Continuing Care Retirement Communities: Your 2024 Guide

Continuing Care Retirement Communities (sometimes referred to as a CCRC or a Life Plan community) have become an increasingly popular option for older adults seeking a dynamic living environment that caters to their diverse needs as they navigate the different stages of aging.

From independent living solutions to a full spectrum of assisted living and healthcare services, these communities offer an integrated approach to senior living, allowing older adults to stay in the same place on one campus throughout their aging experience - all while ensuring peace of mind for residents and their families.

A CCRC or life plan community typically combines support for independent living, assisted living, memory care, and 24/7 skilled nursing facility care into one property, providing seniors with the ability to live independently and to age in place.

Joining a CCRC and living independently as an active adult makes it easier for aging adults to obtain long-term care services. It is possible and common for older adults to become a resident of a CCRC senior living community as an independent, active adult and then receive more personal care as they need it.

As your needs change, you have the option to move on to assisted living or to an on-site skilled nursing facility if you require a higher level of care. This continuum of care ensures that you remain a part of the same community even if you require personal care, something that many seniors find very important.

While the primary objective of Continuing Care Retirement Communities (CCRCs) is to provide a continuum of care, it is common to find communities that incorporate specific themes, lifestyle preferences, or environments to cater to seniors with varied interests. Some models of CCRCs may include:

• Lifestyle-Themed Communities: These CCRCs can focus on promoting a particular lifestyle or cater to seniors with specific interests, such as golf, equestrian activities, health and wellness, or arts and culture.
  • Check out Village at Proprietors Green to see how arts are integrated into every program
• Faith-Based Communities: Many CCRCs are affiliated with religious organizations, offering seniors the opportunity to live in a community that shares and supports their faith, values, and traditions.
  • See Newbridge on the Charles, operated by Hebrew Senior Life for best in class faith-based senior living (that also leverages a strong partnership with Harvard University.)
• University-Based Communities: These CCRCs are located near or partnered with colleges or universities, providing seniors with access to educational programs, lifelong learning opportunities, and cultural events.
  • Browse Mirabella at ASU in Tempe, AZ for a stunning example of university integration!
• Green/Sustainable Communities: Some CCRCs emphasize eco-friendly living, with energy-efficient buildings and environmentally-conscious practices, appealing to seniors who prioritize sustainability.
  • Take a look at Essex Meadows in Essex, CT to see how sustainability is integrated into senior programming.
• Luxury/High-End Communities: These communities offer upscale accommodations, premium amenities, and personalized services catered to seniors who seek a refined living experience during their retirement. From myriad dining options to in-house spa treatments, these are often hotel-like environments.
  • White Sands at La Jolla is widely known as one of the premier luxury CCRCs in the country.

Most CCRCs have different buildings spread out in a small complex, similar to a gated community. These buildings will usually be a combination of shared facilities (pools, chapels/sanctuaries, dining rooms, and other amenities), individual homes or apartment buildings, and larger buildings to house the memory care, skilled nursing care, and assisted living units.

The individual homes available to potential residents in the independent living section of the community might take the form of townhomes, cottages, or studio, one- or two-bedroom apartments. Of course, a CCRC in an urban area might build "up" instead of "out" and have different levels of health care services and amenities on different levels of a high rise. 

As we mentioned above, some continuing care retirement communities might cater to particular groups of people. For example, you might find Spanish-speaking CCRCs, a Jewish CCRCs that offer kosher meals, or a CCRC that caters to members of the LGTBQ+ community.

CCRCs might provide transportation and housekeeping services, even to those residents still enjoying the independent side of the complex (though as we explain below, that might cost extra). Activities from exercise classes to speed dating and movie nights can include everyone from different parts of the community. 

Moreover, continuing care retirement communities often make it simple for couples or family members to stay close to each other even if one needs more care than the other. For example, a husband who needs memory care can be just steps away from his wife who lives in the independent or assisted living section of the community. 

Since continuing care retirement communities are designed for active seniors, they generally provide a variety of recreational and social opportunities. These activities and events vary, but they can include book clubs, continuing education classes, movies, sports, fitness clubs, holiday celebrations, and more. Here are some of the most common luxury-style amenities at CCRCs:

• Concierge Services: Personalized assistance for various needs such as event planning, travel arrangements, or errands to ensure a hassle-free and luxurious lifestyle for residents.
• Spa Facilities: On-site spa and wellness center, offering services such as massages, facials, and other rejuvenating treatments for relaxation and pampering.
• Fine Dining and Gourmet Restaurants: High-quality, on-site dining options featuring gourmet cuisine, chef's table experiences, and upscale bars or lounges for socializing.
• Resort-Style Swimming Pools: Expansive, heated pools with features like infinity edges or beach entries, accompanied by comfortable lounge areas, cabanas, or poolside services.
• Golf Courses and Tennis Courts: Premium sports facilities, such as well-maintained golf courses or professional-grade tennis courts, offering residents exclusive access to high-end recreational options.
• State-of-the-Art Fitness and Wellness Centers: Advanced fitness facilities featuring the latest in exercise equipment, personal training services, and a diverse range of specialized wellness classes, such as yoga or Pilates, for personalized fitness regimens.
• Art Studios and Cultural Programs: Access to art studios, galleries, or entertainment venues, as well as regularly scheduled workshops, classes, or cultural events, cateringHow much does a CCRC cost?

To lay it on the line: a continuing-care retirement community is the most expensive long-term-care option available. Living in a CCRC generally requires an entrance fee for service contract and monthly charges for residents, though some of the newer life plan communities are eschewing that up-front deposit. Entrance service fees can range between $100,000 and $1 million, while monthly rent can range between $3,000 and $5,000.

Many residents pay for CCRC an upfront fee for entrance. In some cases, they prepay for care and provide money to the facilities to support their operations. In other cases, they choose to forgo "locking in" future pricing for higher acuity care and agree to pay the future market rate.

In short, the world of CCRC pricing is highly faceted and it's so important to make sure you understand which costs are fixed and which are variable over time. It's also important to understand if your CCRC of interest guarantees memory care or assisted living rooms as your care needs change, or if you are placed on a waiting list for access. Depending on your priorities, these may be trade-offs you make between security and price.

About monthly fees for CCRCs

Here are a few things to consider when comparing fees for CCRCs or life plan communities:

• Scope of services covered: The monthly fee for CCRCs typically cover a broad range of services such as housing, utilities, maintenance, meals, access to amenities, and various social and educational activities. As residents transition through the different care levels, the monthly fee might also include additional services like personal care, nursing, care or rehabilitation.
• Fee structure and adjustment: CCRC fees are often based on the type of residence, care level, and the specific contract chosen. The monthly fee might increase periodically due to inflation, operational costs, or when residents require a higher level of care, such as a move to a skilled nursing facility wing. It's crucial to review the contract details and understand how and when the fees may change. Ask for a schedule of rate increases for each level of care, and be sure to enquire as to whether or not there are annual caps on increases.

About entrance fees for CCRCs

• Purpose of the entrance fee: The entrance fee, often called a buy-in fee, is an upfront payment made to secure a residence and contractual access to the continuum of care provided in the community. This fee typically goes towards community development, capital improvements, and in some cases, acts as a prepayment for future healthcare services.
• Varying cost: The cost of the entrance fee can vary significantly depending on factors such as the type of residence, care level, location of the community, and the specific contract chosen.This fee can range from tens of thousands to several hundred thousand dollars. It's essential to review the financial requirements of each community and compare them to your budget and needs.
• Refundability: Many CCRCs offer different contract options with varying refund policies for the entrance fee. Some contracts provide a only a portion of the deposit in return, depending on the length of stay or if the resident decides to leave the community. Other contracts may have non-refundable fees or amortize the refund over a specific period.

When evaluating a CCRC, it's vital to fully understand the fee structure, the scope of services included in the monthly fees.

About additional fees for CCRCs

Often a CCRC resident will pay additional fees for other services, such as meal services, transportation, housekeeping, and social activities. Several different types of fee-for-service contracts are used for CCRC residents. It’s always important to review the CCRC contract carefully and get legal advice before signing. In addition, you can always consult with your financial advisor to create a budget that works best for you.

Finally, if you are considering a high-end or luxury CCRC, it would be important to understand the planned maintenance and refurbishment schedule. Since so many of these communities rely on high-end finishes and modern design, you'll want to make sure the community has considered the financial implications of maintaining the look and feel that attracted you to the community in the first place.

In most cases, residents fund the move from their home to a CCRC by selling their home and through the use of investments and retirement accounts. Applicants are generally required to prove that they have the means to meet entrance fees and monthly fees before they move into the community.

Medicaid and Medicare cannot be used to fund life care contracts in a CCRC. However, Medicare, and in some cases Medicaid, may be used to help fund the cost of life care contract-specific services according to the U.S. Department of Health & Human Services.

How do CCRC costs compare to home care costs?

With home care, services can vary based on unique needs. These may include medical care, medication monitoring, help with self-care, meal delivery, medication management, housekeeping, transportation, companionship, and minor health care services. However, once more advanced medical treatment or care is needed, other options may need to be considered.

Both CCRCs and home care make it possible for seniors to enjoy aging in place. The cost per hour for home care can range between $14 - $40 per hour: multiply this by how much help you might need every day and compare it to the CCRC costs we outline in the next section.

Because continuing care retirement communities offer various levels of care in a single community in one location, it’s possible for these communities to meet your needs over time, even as they change. 

Many older adults find that they don’t want to leave their established home within a CCRC when their care needs change. Instead of residents moving to a different area of campus for memory care or for assisted living, many senior residents choose to go with private in-home care.

As many CCRCs begin to recognize this trend among aging adults, they are offering residents the choice to enter different levels of care instead of only allowing residents to enter first as part of the independent living community. For this reason, it’s essential to find out what every CCRC requires for entry. Additionally, it might be helpful to understand the scope of care you're looking for before entering a CCRC. skilledIndependent living in a CCRC

Independent Living in a CCRC

Most residents begin their stay at a CCRC when they are still independent, active adults. Residents have freedom and apartment-style accommodations with a variety of residential services and financial resources available to make life easier. In many cases, independent living offers fitness classes, desirable amenities, and likeminded community living.

Assisted living communities in a CCRC

Many continuing care retirement communities offer assisted living services, which may include memory care if needed, as a step between independent living and skilled nursing care. Residents enjoy having the assistance they need with activities of daily living without 24/7 nursing.

Skilled nursing facility in a CCRC

Both short-term and long-term skilled nursing care may be offered at a CCRC, including round-the-clock nursing home call services, medical care, or rehabilitative care. In some cases, a move to this type of care may only be temporary. Skilled nursing facilities are an excellent option for those looking for specialized care.

Generally, there might not be any “signs.” To make the most of a CCRC and your investment in it, you should make the move while you’re still healthy and active and can enjoy the social life that independent living can offer.

Perhaps you know that you’re ready to let go of home maintenance like lawn care and snow removal. Maybe you’re already aware of hereditary or diagnosed medical conditions that might make everyday life a little bit harder for you as you age.

If you’re thinking of the future and want to minimize changes that will come down the line, it might be time to consider a CCRC.

Peace of mind

If you value security and you want to have peace of mind knowing that your changing medical needs will be met now and in the future, then a CCRC may be the right move for you. This option is a great choice for active adults that want to enjoy having a sense of community, nearby friends, and plenty of activities to enjoy. 

If you think a continuing care retirement community is a good option for you or your loved one, begin comparing communities

The earlier you begin considering a CCRC the better. These communities are designed for seniors who are healthy and active enough to live independent, full lives. Most CCRCs offer premium recreational activities and amenities tailored to the desires of active seniors. Since these communities make it possible to move seamlessly from one kind of care to the next, it’s a flexible, comprehensive type of senior care that is a perfect option for seniors who want to enjoy their golden years without worrying about big moves or home and grounds maintenance in the future.