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What is a Continuing Care Retirement Community

Know the Difference and Decide What’s Right for You


What is a Continuing Care Retirement Community
Peter Dazeley, Getty Images

If you are new to aging services and are considering a career that involves caring for elders in a home-like environment, you need to know the differences between a Continuing Care Retirement Community (CCRC), an Assisted Living Facility (AL), and a Skilled Nursing Facility or Nursing Home (SNF). Let’s plow in.

What is a CCRC?

CCRC stands for Continuing Care Retirement Community. The key words here are continuing care. This type of community typically has independent living, assisted living and skilled nursing all on one campus. Residents move as needed from one level of care to the next in a seamless continuum of services.

Social programs, meals, activities, fitness facilities, pool, library, computer center, housekeeping and laundry services are usually provided.

Who Pays?

With the exception of Medicare or Medicaid reimbursed services, typically in the skilled nursing and skilled home health areas, the resident enters into a contract with the CCRC. According to Leading Age, there are four types of CCRC’s each with different entrance fees requirements and monthly fee amounts.

  • Extensive Contract: A resident pays an upfront entrance fee and an ongoing monthly fee for the right to live in an independent apartment and also receives certain services and amenities. Residents who require assistance or health care may receive some services in their apartment or they may move to an assisted living or skilled nursing portion of the community, but they pay essentially the same monthly fee.
  • Modified Contract: A resident pays an entrance fee and an ongoing monthly fee for the right to live in an apartment. However, the CCRC is obligated to provide an appropriate level of assisted living or skilled nursing for a specific period of time or at a discounted rate for a stated period of time or indefinitely.
  • Fee for Service: This also requires an entrance and a monthly fee, but the fees to not include any free or discounted health care or assisted living services.
  • Rental: Some communities that have independent apartments and offer certain assisted living or nursing services will use the title of a CCRC. The resident pays the prevailing rate for all services offered.

A Lifecare Retirement Community is a type of CCRC where residents typically pay a little more but are guaranteed lifetime care even if their finances are exhausted.

To many, if they can afford it, a CCRC is the best of all worlds offering independence and privacy of living, opportunities for socialization, active lifestyles with the security of health services nearby.

What is an Assisted Living Facility?

Assisted living is a senior living option that combines housing, support services and health care, as needed. Assisted living is designed for individuals who require assistance with what are called activities of daily living (ADL). These include:

  • Personal hygiene and grooming
  • Dressing and undressing
  • Feeding
  • Functional transfers
  • Voluntarily controlling urinary and fecal discharge
  • Elimination
  • Walking/Ambulation

Assisted living facilities typically do not care for those needing continuous nursing care; however, you may find such residents in these facilities. Typically they started living there needing the basic ADL assistance. Facilities and residents alike often do not want to part company even as the resident’s condition worsens. It is not uncommon to find advanced dementia and Alzheimer’s residents in assisted living facilities.

Who Pays?

The resident pays typically on a month-to-month lease. The basic rate may cover all services or there may be additional charges for special services. Some states offer "home and community-based waivers" that allow low-income residents to live in assisted living. Long-term care insurance will also pay though relatively few people choose to purchase it.

There are 36,000+ assisted living communities nationwide serving more than one million seniors and they are regulated in all 50 states. All settings offer 24-hour care and supervision for those who need assistance.

Assisted living communities provide many of the services as the CCRC – meals, housekeeping, transportation, security, exercise and wellness programs, laundry, social and recreational services.

Many assisted living facilities are built in proximity to hospitals so that there is quick access to health and medical services. They may offer emergency call systems, medication management and other health and safety options.

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