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Old 02-12-2021, 08:44 PM   #161
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I can't speak for all CCRC's, but all the Type A CCRCs we shopped had provisions that if the CCRC's SNF beds were occupied, the CCRC would find comparable care in the community (still at no change in cost to a resident). Our property is, in fact, restricted from accepting any non-resident to our SNF/Asst Living after our official start-up periods ends. Any resident in an off-site property would be returned to the home property at first vacancy.
It is definitely an issue to understand well when shopping a CCRC.
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Old 02-12-2021, 09:23 PM   #162
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Originally Posted by nwsteve View Post
I can't speak for all CCRC's, but all the Type A CCRCs we shopped had provisions that if the CCRC's SNF beds were occupied, the CCRC would find comparable care in the community (still at no change in cost to a resident). Our property is, in fact, restricted from accepting any non-resident to our SNF/Asst Living after our official start-up periods ends. Any resident in an off-site property would be returned to the home property at first vacancy.
It is definitely an issue to understand well when shopping a CCRC.
It's something you have limited control over in light of changing circumstances and demographics at a CCRC. Since we're still in the hunt for a CCRC back-up plan (even though we're on the waitlist for one), we study the CCRCs in our area to see current SNF capacity and expansion plans. One of the draws to us in a CCRC is the campus life care trappings afforded to residents, especially if one of us goes has to go into skilled nursing care. It is of incalculable value to us to remain together on one campus to visit each other if one of us winds up in skilled nursing care -- thus, it would be quite distressing if a SNF bed was not available to us on the CCRC campus, especially if the "comparable facility" was not located within a 5 mile drive from the CCRC. We place a very high premium on getting the SNF bed in the CCRC facility in which we would purchase a residence.

The CCRC we've waitlisted currently has 60 beds in it's SNF wing, which is now at full occupancy. It plans on expanding capacity and had developed construction plans to accomodate future needs. CCRCs have to carefully plan for potential demand.
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Old 02-12-2021, 11:03 PM   #163
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The CCRC we've waitlisted currently has 60 beds in it's SNF wing, which is now at full occupancy. It plans on expanding capacity and had developed construction plans to accomodate future needs. CCRCs have to carefully plan for potential demand.
While still no guarantee, in your example, I would ask for a couple pieces of data:
1. the name of the facilit(ies), the CCRC is currently sending their overflow. I would then research those properties and their State's inspection ratings. This exercise should give an idea of how the management protects their residents.
2. For all residents who were moved off campus, how long before they returned to home campus.
3. Look at age demographics of current residents and ask for recent trends of residents entering asst living and/or their SNF.
4. Determine if building permits have been actually issued for their SNF expansion.

We considered originally going to a new building at a CCRC campus which was totally remodelling/expanding their SNF and adding a new IL building (our target). All the planning and design and plans were done and ground breaking scheduled in 12 months. Whoops, neighbors appealed expansion plans to city's planning board, but loss and appealed to courts. Three years later, still no ground breaking. We pulled our deposit when original groundbreaking didn't happen.
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Old 02-12-2021, 11:36 PM   #164
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The vast majority of the CCRCs in the SF Bay Area are analogous to leasing. I believe this is true throughout the US. However, there are some that include (require) unit ownership. While that might sound like a good thing to some, I view it as a disadvantage because one (or oneís heirs) typically continues to pay the monthly fee until the unit is sold. And, there is a limited buyer population for such units so, it can take a while.
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I'm on the wait list for a CCRC in my neck of the woods. It's a Type C business model with equity ownership -- you own the unit and pay-as-you go for home care or skilled nursing care if you can no longer independently care for yourself. The wait list is 4 plus years long and there's never been a shortage or timing issue with new residents taking over units once they become available. Typically, new residents customize their units, which might take up to 4 months. I'm not aware of this CCRC charging heirs any monthly maintenance fees once the owner has left the campus -- and even if they did, this would be a very minor expense given the speed in which these units are sold and the appreciation in value these units have had over the 22 years this CCRC has been in existence.
Two very different environments, and I expect this is very location and property dependent. Just one more example of CCRC research that should be done before making a decision.
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Old 02-12-2021, 11:38 PM   #165
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Wow! Very informative post. I see I will have to research what models CCRC's even exist here in my neck of the woods where my three kids are. Thank you for taking the time to post!
I believe Willamette View is a Life Care CCRC. I haven't checked it out but, you may want to.
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Old 02-13-2021, 05:17 AM   #166
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I can't speak for all CCRC's, but all the Type A CCRCs we shopped had provisions that if the CCRC's SNF beds were occupied, the CCRC would find comparable care in the community (still at no change in cost to a resident). Our property is, in fact, restricted from accepting any non-resident to our SNF/Asst Living after our official start-up periods ends. Any resident in an off-site property would be returned to the home property at first vacancy.
It is definitely an issue to understand well when shopping a CCRC.
This is how our Type A CCRC operates--no outsiders allowed into the skilled nursing, etc. If there is no skilled nursing (or memory care) bed available they have to find you a comparable one. This CCRC has been in existence for about 20 years. I have asked and have been told that they have NEVER had to ship someone off for skilled nursing in another facility. They have a large skilled nursing/memory care building and when I look at occupancy rates there are always a few beds available. It is expensive to get in but worth it in my opinion (and the opinion of many others) hence the 10 year waiting list.

They are very strict about admittance. We know several people who could not get in because one of the spouses could not pass the memory test. If you have had cancer it is a 5 year wait. You cannot get in if you have Parkinsons or MS.
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Old 02-13-2021, 12:15 PM   #167
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We took "the tour" of a CCRC in our old area. They put quite the "rush" on us. The complex had a mix of cottages and apartment units up to 3 BR IIRC. Very nice, indeed. In all, it took up an area of perhaps 3 city blocks. When we stuck our heads in the door of the on-site SNF, it appeared to be a "ward" with maybe 8 beds (full). Our enthusiasm for CCRCs quickly diminished, though I'm sure there are some really good ones. YMMV
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Old 02-13-2021, 01:02 PM   #168
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We took "the tour" of a CCRC in our old area. They put quite the "rush" on us. The complex had a mix of cottages and apartment units up to 3 BR IIRC. Very nice, indeed. In all, it took up an area of perhaps 3 city blocks. When we stuck our heads in the door of the on-site SNF, it appeared to be a "ward" with maybe 8 beds (full). Our enthusiasm for CCRCs quickly diminished, though I'm sure there are some really good ones. YMMV
Just guessing here but I suspect your CCRC trip was not to a Type A property. But your visit is a great illustration of the benefits of the personal visit. Experiencing is worth a lot more than a fancy brochure. ;-)

In our case, during our visits to the Type A properties (all non-profits), we never felt any pressure. In fact, it was much more of a facilitation to understand what our retirement objectives were and how their facility met those needs. We found it helpful to get a clear understanding prior to our visit what category a particular CCRC was positioned.
As a generalization, Type A properties recognize they are in the business of a life long decision and have no interest in a failed match. YMMV
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Old 02-13-2021, 06:39 PM   #169
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In addition, the LTCi pays less per day for in home care than it would for 24 hr care in a facility.
Oh, I never thought of that. I just noticed that my mother would have received benefits only with the 2 ADL trigger. If one ADL you are on your own.

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Timely thread for DW and I. We, just last month, decided to cancel our LTC policies that we've had since 2005 (we were in our late 40s at the time).
I would probably do the same. I had disability and life insurance at one time but dropped them when assets rose and the need for insurance receded. I was always skeptical that buying LTC while young would get you a better premium later.
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Old 02-14-2021, 06:19 AM   #170
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Having spent a lot of time in NHs and SNFs for my brother, the thing I observed is this:

Life changes for both spouses. The healthy spouse now spends most of his/her day visiting the sick spouse.

As a result, the cost of LTC is not in addition to your current expenses but your overall expenses change. No more vacations, expensive dinners, two cars, shopping, maybe get rid of that boat/second home. A lot of discretionary spending comes to a grinding halt.

So --depending on your healthy/current spending-- a LTC facility that costs maybe $80K a year might "only" be costing you an additional $40K a year as your spending profile shifts away from healthy spending which neither of you can no longer do.
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Old 02-14-2021, 04:36 PM   #171
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Just guessing here but I suspect your CCRC trip was not to a Type A property. But your visit is a great illustration of the benefits of the personal visit. Experiencing is worth a lot more than a fancy brochure. ;-)

YMMV
Agreed, an extensive tour is a minimal starting point.

I believe the complex we visited offered Type A and other contracts. I recall, for instance that they told us there would be a financial determination of whether we would qualify. Our discussion in their office indicated we would easily qualify.

I DO recall being "urged" to get on their waiting list. YMMV
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Old 02-14-2021, 06:15 PM   #172
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I DO recall being "urged" to get on their waiting list. YMMV
Koolau, the "waiting list" option is just another component of managing timing while protecting your options. With ST interest rates in timing, you may want to consider a waiting list "investment" seriously if you believe you have found a potentially acceptable location.
At the properties we visited, all offered a pretty flexible waiting list policy and full refund. One property shared that one prospect had been on their "waiting list" for over 10 years. Every time they offered him a unit matching his requirements, he would tell them he just was not ready yet. I guess he was pushing 90 and still thinking about it. At this property, at least, he preserved his position on the list and so would had an easy move once he decide he was "ready".
We actually ended up moving our deposit from a property than ran into building permit issues to another property that was part of the CCRC parent operations. Turned out for the better in many ways.
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Old 02-14-2021, 06:59 PM   #173
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Waiting lists for CCRC work in different ways. At the CCRC where we are on the waiting list it takes about 10 years for your name to get to the top of the list. Once you get to the top of the list you are offered an opportunity to move in 3 times and if you refuse 3 times you go back down to the bottom of the list. There is no "hard sell" to get on the list --the place is so popular they don't have to sell it. In fact to even get on the list you have to give them a financial statement to prove you can afford to move in and put down a deposit. The deposit is applied against your move in fee but if you never move in you lose your deposit.
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Old 02-14-2021, 07:27 PM   #174
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Waiting lists for CCRC work in different ways. At the CCRC where we are on the waiting list it takes about 10 years for your name to get to the top of the list. Once you get to the top of the list you are offered an opportunity to move in 3 times and if you refuse 3 times you go back down to the bottom of the list. There is no "hard sell" to get on the list --the place is so popular they don't have to sell it. In fact to even get on the list you have to give them a financial statement to prove you can afford to move in and put down a deposit. The deposit is applied against your move in fee but if you never move in you lose your deposit.
Exactly why you want to ask any target CCRC very explicit questions about any and all financial and living parameters important to your decision. For that reason, we had a check list to be sure we got answers on each item. When we got to our final choice, compared our answers to what the contracts actually said. And I recommend you get your contracts well before you are going to sign. Ours made getting a mortgage look easy. ;-).
In our market, the CCRCs are more flexible than Harllee's market--key is to make no assumptions--look at the deposit docs and be sure there are no questions about a refund. All of CCRC of interest to us did ask for 10% deposit and one had no wait list--as in they weren't providing that choice.
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Old 03-02-2021, 10:24 AM   #175
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Dd852, I am so sorry about your mom and now you are having to deal with a LTC company that seems to be stonewalling you. And you even had a hard time getting them to stop taking the premiums after her death? What a racket. I am afraid the same thing is going to happen eventually with my mom's LTC policy. She has paid premiums for 35 years on the policy and may never get any benefit from it. Even if my mom where to somehow get the maximum amount under her policy she will never get her money's worth. In my opinion in most cases LTCI just is not a good deal financially. It seems sort of like dental insurance-- the maximum amount you can receive under the policy is not enough to justify the premiums paid in.

Funny enough, despite the agent agreeing on the phone that they wouldnít take another premium, I just got a dunning letter ó to my address so they clearly had updated their records, wanting a premium extending coverage five months past my motherís death. Iíve simply passed to the lawyer handling her estate - let him fight it. But I must say Met Life has not impressed me.
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