Moved into CCRC today

[lucky penny]

Just curious. Do folks here have info on pricing for CCRCs. We've so far looked into assisted living places and their prices seem to start around $4K/month for an efficiency with 2 people up to $7K/month for a stand alone "house" on the grounds. IIRC the fee covers all meals.

Keep in mind, these are Hawaii prices. Thanks.

At a very nice CCRC near NYC that I'm familiar with, entrance fees range from $350K-850K, monthly fees are $5.5K-$6.5K for a 1-bedroom apartment. The fee covers 30 meals a month. NYC has no CCRCs but plenty of assisted living residences, & nice ones can easily cost around $14K per month for a 1-BR apartment.

 

[Koolau]

At a very nice CCRC near NYC that I'm familiar with, entrance fees range from $350K-850K, monthly fees are $5.5K-$6.5K for a 1-bedroom apartment. The fee covers 30 meals a month. NYC has no CCRCs but plenty of assisted living residences, & nice ones can easily cost around $14K per month for a 1-BR apartment.

Wow, the fees for AL in NYC are maybe twice that in Honolulu. Kinda shocked.

 

[lucky penny]

Wow, the fees for AL in NYC are maybe twice that in Honolulu. Kinda shocked.

The market rental rate in Manhattan for 1-BR "luxury" apartments (i.e., a nice doorman bldg in a good neighborhood) is at least $5000-$6000 a month, so when desirable assisted living services & amenities are added, not to mention food, that's what you get. Less expensive places are available, but you get what you pay for.

 

[Koolau]

The market rental rate in Manhattan for 1-BR "luxury" apartments (i.e., a nice doorman bldg in a good neighborhood) is at least $5000-$6000 a month, so when desirable assisted living services & amenities are added, not to mention food, that's what you get. Less expensive places are available, but you get what you pay for.

I've visited Manhattan several times and loved it. Never looked into housing as I don't need it. Actually for an apartment, I would kinda guess around $6K. But sorta shocked by $14K for assisted living. Oh, well, I'll never need AL in NYC. (I miss NYC.)

 

[lucky penny]

I've visited Manhattan several times and loved it. Never looked into housing as I don't need it. Actually for an apartment, I would kinda guess around $6K. But sorta shocked by $14K for assisted living. Oh, well, I'll never need AL in NYC. (I miss NYC.)

Thanks, K. I love it too.

 

[nwsteve]

When looking at fees, imho critical to put in context. Life care (Type A) properties will have higher buy ins since you are locking-in LTC at today's price.
Our property has several different contracts, depending on desire/need for refund. Also our prop will still take a couple when one can't pass the entry "tests" but then must have resources/guarantee they will pay higher rates for the non-qualifying spouse. In some cases, non qualifying spouse pass away before moving to higher levels of care.
Very dangerous to generalize as each couple may have ubique issues/assets
We have a 1250 sq ft 2 bedroom +den--our buy-in with no refund after 5 years was approx 350K. Monthly fee is 7K for 2 peope.

 

[harllee]

When looking at fees, imho critical to put in context. Life care (Type A) properties will have higher buy ins since you are locking-in LTC at today's price.
Our property has several different contracts, depending on desire/need for refund. Also our prop will still take a couple when one can't pass the entry "tests" but then must have resources/guarantee they will pay higher rates for the non-qualifying spouse. In some cases, non qualifying spouse pass away before moving to higher levels of care.
Very dangerous to generalize as each couple may have ubique issues/assets
We have a 1250 sq ft 2 bedroom +den--our buy-in with no refund after 5 years was approx 350K. Monthly fee is 7K for 2 peope.

Thanks nwsteve, interesting how all the CCRCs differ. At our CCRC both residents have to pass the health and cognitive tests. Friends of ours could not get in because the wife could not pass the cognitive test. I think our CCRC is more expensive than most and stricter on the entrance requirements because it is a Class A LifeCare in a very desirable area and it has a very long wait list. They can afford to be very strict. In our area CCRCs are very much a sellers market.

 

[explanade]

They don't base the entrance fee on your assets do they?

 

[ChrisC]

At a very nice CCRC near NYC that I'm familiar with, entrance fees range from $350K-850K, monthly fees are $5.5K-$6.5K for a 1-bedroom apartment. The fee covers 30 meals a month. NYC has no CCRCs but plenty of assisted living residences, & nice ones can easily cost around $14K per month for a 1-BR apartment.

You missed this newly-minted CCRC that appears to be operational and past the in-development stages in NYC:https://riversedge.org/

 

[braumeister]

They don't base the entrance fee on your assets do they?

No, the fees are published, often on the website.

 

[lucky penny]

You missed this newly-minted CCRC that appears to be operational and past the in-development stages in NYC:https://riversedge.org/

River's Edge, in the Bronx, isn't "newly-minted"; it hasn't been built yet. Their 2017 development plan states construction will start when they have deposits (10% of the entrance fee) for 75% of the residences; it estimates that would be in June 2019, with a projected opening in 2021. They are still a long way from 75%, so the opening date (originally 2021) keeps getting postponed. It's aggressively marketed & they give frequent, optimistic promotional events, blaming the delays on Covid. The projected opening is now 2025.

 

[ChrisC]

I wouldn't describe it as harsh--when you have hundreds of people on the wait list you don't want to have to mess with people who are not serious about moving in, so if a person turns them down 3 times they go to the bottom of the list. I looked at 4 CCRCs in my area and all of them have the 3 strikes you are pushed to the bottom rule.

How does one get selected off the waitlist at your CCRC? If on the waitlist, do you provide the CCRC with the type of unit and price for the unit that you're willing to take if one becomes available, and then when availability occurs, you're offerred that unit? On our waitlists, you can stay on the waitlist indefinitely; in fact, the marketing folks at one of our waitlisted CCRCs says that someone's been on the waitlist for over 20 years (an unusual circumstance nonetheless). Here, in my neck of the woods, with waitlists 4+ years, you list the type of unit, which could include specific location (as in 5th floor apartment overlooking lake/pond, or cottage in cul-de-sac, or ground floor unit in bldg X), but you're not offerred an available unit which meets your specifications until you've actually told the CCRC that you're ready to move! So, we have met some folks who've been on the waitlist for 7+ years, and we've been on the waitlist for over 3 years now and we're not ready to move yet and won't likely be ready, if at all, for perhaps 3-4 more years.

And BTW, once you come off the waitlist and it doesn't necessarily mean you have to immediately move into the unit. There's a significant amount of remodeling and renovating that takes place for many residents who move into their units -- and this is true for seasoned CCRCs (those that have been in existence for 25 plus years) as well as newer ones (those that came operational the last 5 years). The seniors who renovate and remodel want their units to meet all their expecations for permanent living space.

Further, I think entrance policies vary widely from place to place. Newer places might be more relaxed in medical qualifications for couples: at least one newer place told us, that they will admit a couple where one member has the onset of early stages of Parkinsons or MS, which is perhaps more lenient that other CCRCs with deep waitlists.

 

[ChrisC]

River's Edge, in the Bronx, isn't "newly-minted"; it hasn't been built yet. Their 2017 development plan states construction will start when they have deposits (10% of the entrance fee) for 75% of the residences; it estimates that would be in June 2019, with a projected opening in 2021. They are still a long way from 75%, so the opening date (originally 2021) keeps getting postponed. It's aggressively marketed & they give frequent, optimistic promotional events, blaming the delays on Covid. The projected opening is now 2025.

Thanks for correcting me!

 

[Koolau]

When looking at fees, imho critical to put in context. Life care (Type A) properties will have higher buy ins since you are locking-in LTC at today's price.
Our property has several different contracts, depending on desire/need for refund. Also our prop will still take a couple when one can't pass the entry "tests" but then must have resources/guarantee they will pay higher rates for the non-qualifying spouse. In some cases, non qualifying spouse pass away before moving to higher levels of care.
Very dangerous to generalize as each couple may have ubique issues/assets
We have a 1250 sq ft 2 bedroom +den--our buy-in with no refund after 5 years was approx 350K. Monthly fee is 7K for 2 peope.

Just running a back-of-the-envelope comparison of our living costs vs the figures you supplied.

Assume you live 20 more years: Then your $350K becomes $1,500/month added to your $7000. Opportunity cost (I'll say 5% to be conservative) on $350 is about $1500/month. Add it up and that's about $10K/month.

I just wanted to compare that to us if we stayed in place and paid for help (medical - visiting nurse, etc.)

Our condo might sell for as much as 700K (I can't even believe I'm saying that. )

Opportunity cost at 5% would be about $3000/month.

HOA dues: Round up to $1000/month

Internal maintenance - negligible - less than $100/mo

Utilities - negligible.

Food (because a CCRC feeds you for your fees, I think) $700/mo

Total: $4700 (let's round to $5000/month)

So, that would give us $5K/month to hire "visiting nurses" or some such to stop by with shots or therapy or vitals, etc. I think that could be done.

Now, as far as amenities: Probably no comparison to what a CCRC has (I've seen the inside of the best CCRC on our Island. It is fabulous and has all kinds of things to do.) Would I pay $5K/month for those amenities. Probably not. If I were there anyway, would I use them and appreciate them. Absolutely.

But my point is we really like it where we are and would like to age in place as long as possible. We're rolling the dice that neither of us has to go to a "facility" (nursing or whatever.) IF we do, we do have pretty good LTCI (at least 3 years - maybe 4.) And our LTCI has provision for home care (of course, it's pretty restrictive - meaning hard to qualify, I'm sure.)

I throw all this out NOT as any criticism for those seeking to live in a CCRC. As I said, I've visited a couple and they look wonderful. My impression of the staff is that they are caring and capable. The food is wonderful. I would say they are like living in a first class hotel - with even more amenities.

SO, please don't take my comparison the wrong way. I'm just trying (for myself) to figure the odds and costs and perhaps some internal* things. Let me know if I'm off base on costs or otherwise in my thinking.

*internal things: I guess I think that when I move into a CCRC or even an Assisted Living place, that's sorta like saying "This is it. The last stop before the grave yard." I know that's silly, but I'm trying to be honest here. I think it plays with my head when I think about giving up our wonderful condo and moving to "the final destination" so to speak.

Again, please assume best motives on my part and no criticism. I applaud those who have found a CCRC that meets their needs and they can afford. I hope you all have a joyous time in your new homes.

 

[harllee]

They don't base the entrance fee on your assets do they?

No the entrance fee is not based on your assets. The entrance fee is based on the size of the unit, the larger the unit the larger the entrance fee. There is also an additional charge for 2 persons.

 

[RetiredHappy]

Just running a back-of-the-envelope comparison of our living costs vs the figures you supplied.

Assume you live 20 more years: Then your $350K becomes $1,500/month added to your $7000. Opportunity cost (I'll say 5% to be conservative) on $350 is about $1500/month. Add it up and that's about $10K/month.

I just wanted to compare that to us if we stayed in place and paid for help (medical - visiting nurse, etc.)

Our condo might sell for as much as 700K (I can't even believe I'm saying that. )

Opportunity cost at 5% would be about $3000/month.

HOA dues: Round up to $1000/month

Internal maintenance - negligible - less than $100/mo

Utilities - negligible.

Food (because a CCRC feeds you for your fees, I think) $700/mo

Total: $4700 (let's round to $5000/month)

So, that would give us $5K/month to hire "visiting nurses" or some such to stop by with shots or therapy or vitals, etc. I think that could be done.

Now, as far as amenities: Probably no comparison to what a CCRC has (I've seen the inside of the best CCRC on our Island. It is fabulous and has all kinds of things to do.) Would I pay $5K/month for those amenities. Probably not. If I were there anyway, would I use them and appreciate them. Absolutely.

But my point is we really like it where we are and would like to age in place as long as possible. We're rolling the dice that neither of us has to go to a "facility" (nursing or whatever.) IF we do, we do have pretty good LTCI (at least 3 years - maybe 4.) And our LTCI has provision for home care (of course, it's pretty restrictive - meaning hard to qualify, I'm sure.)

I throw all this out NOT as any criticism for those seeking to live in a CCRC. As I said, I've visited a couple and they look wonderful. My impression of the staff is that they are caring and capable. The food is wonderful. I would say they are like living in a first class hotel - with even more amenities.

SO, please don't take my comparison the wrong way. I'm just trying (for myself) to figure the odds and costs and perhaps some internal* things. Let me know if I'm off base on costs or otherwise in my thinking.

*internal things: I guess I think that when I move into a CCRC or even an Assisted Living place, that's sorta like saying "This is it. The last stop before the grave yard." I know that's silly, but I'm trying to be honest here. I think it plays with my head when I think about giving up our wonderful condo and moving to "the final destination" so to speak.

Again, please assume best motives on my part and no criticism. I applaud those who have found a CCRC that meets their needs and they can afford. I hope you all have a joyous time in your new homes.

+1

I see CCRC as a potential solution for those who don't have or don't qualify for LTCI.

We both have great LTCI coverage and want to age in place. We are also introverts and very private people. Facility living is not our thing. One of the huge negatives that stand out for us in AL (past independent living) is that you have to turn over all medications and they will be controlled by the facility to dispense. We see facility living as giving up a huge piece of control and choice, over our lives. No, thank you.

We spent 8 years of our working lives as our last career in the long term care industry, running a successful home care business. We have seen it all. For us, the best place is to be home.

There are many who thrive in CCRC and facilities settings, especially extroverts. It is just not for us.

 

[harllee]

How does one get selected off the waitlist at your CCRC? If on the waitlist, do you provide the CCRC with the type of unit and price for the unit that you're willing to take if one becomes available, and then when availability occurs, you're offerred that unit? On our waitlists, you can stay on the waitlist indefinitely; in fact, the marketing folks at one of our waitlisted CCRCs says that someone's been on the waitlist for over 20 years (an unusual circumstance nonetheless). Here, in my neck of the woods, with waitlists 4+ years, you list the type of unit, which could include specific location (as in 5th floor apartment overlooking lake/pond, or cottage in cul-de-sac, or ground floor unit in bldg X), but you're not offerred an available unit which meets your specifications until you've actually told the CCRC that you're ready to move! So, we have met some folks who've been on the waitlist for 7+ years, and we've been on the waitlist for over 3 years now and we're not ready to move yet and won't likely be ready, if at all, for perhaps 3-4 more years.

And BTW, once you come off the waitlist and it doesn't necessarily mean you have to immediately move into the unit. There's a significant amount of remodeling and renovating that takes place for many residents who move into their units -- and this is true for seasoned CCRCs (those that have been in existence for 25 plus years) as well as newer ones (those that came operational the last 5 years). The seniors who renovate and remodel want their units to meet all their expecations for permanent living space.

Further, I think entrance policies vary widely from place to place. Newer places might be more relaxed in medical qualifications for couples: at least one newer place told us, that they will admit a couple where one member has the onset of early stages of Parkinsons or MS, which is perhaps more lenient that other CCRCs with deep waitlists.

At my CCRC you pick 3 types of units you would accept and you are on the waiting list for those 3 and when you come to the top of the list for one of those units the CCRC contacts you. Then you can say no for a maximum of 3 times. You cannot specify the location of the unit. When we were offered a first floor unit with a patio I was thrilled and immediately jumped on it. Once we said yes for the unit, then we had to put down a deposit of 25%. Then they did the financial, health and cognitive tests on us and that took about a month. If we had flunked any of those tests we would have gotten our deposit back. Once we passed the tests then we picked all our interior wall colors, countertops, cabinets, etc and remodeling took 3 months. Then we had the closing and owed the rest of the entrance fee. We had to use the CCRC contractors for all the work and had to use approved suppliers for all the materials. We were able to upgrade some things (like flooring, countertops and light fixtures) but we had to pay extra fr those. We are not allowed to make any changes to our units without approval.

 

[explanade]

River's Edge, in the Bronx, isn't "newly-minted"; it hasn't been built yet. Their 2017 development plan states construction will start when they have deposits (10% of the entrance fee) for 75% of the residences; it estimates that would be in June 2019, with a projected opening in 2021. They are still a long way from 75%, so the opening date (originally 2021) keeps getting postponed. It's aggressively marketed & they give frequent, optimistic promotional events, blaming the delays on Covid. The projected opening is now 2025.

So if a CCRC doesn't have a track record of operating for years, how do you know if they will be financially viable?

Do CCRCs go bankrupt and the residents have to move out? Are they required to maintain certain capital levels based on the amount they take in, both for entrance and monthly fees?

Or is it common for them to raise monthly fees?

Are there limits on how much they can raise in a given year or can they raise it by 20% say and point to the 8-9% year over year CPI we went through last year?

They perform financial due diligence on applicants but should people considering them do their own financial due diligence?

Maybe there is a reporting requirement and some CPAs have to certify that a given place is financially sound? Or is there a board which has fiduciary responsibilities?

Are they owned by large corporations which can be sued for non-performance of the agreement or do you waive that right when you sign the contracts they put in front of you?

 

[braumeister]

Those are all reasonable questions, and can all be answered by interacting with the staff at a CCRC you're interested in, reading their documentation (often online), and checking their financial status (also usually available online either at their own site or a state agency).

They are all different, so no way to give blanket answers.

 

[Koolau]

+1

I see CCRC as a potential solution for those who don't have or don't qualify for LTCI.

We both have great LTCI coverage and want to age in place. We are also introverts and very private people. Facility living is not our thing. One of the huge negatives that stand out for us in AL (past independent living) is that you have to turn over all medications and they will be controlled by the facility to dispense. We see facility living as giving up a huge piece of control and choice, over our lives. No, thank you.

We spent 8 years of our working lives as our last career in the long term care industry, running a successful home care business. We have seen it all. For us, the best place is to be home.

There are many who thrive in CCRC and facilities setting, especially extroverts. It is just not for us.

I think the "extrovert vs introvert" is a good point. MIL went to assisted living toward the end of her life. She could no longer live at home as she wouldn't take her meds properly. We found her on the floor a couple of times and insisted that she go to assisted living. Otherwise, we would have had to go to her house 2 or 3 times/day to insist she take her meds.

So she never fit into the AL place she went (it was beautiful, new, good staff, etc.) but she was so private that she would often sit alone during meals. Folks would come to sit with her and she would more or less shut down. It was really sad.

She eventually ended up in a nursing home and she hated being in a two-bed room. No privacy for a very private person. Again, so sad to live out your days in such a situation. YMMV

 

[Huston55]

Just a few comments (IMHO) on posts above:

- Discussions about CCRCs, LTCI, etc are really discussions about how to manage the last phase of our lives; specifically, how we guard against asset depletion and ending up in a sad, terrible Medicaid facility or worse.

- Almost everyone wants to “age in place” as a first choice but, almost none of us have the financial resources to do so in circumstances that involve a long, slow decline, which is the scenario for which most of us are trying to plan.

- With rare exception, LTC insurance is not really “insurance”; it’s a rebate of your premiums after you satisfy the insurance company’s ADL requirements. So, comparing it to a CCRC (Type A) Life Care contract is marginally useful.

- There is no ‘free lunch’ on this issue. We either pay in advance: 1, Life Care contract, which also comes with a bit of risk; 2. LTCI, which prepays for a few years of care but, is basically getting your own money back; or, 3. Go naked and hope for a short morbidity before death.

BTW, if you check the ‘sticky posts’, you’ll see that I’m a CCRC advocate. But, that’s largely because it fits our situation. YMMV.

 

[pacergal]

This is a great discussion, CCRC is something DH and I have discussed as a possibility, although DH is not as enthused.
At 66, it would be a ways off, but I guess it wouldn't hurt to start looking, especially if there are long wait lists.
We are not ready to give up our SFH now. And also look at the alternative of staying and paying for help, as Koolau wrote above. That is DH greatest wish, stay at home.

 

[Koolau]

Just a few comments (IMHO) on posts above:

- Discussions about CCRCs, LTCI, etc are really discussions about how to manage the last phase of our lives; specifically, how we guard against asset depletion and ending up in a sad, terrible Medicaid facility or worse.

- Almost everyone wants to “age in place” as a first choice but, almost none of us have the financial resources to do so in circumstances that involve a long, slow decline, which is the scenario for which most of us are trying to plan.

- With rare exception, LTC insurance is not really “insurance”; it’s a rebate of your premiums after you satisfy the insurance company’s ADL requirements. So, comparing it to a CCRC (Type A) Life Care contract is marginally useful.

- There is no ‘free lunch’ on this issue. We either pay in advance: 1, Life Care contract, which also comes with a bit of risk; 2. LTCI, which prepays for a few years of care but, is basically getting your own money back; or, 3. Go naked and hope for a short morbidity before death.

BTW, if you check the ‘sticky posts’, you’ll see that I’m a CCRC advocate. But, that’s largely because it fits our situation. YMMV.

This is an interesting take on LTCI and CCRCs. The point I would disagree with is the that LTCI makes much of it's money based on only a "few" people ever using it. It also unfortunately for the LTCI companies depended on people dropping out over the years. Apparently they did not, so rates have risen. BUT if you do the math, if anyone were to use their full benefit they would get back WAY more than they put it in. Yeah, they get THEIR money back but they also get a lot of other people's money as well.

LTCI is NOT like dental insurance (pay ahead for your care.) It's "real" insurance where the LTCI company bets you won't need it and you bet that you will. If you're lucky, of course, you lose the bet.

 

[RetiredHappy]

This is an interesting take on LTCI and CCRCs. The point I would disagree with is the that LTCI makes much of it's money based on only a "few" people ever using it. It also unfortunately for the LTCI companies depended on people dropping out over the years. Apparently they did not, so rates have risen. BUT if you do the math, if anyone were to use their full benefit they would get back WAY more than they put it in. Yeah, they get THEIR money back but they also get a lot of other people's money as well.

LTCI is NOT like dental insurance (pay ahead for your care.) It's "real" insurance where the LTCI company bets you won't need it and you bet that you will. If you're lucky, of course, you lose the bet.

+1. You just keep putting my thoughts into words. My monthly premium is only $117.62 and it covers $9,076 monthly benefits, with a total lifetime benefits of $545K, compounding at 3% a year. That is after getting 2 premium increases over the past 14 years. I have only paid $16,234 todate. If I need LTC right now, I will be getting back way more than I have put in.

 

[harllee]

For those of you counting on Long Term Care Insurance--I am battling my mothers long term care insurance company right now and so far I am losing. Mother is in her 90s, has dementia and heart failure, has caretakers several times a day and needs to move to memory care but her long term insurance company is dragging their feet and refusing to pay. i have spend many hours on this and am probably going to have to hire a lawyer who specializes on this. I have another thread on this issue.

It is possible to pay in more on long term care insurance than you will get in return--my mother has. She has had the policy for about 40 years. The policy only pays $250 a day for 3 years. Her premiums have skyrocketed and she has now paid in more for premiums than the policy will ever pay out.

My mother is in a nice CCRC but unfortunately it is not a Class A Lifecare CCRC, it is the pay as you go type of CCRC so I need to get the LTC policy to pay so she can move into memory care. I am at my wit's end.