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The following was substantially taken from two websites: The Rehabilitation Accreditation Commission (www.carf.org) and My Guide to Communities for Seniors (www.myguideforseniors.com). Our admonition is to “look for before you leap” and leap before you are pushed. You do not want your circumstances forcing you into making a decision. You need to move while you are in control of the decision and in full command of your circumstances. This requires that you move before you think you need to move. So start to investigate where you might want to move long before you think you need to so that you become acclimated to the thought of moving. Not only do you need to be in command and control but you need to be at peace with your decision. This requires time.
A GUIDE: The first thing you need to decide is whether or not a Continuing Care Retirement Community (CCRC) is right for you. This requires that you begin now to visit a number of such communities. There is often a waiting list to get into the most desirable locations. The sooner you decide the sooner you can get on this list and the more likely you will be able to move in while you are still active and able to assimilate to your new surroundings. Find out what kinds of services and facilities are typically offered by CCRCs in geographical areas where you might want to move. Then put together a list of services and facilities that are important to you. As you visit CCRCs in the geographical areas of interest to you determine which of the services and facilities offered are important to you and are included for no additional charge plus which ones require additional charges. Inquire as to what kinds of contracts are available to you. The CCRC contract is a legal agreement between you and the community. This agreement generally secures living accommodations and services, including health care services, over the long term. This agreement is only as good as the ability and commitment of the CCRC to live up to it. Many providers of CCRC facilities are private companies who are often unwilling to disclose audited financial information. This is a red flag in my opinion. The most common types of CCRC agreements are:
a. Extensive (Type A) Agreements include 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. b. Modified (Type B) Agreements include housing, residential services, 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 amounts of health care is used, persons served pay either a discounted rate or the full per diem rates for the required health care services. This agreement is not as open-ended with respect to the health care provided as is the Type A Agreement. c. Fee-for-Service (Type C) Agreements includes housing, residential services and amenities for the fees stated in the resident agreement. Access to health care is guaranteed, but it may be required at full fee-for-service rates. d. Rental Agreements allow 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. e. Assisted Living Agreements allow the person served to enter into a skilled nursing agreement at the time needed and they pay the per-diem or market rates for the assisted living services. f. Skilled Nursing Agreements allow the person served to enter into a skilled nursing agreement and they pay the per-diem or market rates for the skilled nursing services.
g. Equity Agreements involve the actual purchase of real estate or membership. They often include condominiums and cooperatives.
4. Determine which of these fee structures and contract options are best for you.
5. Find out if the CCRC is subject to licensure. If so, ask to see the most recent inspection reports.
6. Find out if the CCRC is accredited by CARF-CCAC, the only accrediting body for CCRCs. Again, ask to see the accrediting report.
7. Before signing a contract have it reviewed by your attorney. Have a CPA review the audit financial statements.
To get further information on how to select a CCRC contact the American Association of Homes and Services for the Aging (AAHSA). They offer a booklet entitled The Continuing Care Retirement Community – A Guidebook for Consumers. Call AAHSA Publications at (800) 508 9442 to order (Item #CCOO1). They also have a website at www.aahsa.org where you can find out if your state has an AAHSA affiliate. A CHECKLIST: The following specifics will be important in helping you make a final selection from the various CCRCs that you have visited. GENERAL INFORMATION
Year Founded
Community Owner
Management Company
Management State
Incorporation State
Publicly Traded
Audited Financials Available
Religious Affiliation
Minimum Age for Admission
Average Age of Admission
Average Age of Resident
Accredited/Certified by
Professional Associations
Title of Community Director
Name of Community Director
Title of Primary Contact
Name of Primary Contact
Phone, Primary Contact
Fax, Primary Contact
Email, Primary Contact FEE STRUCTURE
Entry Fee
How is it Paid
Unit Purchase Price
How is it Paid
Monthly Fee for
Independent Living
Assisted Living
Skilled Nursing Bed
Costs for Additional Person
Entry Fee
Unit Purchase Price
Monthly Fees
Number of Meals provided in monthly fee
Availability and Cost of Additional Meals
Special Dietary Services Available
Average annual increase in fees over the past 5 years
Reserves held for Residents.
Refund Policy for Deposits
Refund Policy for Entry Fee or Unit Purchase Price
Portion of All Fees that are Tax Deductible THE COMMUNITY
Total Independent Units
Total Assisted Living Units
Minimum Number of Nursing Beds
Average Wait for Independent Living Residents
Style of Independent Living Residences Available
Resident Demographics
Residents on Board of Directors and/or Committees
Number and Nature of Committees
Number and Nature of Committee Activities
Language(s) Spoken by Staff
Pets Allowed and Replacement
Pet Size Policy ON-SITE HEALTH SERVICES
Services Provided, if needed, in Independent Living Units
Activities of Daily Livings (ADLs)
Staffing
Medical Care Services Provided
Medical Clinic
Physician Services Available
Dental Services Available
Medical costs covered in Contract
Prescription costs covered in Contract
Care transportation covered in Contract
How is it determined if and when you need these services? Can you and family members or trusted friends participate in the decision? SERVICES & AMENITIES
Frequency of Included Housekeeping & Linen Service
Guest Accommodations Available
Meals
Parking
Community Convenient to Local Transportation
Complimentary Transportation provided to
Frequency
Swimming Pool
Lifeguard on Duty
Fitness Center
Staffing & Equipment
Library
Hair Salon & Barber
Convenience Store
Snack Bar/Café
Resident Parking
Number of Vehicles Permitted
RV Parking
Storage Units
Resident Advocate or Ombudsman Available
CHECK IT OUT BY WANDERING AROUND AND SLEEPING OVER: Is the community open to having you wander around on your own to talk to staff and residents? Are you invited to stay for a meal or to even stay the night? Can you bring a trusted friend with you when you walk around, talk to the residents, have a meal or stay over? Here are some things to look for: How do the staff members respond to the residents?
Are the residents treated with dignity?
Do the staff members respect cultural, gender and age differences?
Do the premises appear to be well maintained, clean and safe?
Are the buildings and living units accessible? Are there handrails, elevators, automatic doors and ramps?
Do you get the sense that the provider or operator of the CCRC is concerned about quality and the satisfaction of the residents?
Are the current residents excited to tell about their experiences as residents?
Do you feel at home?
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