A Retirement Resources Blog for Seniors and Retirees – HOME

I read an article recently written by a Community Relations Director about how to select a Continuing Care Retirement Community (CCRC). What was so interesting about this article was that the author works for a company that does not offer the critical skilled nursing component of the continuum, yet she gives advice about choosing one that does. 
There is a growing trend for free-standing assisted living communities to self identify as a CCRC. They typically have “independent living” as well as assisted living apartments and offer a continuum through the “ability to arrange for skilled care.” Recently, the term Continuing Care Retirement Community is used more often by facilities that only promise to arrange for care services. Traditionally, consumers knew this type of community to offer a full spectrum of care – residential homes, assisted living and skilled nursing. They choose a CCRC because they want the security of knowing who will provide skilled nursing and rehabilitative care if and when they need it. The lines are getting blurred and consumers are the ones at risk of being confused.    

Anyone can arrange for skilled care; from hospital discharge planners to family members. The reality is that for families burdened with the task of looking for skilled nursing, it is overwhelmingly difficult to find and secure placement in a facility that has a reputation for high quality care in a pleasant environment. Many feel lost in a foreign world, not knowing if they are choosing the best for their loved one. These newly self-identified CCRCs offer only to help arrange for care from an outside provider. Residents and family members still have to advocate for their loved one and bear the burden of researching different providers to make sure they have the best care available.

When older adults choose to live in a “traditional” CCRC, they often choose the community because of its reputation for quality care and guaranteed access to the skilled nursing services. They do this so that they can make their own choice in where they want to receive care and to relieve the burden on their families of having to make a choice during a health crisis. Knowing where they will receive care if and when they need it provides a sense of security for residents of CCRCs.

The National Investment Center conducts research on senior housing and care providers, both for-profit and not-for-profit.  They define a CCRC as a community that offers both independent housing and skilled nursing on the same property. Some newer communities in the Seattle market are asking for entrance fees well over $100,000.00 but are not planning to offer a skilled nursing component and are relying on existing nursing homes to care for their residents in the future. Consumers should look at other options that include the full continuum, especially when they are paying such high entrance fees.

Here are some tips on choosing a Continuing Care Retirement Community:

1. Decide which type of community makes you most comfortable
   1. Life Care Community (Type A): This contract offers the same rate throughout the continuum. You will pay the same if you are in skilled nursing as you did in your residential accommodation. Typically, this requires a higher rate at entry and monthly fee as you are pre-paying for some of the care you may need later on.

   2. Modified Contract (Type B): This contract gives you a discounted rate when you need Assisted Living or Skilled Nursing. Some contracts provide a limited number of free days in skilled nursing under this contract.

   3. Fee For Service Contract (Type C): Under a fee for service contract, you pay as you go. This may provide you with more flexibility in how you receive and pay for care, i.e. hiring a home health agency to bring care to you.

2. Look for a faith based or mission driven organization. Such not-for-profits reinvest their resources into services and programs for their communities and often have a longer average residency.

3. Tour all areas of the community including Assisted Living and Skilled Nursing so you can see for yourself the quality of care you will receive if you need that care.

4. Ask about home health options. Does the community have an affiliate agency that provides home health? Does the community have any restrictions on private caregivers?

5. Find out how the community handles transitions through the continuum. Is there a social worker to help you and your family make a transition when necessary? Is there a wait for a higher level of care?

6. If the community does not have its own Skilled Nursing facility, how does it choose the facilities it refers? Is there a financial reward for referrals? How much involvement does the community continue to have with the resident after he or she is moved to Skilled Nursing?

When looking for a CCRC, be informed about the differences. For more information visit the American Association of Homes and Services for the Aging at www.AAHSA.org or your local not-for-profit CCRC.

This entry was posted on Tuesday, March 4th, 2008 at 11:05 am and is filed under General Info. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.