CCRC's - You should know

[imoldernu]

An article from Money that covers the important points about the cost and benefits of Continuing Care Retirement Communities. From my standpoint, after of living in one for the past 15 years, it is almost spot on.

The only difference that found was in the cited prices. In some cases much, much higher than our own Liberty Village.

In general, I'd suggest that knowing about the facilities and costs would be helpful, even for those who plan to age in place. We never know what the future may bring, healthwise. A CCRC, is much more than a nursing home, and understanding the differences is important.

Continuing Care Retirement Community: Can You Afford It? | Money

 

[imoldernu]

Follow up for a comparison of the numbers listed in the article. The rates shown were for our CCRC, last year. Up just a little bit for this year, but numbers close enough to give an idea of the cost of services in Liberty Village of Peru.

 

[joeea]

The only difference that found was in the cited prices. In some cases much, much higher than our own Liberty Village.

As the article states "Costs vary widely among communities."

Sounds like you are happy with your community. That's great!

 

[youbet]

A heads-up to all....... You have to be very careful comparing CCRC costs as features and services vary tremendously. To compare the numbers imoldernu has shared (THANKS!), additional detail as to what you're buying would be helpful.

We've been visiting some CCRC's in the general area (northeast Illinois) that imoldernu is in. The most important thing we've found, at least concerning finances/expenses, is to fully understand:

The type of contract: A, B or C.

Buy-in costs and details concerning portions that are refundable.

Customizability of services.

Whether or not your top personal requirements will be met. For example, DW and I have decided that if we move into a CCRC, we want the feature of our independent living arrangements being very handy (like an all indoor walk) to the LTC area. DW spent almost five years commuting a half hour each way to visit her mother in a NH almost daily. With Chicago winters, traffic, etc., it took a toll on her.


Contract type is especially critical. Type A contracts (sometimes called "LifeCare") offer a feature similar to LTCI which may appeal to some but also requires entering while fully independent, similar to passing a LTCI physical exam. Costs are higher, similar to adding LTCI premiums to your bill, but if you need a lot of NH care it can be a bargain. Like all "insurance," a bargain if you need it or just another expense if you don't.

Imoldernu...... Can you share some details about your contract type? From the ongoing monthly prices you shared, it looks like either B or C and not a type A LifeCare community. That is, no LTCI component. Or, looking closer, you might be in a community that does not offer full nursing services at all (only assisted living and memory care). If that's the case, how are you planning on handling it if one or both of you eventually needs full nursing care?

In general, DW and I are finding that differences between costs (both one-time and ongoing), services offered, amenities provided and ability to meet various contingencies are making research and comparison shopping an eye-spinning ordeal.

 

[imoldernu]

A heads-up to all.......

Imoldernu...... Can you share some details about your contract type? From the ongoing monthly prices you shared, it looks like either B or C and not a type A LifeCare community. That is, no LTCI component. Or, looking closer, you might be in a community that does not offer full nursing services at all (only assisted living and memory care). If that's the case, how are you planning on handling it if one of you needs several years of full nursing care?

You are correct. We are in a type C. This could be a little confusing... We are not yet in one of the facilities that are price quoted. We actually live in a self owned home, called a Villa... Our association with the CCRC is that we live on the "campus" and have access to everything except the "room and board". By being part of the CCRC community, we will have first access to independent living , assisted living, bounceback (rehab), nursing home or memory care.

At present, living in the villa, we pay nothing to the CCRC. As we go to whatever comes next, we will pay the going rate. the benefit, again, is being a part of and having accessibility to all services.

As to your nursing home question... yes... full services both nursing home, and memory care.

Our planning includes long term care policies for each of us. They will not pay for the entire expense, but just $100/day. For instance... should either of us have to go into the nursing home (Manor Court), or the Alzheimer unit (Memory Lane)... the policy would cover about 1/2 of the approximate cost of $70,000/yr. We have paid about $1,000/yr for each of the policies.

I cannot overemphasize the difference between the social interaction provided by a CCRC, versus a nursing home. In the case of the independent living part... the lifestyle and social lives of the residents provide activity, safety, and awareness that is not always there for people who live in their home alone... more isolated as they grow older.

To tell the truth... this social interaction was not on our horizon when we first retired 30 years ago.

I applaud you for your efforts to do the research. One size does not fit all... but being prepared can avoid future regrets.

 

[Teacher Terry]

So if you live in a apartment I am assuming you get 3 meals a day in the dining room and your apartment cleaned?

 

[mamadogmamacat]

I found it interesting that the Money article states the average age of entry into a CCRC is 81, older than I would have expected, especially considering the large entry fees.

Thanks, Imoldernu, for this information. Bookmarking it for future more detailed perusal.

 

[KB]

So if you live in a apartment I am assuming you get 3 meals a day in the dining room and your apartment cleaned?

My parents CCRC provided a nice breakfast buffet and one meal a day included in their monthly fee. Weekly cleaning also.

My sister gets a monthly dollar amount to use for meals and if she goes over, they add to the monthly bill. She has bi monthly cleaning.

So each place is different.

 

[audreyh1]

I found it interesting that the Money article states the average age of entry into a CCRC is 81, older than I would have expected, especially considering the large entry fees.

That’s very consistent with what I have heard - maybe even a little lower. I’d read numbers like 82 - 85.

 

[mamadogmamacat]

I wonder how long then, before a person has the need to go into the nursing home or memory care facility part of the CCRC, or even just passes away, on average.
Seems as though choosing a CCRC that refunds the bulk of the entry fee to the estate/heirs, and is financially stable so as to be able to do so is a very important consideration.

 

[audreyh1]

I wonder how long then, before a person has the need to go into the nursing home or memory care facility part of the CCRC, or even just passes away, on average.
Seems as though choosing a CCRC that refunds the bulk of the entry fee to the estate/heirs, and is financially stable so as to be able to do so is a very important consideration.

Highly variable, I would think. An average would be meaningless to an individual.

 

[mamadogmamacat]

Well, whack me with a wet noodle for my curiosity

I just found this interesting, if dated, study:

https://www.soa.org/globalassets/assets/files/research/exp-study/nia_report.pdf

from quick scan it looks like 8 yrs for females and about 6.5 yrs for males in terms of longevity after entry. Also, if I read it correctly, once a person enters the skilled nursing part of the CCRC, they have a morbidity that is not significantly different from the general population. I suppose there might have been some expectation that CCRC residents, being of higher socio economic background, would last longer.

Life Expectancy Compression: The impact of moving into a long term care facility on length of life - Life Care Funding

This is a somewhat more recent article and it claims an average stay in CCRC of 77 months.

And here is a much more recent study focusing on just North Carolina CCRCs

https://cdn.ymaws.com/www.leadingagenc.org/resource/resmgr/Docs/2015_CCRC_Economic_Impact_St.pdf

Here is a more detailed study of the demographics in CCRC's, from 2014:

An introduction to continuing care retirement communities - Milliman Insight

I found it useful, from the quote below, to know the percentages of time spent living independently vs in care, from the quote below:

"The ages at entry of residents who enter CCRCs typically range from 65 to 95. In the last 20 years, average entry ages have increased from the mid 70s to the lower 80s. Today, average ages at entry are generally in the 80 to 83 range, but this can vary from community to community. A mature CCRC (over 10 years old) will have an independent living population with an average age of between 85 and 87.

Both singles and couples enter all CCRCs. The percentage of couples at entry can range from as low as 10% to as high as 70%. While most couples are married males and females, there are also same-sex couples, sisters, brothers, or mother and daughter couples that occupy CCRC units. Because residents tend to spend their remaining lifetime at the CCRC, the existing resident population at any community will contain many single residents who originally entered as part of a couple, but are now living as a single resident due to the death or permanent transfer of their spouse or partner.

Residents who enter CCRCs as singles are overwhelmingly female, although this has changed somewhat in the last 20 years. The percentage of single residents who are female can range from 70% to 85%.

Average life expectancies range from 10 to 12 years at entry, but this can obviously vary by age, sex, and health status. On average, residents can expect to spend 70% to 80 % of their lifetime at a CCRC in the independent living level of care (ILU), 10% to 20% in the assisted living level of care (ALU), and 10% to 20% in the skilled nursing level of care (SNF)."

 

[audreyh1]

Wow, thanks for the research!

 

[Teacher Terry]

I am assuming that the people in apartments are taking care of themselves and that’s a lot of money for what’s provided. My aunt has plenty of money but no wonder at 94 she is in her own apartment with a cleaner coming in every few weeks. She does have a daughter that takes her places because she is retired. But she could hire many Uber’s minus that.

 

[audreyh1]

It depends I’m sure. But people I know have weekly housekeeping and regular maintenance even when staying at a townhouse type independent living situation.

 

[Huston55]

well, whack me with a wet noodle for my curiosity

i just found this interesting, if dated, study:

https://www.soa.org/globalassets/assets/files/research/exp-study/nia_report.pdf

from quick scan it looks like 8 yrs for females and about 6.5 yrs for males in terms of longevity after entry. Also, if i read it correctly, once a person enters the skilled nursing part of the ccrc, they have a morbidity that is not significantly different from the general population. I suppose there might have been some expectation that ccrc residents, being of higher socio economic background, would last longer.

life expectancy compression: The impact of moving into a long term care facility on length of life - life care funding

this is a somewhat more recent article and it claims an average stay in ccrc of 77 months.

And here is a much more recent study focusing on just north carolina ccrcs

https://cdn.ymaws.com/www.leadingagenc.org/resource/resmgr/docs/2015_ccrc_economic_impact_st.pdf

here is a more detailed study of the demographics in ccrc's, from 2014:

an introduction to continuing care retirement communities - milliman insight

i found it useful, from the quote below, to know the percentages of time spent living independently vs in care, from the quote below:

"the ages at entry of residents who enter ccrcs typically range from 65 to 95. In the last 20 years, average entry ages have increased from the mid 70s to the lower 80s. Today, average ages at entry are generally in the 80 to 83 range, but this can vary from community to community. A mature ccrc (over 10 years old) will have an independent living population with an average age of between 85 and 87.

Both singles and couples enter all ccrcs. The percentage of couples at entry can range from as low as 10% to as high as 70%. While most couples are married males and females, there are also same-sex couples, sisters, brothers, or mother and daughter couples that occupy ccrc units. Because residents tend to spend their remaining lifetime at the ccrc, the existing resident population at any community will contain many single residents who originally entered as part of a couple, but are now living as a single resident due to the death or permanent transfer of their spouse or partner.

Residents who enter ccrcs as singles are overwhelmingly female, although this has changed somewhat in the last 20 years. The percentage of single residents who are female can range from 70% to 85%.

Average life expectancies range from 10 to 12 years at entry, but this can obviously vary by age, sex, and health status. On average, residents can expect to spend 70% to 80 % of their lifetime at a ccrc in the independent living level of care (ilu), 10% to 20% in the assisted living level of care (alu), and 10% to 20% in the skilled nursing level of care (snf)."

admin: Pls add this post to the ccrc faq.

 

[nwsteve]

A heads-up to all....... You have to be very careful comparing CCRC costs as features and services vary tremendously. To compare the numbers imoldernu has shared (THANKS!), additional detail as to what you're buying would be helpful.

We've been visiting some CCRC's in the general area (northeast Illinois) that imoldernu is in. The most important thing we've found, at least concerning finances/expenses, is to fully understand:

The type of contract: A, B or C.

Buy-in costs and details concerning portions that are refundable.

Customizability of services.

Whether or not your top personal requirements will be met. For example, DW and I have decided that if we move into a CCRC, we want the feature of our independent living arrangements being very handy (like an all indoor walk) to the LTC area. DW spent almost five years commuting a half hour each way to visit her mother in a NH almost daily. With Chicago winters, traffic, etc., it took a toll on her.


Contract type is especially critical. Type A contracts (sometimes called "LifeCare") offer a feature similar to LTCI which may appeal to some but also requires entering while fully independent, similar to passing a LTCI physical exam. Costs are higher, similar to adding LTCI premiums to your bill, but if you need a lot of NH care it can be a bargain. Like all "insurance," a bargain if you need it or just another expense if you don't.

Imoldernu...... Can you share some details about your contract type? From the ongoing monthly prices you shared, it looks like either B or C and not a type A LifeCare community. That is, no LTCI component. Or, looking closer, you might be in a community that does not offer full nursing services at all (only assisted living and memory care). If that's the case, how are you planning on handling it if one or both of you eventually needs full nursing care?

In general, DW and I are finding that differences between costs (both one-time and ongoing), services offered, amenities provided and ability to meet various contingencies are making research and comparison shopping an eye-spinning ordeal.

Amen to making careful comparisons between CCRC plan types. The marketing types will try to discount the differences but they can be material.
We moved into a Lifecare CCRC (Plan A) about three months ago. It is a new property opening in Sept, 2017. Average age is one of the younger we visited (78). A sister property we looked at was 83 but has been open over 20 years. We are one of the younger couples at 71/72 but the pricing and timing worked for us and we did not want to move twice at this stage of our life. As a new property, we also got the benefit of attractive pricing. We targeted LifeCare CCRC's since we chose not to pay for LTCI.

One of the key benefit of LifeCare CCRC is the tax deductibility of a portion of our entry fee and monthly payments. For our property approx. 35% of our entry fee is deductible as a medical expense since we choose a entry contract which has no refund after 5 years. A similar percentage of our monthly payment is also deductible. It is my impression that only LifeCare CCRC property's have this deductibility feature.

One of the key features of LifeCare is one spouse can move to Assisted Living or Skill Nursing while the other remains in their Independent Living unit, at no additional cost beyond the State mandated additional meal service in AL.

While some entry fees allow for a partial refund to heirs, keep in mind that most contracts are only refunding a portion of the original cost, not current market. Since we believe we will have approx. 15-20 years in our unit, a no refund contract at a 40% discount to 75% refundable made sense.

As YouBet noted, there are a lot of details for devils to hide in CCRC contracts.

 

[imoldernu]

What nwsteve said with a little bit more, to explain how our CCRC, is different than many, in that we have the extra benefit of the Villas. To see how it works, you can search Liberty Village of Peru. I am posting a picture of our home below.
1560 SF, with current prices between $170K and $190K. We paid $140K, in 2004.

What's nice about this kind of arrangement, is that it's an easy transition from living in your previous home, with several advantages.

1. It's still a private home, as opposed to being an apartment. No Fees for being part of the CCRC. (We've been here 15 years).
2. Villas are built for easy care, and safety. Vaulted ceilings, carpeting, (for fall safety), raised toilets, safety "grabs" in the bathrooms, fireplaces, no stoop wall plugs, no sills between rooms, full insulation.. windows, doors and walls, efficient kitchen w/ bar style counter, open concept living room dining room.
3. HOA... by residents... no problems since we moved. Began with $125/mo. dues... just increased last year to $150. Pays for grass and shrub care and the best snow removal team ever. (yeah... we have winter in Peru).
4. While we don't pay CCRC dues, living in the Villas, entitles us to all the facilities of the Liberty Village except meals, which we can get, but have to pay for. We'll be first on the list for rehab, independent living, health facility, AJ's Fitness, which jeanie and I just came back from an hour on the machines.
5. We are also entitled to use the regular scheduled transportation to shopping or entertainment (dining out, or maybe the River Casino gambling).
6. Since most of the people in the villas, somewhat younger, and healthy, we do have an internal society for cookouts and yard get togethers. It's not like moving in to a nursing home where people are confined to bed, or have limited mobility.
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If and when something happens to one of us, and has to go in to a different part of the Village, it's a few minutes walk to all of the facilities, instead of a long car ride.

The other great part of living here, has nothing to do with the CCRc... Peru, is a very nice community, with good people. Driving is super easy, with very few stop lights... Last night I had to go out... no cars at all on the roads, but cars stopped at every stop sign... no matter what. No crime at all so far this year.

And one more thing about the villas. People who buy in the villas, more often than not, don't move into the Estates or other parts of the community, until they are in their 90's.
.............................................................................................
To correct an error from above... The Estates meals... are two sit down meals a day, in the dining room, but always available is the coffee/cocoa/tea shop with cookies or doughnuts. The Estate rooms all have full kitchen refrigerators, ranges etc. Apartment cleaned weekly, and assists with laundry. Free TV, Internet, and all utilities.
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If you've heard all of this before, sorry... but there are new members that might have an interest and I don't wanna send them to my long wordy thread.

 

[Teacher Terry]

Bob, it looks really nice. I can see why you like it.

 

[ncbill]

Again just understand there's no guarantee you'll get the higher level of care at your CCRC itself.

Over the course of 20 years they lived there my grandparents' CCRC added dozens of independent & assisted living apartments, but tore down their old skilled care facility & rebuilt it with only half of the previous number of skilled nursing beds.

The CCRC would still have covered care for those requiring skilled nursing, but it became much more likely that would be at an off-site nursing home with who knows what rating instead of at the CCRC's skilled nursing facility.