Rethinking CCRC living

[ncbill]

When people have a spouse that is declining it gets tougher as you get older to take care of them. By the time my dad died my mom was exhausted and only 73 but 14 years of caregiving is a lot. Personally I am glad that I only need to worry about taking care of my dogs and myself. I noticed that most people in my friend’s ccrc are much older than him.

That's why i plan to buy LTC insurance...for help with at-home (or in-ALF) physical care.

I also have written a very restrictive health care POA so I won't be one of those living nearly decade (like my mom did) after becoming bedridden.

Very restrictive = any terminal diagnosis, including any form of dementia, comfort care only...NO antibiotics, period.

 

[lucky penny]

I am 65. When should I be getting on the waiting list for ccrc? Once at top can you just stay there for years? I seem to remember that there was a fee to get on the list when I looked into it for stepdad. I think they said it could be refunded, but the contract did not say.

A CCRC I'm considering has a waitlist deposit that is refundable at any time for any reason, less a $250 administrative fee, & if you move in it's applied to the cost. So it seemed like a no-brainer to make the deposit, though the possibility of actually making the move seems years away & I might never be ready to do it; still, it feels good to have the option. The waitlist is years-long, depending on the kind of residence you want, & when you reach the top of the list, you don't lose your spot if you decline to accept (no matter how many times) when a residence becomes available. I know some who have deposits at 3 or 4 CCRCs, but after researching this for a while I've found only one that might work for me. Still exploring though, & undecided.

I would only consider a CCRC that offers a "life plan" contract, where the monthly charge does not increase if/when you need a higher level of care (assisted living, memory care, and/or skilled nursing). At the independent living level the monthly charge might seem high, but part of that amount is prepayment of future health care (& is tax-deductible); I see it as a form of long-term care insurance for those who don't have it & a supplement for those who do. (If you do have LTC, the CCRC is glad to accept it). Of course, you might never need to use the benefits of that prepaid insurance, but if you do, it provides a huge financial benefit if you end up needing a higher level of care for many years, which would otherwise cost a fortune.

 

[Time2re]

I am 65. When should I be getting on the waiting list for ccrc? Once at top can you just stay there for years? I seem to remember that there was a fee to get on the list when I looked into it for stepdad. I think they said it could be refunded, but the contract did not say.

We got on a waitlist about 6 months ago, est wait of 18 months to 2 years, with a fully refundable deposit. DH disabled, I worry whether he will pass the part about living independently. A good friend also paid deposit, thinking same time frame. Last week the CCRC offered her the exact unit she requested. (1 bedroom versus 2 bed) I went with her to finalize the paperwork, and am even more impressed. A side bonus, as future residents, we have access to the pool, fitness facility, special events, all without cost. I think a few residents think I live there!

We have three times to accept/reject when we make it to the top of the waitlist. After that, we go back to the bottom of the list.

 

[joesxm3]

Thanks for the info on waiting lists. This thread has given me a lot to think about.

 

[bmcgonig]

It seems like limiting yourself to places with long waiting lists might be another good way to vet the place? With that long a waiting list one could assume it’s well funded. Also, the quality should be at the top since so many want to join?

 

[harllee]

It seems like limiting yourself to places with long waiting lists might be another good way to vet the place? With that long a waiting list one could assume it’s well funded. Also, the quality should be at the top since so many want to join?

One advantage of a long waiting list is that the CCRC can be very picky about who they let in--only people with adequate funds and good health. That should definitely help the bottom line.

 

[Jerry1]

So, what are some typical disqualifiers from a health point of view? For example, I’m considered disabled for Social Security and will go in Medicare early because my kidneys have failed. Other than dealing with dialysis, I lead a pretty normal life. Not looking to discuss my situation specifically (because I’m 61), however, how restrictive are CCRC’s?

 

[harllee]

So, what are some typical disqualifiers from a health point of view? For example, I’m considered disabled for Social Security and will go in Medicare early because my kidneys have failed. Other than dealing with dialysis, I lead a pretty normal life. Not looking to discuss my situation specifically (because I’m 61), however, how restrictive are CCRC’s?

I don't know about kidney failure/dialysis but for the CCRC I am moving to I have been told these are some of the disqualifiers: any form of dementia, MS, Parkinson's, any cancer within the last 5 years (except for non melanoma skin cancer). We specifically asked about DH's autoimmune disease and need for a knee replacement and we were told those would not disqualify him. Regarding the dementia issue, they give you a memory test and if you cannot pass it then you are disqualified (I have found out the types of questions on the test and have been practicing) Some CCRCs are less strict than ours. We had friends that wanted to get into our CCRC and the wife could not pass the memory test, they later found another CCRC that overlooked her memory issues and they were able to move there. I think our CCRC is stricter because it is a Type A Life Care Community where your monthly fees do not increase if you have to go to a higher level of care such as assisted living, skilled nursing or memory care.

 

[bmcgonig]

I don't know about kidney failure/dialysis but for the CCRC I am moving to I have been told these are some of the disqualifiers: any form of dementia, MS, Parkinson's, any cancer within the last 5 years (except for non melanoma skin cancer). We specifically asked about DH's autoimmune disease and need for a knee replacement and we were told those would not disqualify him. Regarding the dementia issue, they give you a memory test and if you cannot pass it then you are disqualified (I have found out the types of questions on the test and have been practicing) Some CCRCs are less strict than ours. We had friends that wanted to get into our CCRC and the wife could not pass the memory test, they later found another CCRC that overlooked her memory issues and they were able to move there. I think our CCRC is stricter because it is a Type A Life Care Community where your monthly fees do not increase if you have to go to a higher level of care such as assisted living, skilled nursing or memory care.

Do the CCRCs that are not type A disqualify some for health issues? I would think that since you’re paying full price for care at all levels, that they may not care?

 

[harllee]

Do the CCRCs that are not type A disqualify some for health issues? I would think that since you’re paying full price for care at all levels, that they may not care?

I think most all of them have some health/dementia screening. My mother is in one that is not type A and she still had to pass health requirements and a memory test.

 

[nwsteve]

As a general rule, Type A properties will have the strictest admission standards reflecting they are on the hook for your "life care" and it is not good for other residents to carry obvious high potential cost risky new residents.
Based our limited experience here at our Type A, there is a "it all depends" element for every location. Our Type A was a fairly new property and was only about 65% full when we entered. As a results, residents that would not qualify at our sister property which has over 200 on waitlist, t were admitted under modified contracts which I suspect cap the property's exposure. I know of one neighbor who had MS at entry but was still admitted. In another case, a couple was admitted even though the wife could not pass her cognitive test. Her spouse told me they got in by having their DD signing a guarantee regarding future costs. New property will generally show more flexibility on admission but will limit their exposure via contract. Established Type A facilities with waitlists will be more restrictive.
Except for obvious examples like Harlee noted above, admission is often a contract negotiation. If you are interested in a property and think there might be potential admission risk, do not hesitate to ask for their admission requirements. If you think there is any question, then explore if the restriction is subject to contract modification. Then be really really sure you understand EVERY word.and they provide an example of how any modification is applied.

 

[lucky penny]

Thanks for the info on waiting lists. This thread has given me a lot to think about.

Here's an article that piqued my interest in CCRCs last year. The writer is a single guy in his 60s who started thinking about the subject after seeing the difficulties his aging parents had. I could definitely relate to both his hesitation & his pragmatism. He finally acted after a friend who lived in one urged him just to make the deposit for the waitlist (which was years long) & then forget about it. The title says it all:"Even in midlife, it's smart to start thinking about where you'll live when you're old":

https://www.washingtonpost.com/heal...8ae604-46de-11ea-8124-0ca81effcdfb_story.html

 

[steelyman]

That’s an interesting article, lucky penny. Thanks for posting (and thanks to others who’ve contributed to this thread).

 

[sengsational]

^WaPo Article

Others relied on wheelchairs, canes, walkers and rollators. (Residents range in age from 62 to 105.)


“This is my future,” I thought with a pang.

I would not say "is" I'd say "could be", and add "if I'm lucky". Something like 20% are ok one day and dead the next. And then a good fraction will get notified they've got a steep decline coming, and won't have years to dawdle around a CCRC.

 

[harllee]

To me it is an easy and prudent thing to do--find a CCRC (or a couple) in your area and put down a couple of thousand or so to get yourself on the waiting list "just in case." I can't understand why a person with plenty of money would not do that. You are not committing yourself, but it gives you options.

 

[JoeWras]

Good food for thought here, all around.

 

[joesxm3]

Being single with no children, I would be interested in thoughts on how to manage supervision of a continuing care situation. As was mentioned with age-in-place that it would be difficult without some sort of general contractor, it seems that if things got bad enough I would need someone supervising and paying the bills etc.

My cousin's wife told me that when her mother was in assisted living, she caught them billing for services that never happened.

Another thing I wonder about is whether the CCRC needs to be close to where I live now, which is a high tax and expense New England state, or if I am uprooting and moving into the community would it be feasible to move to a lower tax and warmer locale?

 

[Turbo29]

My cousin's wife told me that when her mother was in assisted living, she caught them billing for services that never happened.

A few years ago I heard that story from a coworker about her mother, who lived in a CCRC.

 

[JoeWras]

Yes, valid concerns about "management."

One thing to be aware of in most of the pay-as-you-go assisted living places is that they WILL nickle and dime you to death. Every pill put into a container, every check in. Everything. Even if they are not cheating, expect the extra charges to be substantial. I saw this with my dad at independent living.

 

[Walt34]

My cousin's wife told me that when her mother was in assisted living, she caught them billing for services that never happened.

Another thing I wonder about is whether the CCRC needs to be close to where I live now, which is a high tax and expense New England state, or if I am uprooting and moving into the community would it be feasible to move to a lower tax and warmer locale?

When my mother was in the CCRC I wasn't shy about letting them know that I worked for the police department, that I worked in the Fraud Section, and that I monitored Mom's expenses closely. They'd have had to be blithering idiots to try overbilling her! That said, I never heard of that being an issue at her facility.

Re moving to a warmer and lower tax area, of course you can move anywhere you want. I talked to a few in both North and South Carolina in hopes of persuading DW to move to a warmer area but wasn't successful. One downside might be the expense/hassle of visiting places farther than a day's drive away, but all of them offer overnight stays for very low cost charges. The amounts seemed to be "break-even" costs, in that it wasn't a money-maker for them, but they wanted to keep out casual lookers not seriously considering the CCRC.

 

[bmcgonig]

Being single with no children, I would be interested in thoughts on how to manage supervision of a continuing care situation. As was mentioned with age-in-place that it would be difficult without some sort of general contractor, it seems that if things got bad enough I would need someone supervising and paying the bills etc.

My cousin's wife told me that when her mother was in assisted living, she caught them billing for services that never happened.

Another thing I wonder about is whether the CCRC needs to be close to where I live now, which is a high tax and expense New England state, or if I am uprooting and moving into the community would it be feasible to move to a lower tax and warmer locale?

Definitely the cheaper the local real estate the less you pay for the CCRC. When I compare prices where I live (Bay Area) to some very nice appearing places in Florida, the cost here is up to double.

Here’s one to look at to compare prices around the country. VI is high end, although I’m not sure they’re all equally so.

https://www.viliving.com/

 

[braumeister]

Re moving to a warmer and lower tax area, of course you can move anywhere you want.

Good point. Since moving into one of these places will most likely be the last move you will ever make, it's wise to consider if it's a place you truly like.

One of the places in my top 5 list to consider is actually over 2,000 miles from where I live now. But it's an area I like very much and I'd be happy to spend my declining years there. Researching these places is time consuming and not at all easy, but I think it's very important.

 

[bmcgonig]

Good point. Since moving into one of these places will most likely be the last move you will ever make, it's wise to consider if it's a place you truly like.



One of the places in my top 5 list to consider is actually over 2,000 miles from where I live now. But it's an area I like very much and I'd be happy to spend my declining years there. Researching these places is time consuming and not at all easy, but I think it's very important.

San Diego? Since you’re in Kentucky I’m taking a wild guess [emoji4]

 

[braumeister]

San Diego? Since you’re in Kentucky I’m taking a wild guess [emoji4]

Sorry. Good guess, but no. Something tells me the San Diego area is way out of my price range.

 

[nwsteve]

Good point. Since moving into one of these places will most likely be the last move you will ever make, it's wise to consider if it's a place you truly like.

While it is probably nor a universal situation, our CCRC contract basically included a "no harm, no foul period" that allowed you to cancel your contract and have all funds, but some administrative costs returned. I think it was six months. In the three plus years we lived hire, we seen it happen once. 3 months after fully moving in from their home in Alaska, they packed and returned to Alaska.
Another item to have on your screening list when doing your initial evaluation.