Continuing care facilities or what is also known as continuing care retirement communities, CCRCs for short, provide the residents with the lifetime care that they need. They also assure that the care that the recipient receives is provided in the best way possible which also includes nursing assistance, especially when this is needed. This kind of living arrangement can also be useful specifically to couples who are financially stable and in need of different kinds of care and prefer to maintain their togetherness, even if the usual CCRC resident is a financially and physically independent, highly educated, single 80-year-old female.
Although the CCRCs have already gained a negative reputation during the 1980s due to some closed financial difficulty, the total number of the CCRCs available in the US has reached a high of 1,200 and it even continues to increase every year. There are around 350,000 residents residing in the not-for-profit as well as the for-profit facilities This number is predicted to increase because more and more people are expected to qualify and meet the requirements that are set for the CCRCs. The entrance restrictions do specify a specific minimum age, along with a certain statute of finances and health. CCRCs also look for the candidate who:
- Has an annual earning of 1.5 to 2 times the monthly fee that they usually charge.
- Will not cost more financially in their contributions especially when they become a resident.
Entrance lists for the qualified beneficiaries are for years and sometimes months. These are long-term residents in the facilities, therefore, it is suggested that individuals begin looking at care facilities that are long term and continue especially for their loved ones.
Levels of Continuing Care
Most of the CCRCs offer three different levels of continuing care: these are the ILUs or the independent living units, the skilled nursing care and assisted living. There are cases wherein the individual progresses through all these levels of care. For example, they require little care at the beginning and then as the days progress, they require more and more attention. There are also cases when the residents need additional care for a certain period and then they return to assisted or independent living over time.
- At the beginning of these levels, especially the independent living units, the resident can choose to reside in his or her own place or residential unit. There are occupancy units that are for married individuals. The majority of this kind of care is for single individuals so they come in the form of single units like a studio apartment, a one-bedroom. For the residents who are married, two-bedroom and larger units are also offered. During their stay, the residential services that the patient can acquire include laundry services, meals, and housekeeping. There’s the acute treatment through physical therapy and skilled nursing and the professionals nearby are there to assist them with their personal needs when needed. Most facilities include gardening areas, recreational facilities, swimming pools, walking trails, tennis courts, golf courses and craft rooms which must be taken advantage of especially when residents will stay there for the long run.
- The assisted living is also a kind of intermediate level of care for residents that prefer to experience the balance between skilled nursing care along with independent living. It is during this period when residents who have been diagnosed with chronic illnesses and require assistance are attended medically and assisted in their personal tasks such as dressing, eating, and bathing.
- Finally, the skilled nursing care set-up is offered in most CCRCs through short-term and long-term rehabilitative services and nursing care. These mentioned services are offered on the site and there are some facilities that are near these nursing homes, just in case they do not have this specific kind within the vicinity.
Under almost every circumstance mentioned, the individual that is a resident must reasonably independent and also healthy in order to be admitted to continuing care facilities. The levels of care that the resident requires are assessed initially and there is a process that must be explained in the contract. Usually, a group assesses the individual and also checks in with the family members and medical advisers of the individual. The residents are also re-assessed regularly – especially when their circumstances require them to change their level of continuing care over a period of time.
Here are some services that continuing care facilities:
- Educational programs
- Gardening space
- Laundry services
- On-site health care and nursing
- Personal conveniences such as banks, haircutters, and library)
- Security Systems
- Processing of Medicare as well as insurance reimbursement forms
- Organized social and recreational activities
- Meal services
- Exercise classes
- Craft and woodworking activities
Fees and Payment of Continuing Care Services
The activities mentioned in the previous part of this article are the reasons why there are continuing care facilities that are more expensive than the rest. All fees indicated must be detailed and clear even if it is just the initial contract for an individual who will be residing in the facility. Before the individual or a loved one, on behalf of the future resident, signs the contract, he or she should seek the advice of his or her financial advisor to check the finances so that it is possible to meet all the terms as stated in the contract through the years since this is a continuing care facility. Additionally, financial advisors should check the finances of the continuing care facilities as well in order to decide whether it is a practical financial investment to make in the future.
There are three kinds of payments that exist for continuing care facilities. This also includes the plan with the monthly and entry fee as well as a plan with the rental fee and the plan that is based on the equity of the
- The monthly and entry fee plans are widely used the most. It is under this coverage that the resident is required to pay an expensive entry fee upfront and most of the time, this is non-refundable. If it is, then it is refundable but it decreases over time. It can also be partially refundable or completely refundable. The policies that concern most residents are the initial fee for entry because it really varies between the different continuing care facilities out there. It is strongly advised that individuals check the contract so that they can go for the specific facility that they feel worth paying for. On average, the entrance fees for these CCRCs range from $60,000 to as much as $120,000. Therefore, the monthly fees can be as much as $1,000 to $1,6000 and these are also charged in order to cover the expenses that are associated with the units that the residents live in, the assistance services and the medical care.
- Rental plans as stated on the contract resort to the monthly fee that comes in the form of the rental to cover the services as well as the housing that the residents receive. There are times when health care is not included in these services so it is better to check carefully especially when looking at the said plans.
- The equity-based plans allow individuals to buy their own residential areas. When they do this, the individuals can gain money all for their appreciation of the resident that they are living in. They can also resell the unit when they are deemed qualified to do so. When this is the case, then the owner’s association is the institution that governs the health care and the residential services, which the residents can purchase aside from the living area that they already are in.
No matter what kind of payment plan that the residents opted for the costs actually vary depending on the age, marital status, gender and location of the facility. Individuals must expect their loved one to pay even more than the average rate if he or she is:
- Young and secure on the financial aspect and capable of consistently paying the monthly rate for a long period of time.
- Female because it is believed that they live longer
- Married because there is a higher possibility that the spouse will eventually become ill and both of them will move to a smaller unit, therefore increase the turnover in the residential area of the resident.
- Looking for units in the West, South, Northeast regions of the United States.
Individuals are also greatly encouraged to have their lawyers review the contract of the CCRCs before signing this. The document because it is a contract legally binds the resident to the CCRCs for the remainder of his or her life.
The payment contracts of continuing care facilities are prepared in one of these three ways:
- These are contracts that are quite comprehensive and completely cover the residential services, long-term nursing care, amenities and shelter and not increase the monthly payments that the resident has already signed up for. There is an excepti0on though and that is for the inflation adjustments if the situation calls for it. The set-up of this kind of contract spreads the risk in health on the residents in order for no resident would experience any form of financial ruin. A majority of the CCRCs offer this kind of agreement.
The modified contract covers the residential services, shelter, and amenities of a specific amount of nursing care. After the period when the stated kind of nursing care has been utilized, then the resident pays for the required services on a monthly or even a daily basis.
The fee-for-service kind of contract covers residential services, shelter, and amenities, as well as short-term nursing care and emergencies. Residents must then pay these fees in the long run but at a number of daily rates.
The overall fees for each kind of contract decrease for every kind of service provided and it decreases as well. It is very crucial to note the resident that a number of CCRCs are also participants of Medicaid and Medicare and sometimes even both of these programs.
Finding the Right Continuing Care Facility
Since no federal regulations for the CCRCs get in the way, it is possible for everyone to look for their local or state guidelines. It is also crucial that they check which facilities are accredited by the CCAC or what is called the Continuing Care Accreditation Commission. This is an accrediting body that is independent and is also sponsored by what is called the Association for the Home and Services of Aging Individuals. The accreditation of the CCAC is required to submit all the financial statements that were incurred yearly and must also be renewed every fifth year of the resident in that said facility.
The same with all the residential communities, the loved ones should also sign the continuing care community facility once they have already checked the facilities. When interviewing prospective facilities, it is very important to have a long list of questions to ask. Here are examples of questions that can be asked especially when a loved one is investing in continuing care. These questions must be asked along with the basic questions regarding the facility.
- Is it accredited by CCAC?
- What kinds of recreational activities can residents engage in? How often are the activities conducted?
- Can the residents have pets?
- How much is the upfront entry fee? Is it refundable?
- How do you calculate the monthly fees?
- What kind of health care do you provide to the residents when they are in your facility? How often are the residents reassessed?
- Do you provide long term or short-term health care?
- Are there limits on the fees?
- Will there be changes in the monthly rates? If so, why?
Once the individual has found the right facility for their loved ones and these fit the needs that they require then it is a good investment to let their beloved elderly stay there and be assured that the latter will be taken care of and looked after in the best way possible.