More information: Consumer Guide to Understanding Financial Performance and Reporting in Continuing Care Retirement Communities (PDF, 786 KB)

How to select a continuing care retirement community

In recent years, many attractive options for retirement living have emerged. One popular option is the continuing care retirement community, or CCRC. This type of community is different from other housing and care options for older people because it offers a long-term contract that provides for housing, services and nursing care, usually all in one location.

At the same time, CCRCs offer some distinct advantages, including physical and financial security, independence and access to health care, companionship of friends and neighbors of similar age and access to community facilities and privacy. The CCRC's emphasis on the individual, coupled with a supportive environment, allows you to continue to pursue your lifelong interests.

There are many different options in the CCRC industry. Consider the community size when making your decision; do you prefer a large community with many options and services, or something smaller and more individualized? Would you prefer a more "formal" environment, or a you a casual person at heart? There are CCRCs of all types and sizes, and you should find one where you will feel most at home. Use the list below as a starting point for asking questions when visiting or contacting communities.

If you have decided that a CCRC is the best option for yourself or a family member, it is best to visit a few facilities. Here is a checklist of things to keep in mind and questions to ask as you decide what facility is best for you:

• Find out what kinds of services the facility offers and which ones are included at no extra cost. Sometimes, extra services are available for additional fees.
• Inquire as to what kinds of contracts are available to you. The CCRC contract is a legal agreement between you (the consumer) and a continuing care retirement community. This agreement generally secures living accommodations and services, including health care services, over the long term. The most common types of CCRC agreements are:
• Type A (Extensive) Agreement: Includes housing, residential services, amenities and unlimited, specific health-related services with little or no substantial increase in monthly payments, except to cover normal operating costs and inflation adjustments.
• Type B (Modified) Agreement: Includes housing, residential services and amenities and a specific amount of health care with no substantial increase in monthly payments, except to cover normal operating costs and inflation adjustments. After the specified amount of health care is used, persons served pay either a discounted rate or the full per diem rates for required health care services.
• Type C (Fee-for-Service) Agreement: Includes housing, residential services and amenities for the fees stated in the resident agreement. Access to health care services is guaranteed, but it may be required at full fee-for-service rates.
• Rental Agreement: Allows residents the opportunity to rent their housing and provides, but does not guarantee, access to health care services paid on a fee-for-service basis.
• Assisted Living Agreement: Person served enters into an assisted living agreement and pays the per-diem (an agreed upon daily rate) or market rate for assisted living services.
• Skilled Nursing Agreement: Person served enters into a skilled nursing agreement and pays the per-diem (an agreed upon daily rate) or market rate for skilled nursing services.
• Equity Agreement: These types of agreements involve the actual purchase of real estate or membership. Includes condominiums and cooperatives.
• Determine what fee structure and contract option best suits your personal circumstances.
• Find out if the CCRC is subject to licensure. Ask to see the most recent inspection reports.
• Find out what the payment schedule is. Also, find out if the residents own or rent their living space.
• Find out if the CCRC is accredited by CARF-CCAC, the only accrediting body for CCRCs.
• Before signing a contract, have your accountant or lawyer review the contract.

Where can I get further information?

For more information about fee structurs and other financial aspects of CCRCs, please see the Consumer Guide to Understanding Financial Performance and Reporting in Continuing Care Retirement Communities (PDF, 786 KB)

Also, visit the AAHSA web site at www.aahsa.org to see if your state has an AAHSA affiliate. AAHSA-affiliated state organizations operate in many states across the U.S.

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