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 healthcare services, physical support or memory care — the transition can feel overwhelming. Thankfully, there are resources, like Continuing Care Retirement Communities, created with our shifting needs in mind.
“A Continuing Care Retirement Community is a living option for seniors that 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 aging adults can transition between different levels of care without needing to move to a completely new facility.
Continuing Care Retirement Communities offer a number of benefits, but the amenities and services also come with a high price tag. Read on to learn more about what continuing care communities are, the common services they offer and what you should know when deciding if they’re right for you or a loved one.
What is a Continuing Care Retirement Community (CCRC)?
“CCRCs work by offering different levels of care in the same community, often in separate buildings,” says Norman. “For example, a resident may start in independent living, then transition to assisted living and later move to long-term care if needed, all within the same community.”
There are approximately 2,000 Continuing Care Retirement Communities in the United States, according to a report by Newsweek. As the population ages, that number will continue to grow. CCRCs provide a continuum of care within a single community. This model allows seniors to transition smoothly between different levels of care as their needs evolve.
“A resident may start in independent living, then transition to assisted living and later move to long-term care if needed, all within the same community.”
— Christopher Norman, geriatric nurse practitioner with the National Council on Aging
Continuing Care Retirement Communities are designed with care transitions in mind, and they aim to reduce the stress of adapting to new circumstances by providing comprehensive support and care. However, they are not always well-known, and many people are unaware of how these communities can assist on this journey. Additionally, they are an expensive care option and 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 perk of CCRCs is in their purpose: “To guarantee that senior citizens won’t have to move or look for another place to live if their healthcare and medical requirements change.” This includes:
- 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 benefits of CCRCs
There are many benefits to living at a CCRC. One of the most 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 the community. “The availability of socialization opportunities is often a big plus at CCRCs, as a variety of activities and events are frequently offered. 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,” says Norman.
Levels of care offered by Continuing Care Retirement Communities
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: This is an arrangement for seniors who can live independently but may enjoy community services such as dining, housekeeping and recreational activities.
- Assisted living: This is for those who need help with activities of daily living, like bathing, dressing and medication management, while still enjoying community amenities.
- Memory care: This is specialized support for those with cognitive impairments, such as dementia, providing a secure environment tailored to their needs.
- Skilled nursing care: This is in-patient service, occasionally short-term, where patients receive rehabilitation services and medical treatment.
As with most living facilities, the specific amenities offered — and the specific dwelling structures, like houses, townhomes, duplexes and more — vary based on cost, location and related factors. However, CCRCs often offer shared dining spaces for communal meals, activity centers with facilitated events, social engagements and outings.
How does a Continuing Care Retirement Community work?
Here’s what you can expect if you’d like to join a Continuing Care Retirement Community.
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 experts we spoke to recommend that a lawyer or financial advisor review this document prior to signing. 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.
It 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.
Estimated fees and costs
Bowdler notes that new residents join a CCRC by paying an entrance fee. “The services are designed to make your daily life easier, and the amenities encourage you to interact with other residents and be active. You can use the community’s facilities and services, which frequently include housekeeping and exercise centers, by paying the entry fee.” Depending on a variety of factors, entrance fees can range from $100,000 to over $1 million.
“CCRCs are often very expensive to buy into, and even when you’re in, the contracts can be very complex.”
— Christopher Norman
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.
Additionally, with the exception of your personal property, you are a renter of the premises, not an owner, says Norman. “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.”
Care needs and health requirements
Norman mentions that there are additional standards and expectations beyond the fee. “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. “People often must meet physical and cognitive standards (which are determined by state regulations and the facility itself) to be admitted and to stay within a CCRC.”
Questions to ask when considering a CCRC
Find a retirement community.
It’s hard to know what to ask when deciding if a particular CCRC, or any CCRC at all, is right for you or your loved ones. LeadingAge, a national organization representing nonprofit and government providers of aging services, recommends asking the following as you assess CCRCs:
- Are you for-profit or not-for-profit?
- What’s included in the monthly fee?
- How do you help me maintain my freedom and independence?
- What kind of emergency response systems do you have?
- How do you measure your residents’ satisfaction? Can I see your last two surveys?
- Can I remain in independent living when my needs change, and how is aging in place supported?
- 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 information about CCRCs in your area. You can also check out the LeadingAge Aging Services Directory to view additional information by state or ZIP code.
Alternatives to Continuing Care Retirement Communities
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.
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“Aging in place in the comfort of your own home could be a wonderful option if you have the means. 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,” Bowdler says.
Other benefits of aging in place include maintaining a connection to the community you’ve established over the years. “You can also avoid the hefty fees that many senior living facilities impose,” he says.
The bottom line
Continuing Care Retirement Communities can offer a convenient and comprehensive solution for aging individuals, allowing for a smooth transition through different levels of care within the same community. However, they’re not for everyone, based on health needs, financial concerns, family expectations and regional availability. “CCRCs provide more flexibility, but it’s reflected in the price tag,” Norman concludes.
Before committing to a CCRC, it’s important to do your due diligence. Experts suggest writing out your needs and preferences, connecting with a lawyer and seeing if local facilities offer the services you need to support yourself or your loved one. Finding the right living arrangement is crucial to ensuring that aging adults can fully enjoy their lives.
