not necessarily offer.
Also, be aware that Medicare will not cover long-term assisted living or residential care, but it might aid with some health care services that you need while in the facility, such as doctor visits and screenings. Medicare also covers up to 100 days of nursing home costs, if you have to move into that part of the facility for any reason – so long as the facility is Medicare-certified.
Howley writes, “For all other aspects of living there, you’ll be out of pocket, so locking in a rate you know you’ll be able to afford over the long right might be a good idea. In addition, find out exactly what you’re getting for that monthly fee. Ask which services and amenities specifically are included, as these details can also vary widely from community to community.”
Buyer Beware: Ownership Changes Might Alter Your Contract
There is one important caveat to all of this. Johansen explains, “Traditionally, CCRCs were run as nonprofit organizations, though today some CCRCs are run by for-profit institutions.”
Why does this matter? Because “if a CCRC is for-profit, you’ll want to understand how a potential sale of the business would affect the resident and their contract,” Johansen adds. For example, if a CCRC facility is sold, resident contracts could be negated or renegotiated without any input from the resident.
Howley advises, “As with any contract, read the fine print and make sure you understand what you’re agreeing to. You may want to involve an attorney and/or a financial planner in determining whether you’re getting a good deal and to make sure any contract you or a loved one signs is solid.”
She concludes with the further warning, “As with any major purchase, buyer beware and do your homework. Some CCRCs have clauses in their contracts regarding whether or not you can get your money back if you decide it’s not the right fit after all. Some will provide a full refund up to a few months after move in; others have stricter limits. This is why it’s so important to read everything, ask all the questions you have and make sure you understand what’s happening before you sign on the dotted line.”
(originally reported at https://health.usnews.com)