One takeaway from the pandemic ...

[explanade]

If a "Life Care" CCRC is your target, don't forget that most properties will require you to be in reasonably good health mentally and physically before allowing you to enter. After-all, they are agreeing to give you care for the rest of your life. Both of us had to pass a comprehensive physical and cognition assessment prior to our admission at out CCRC.
Timing to enter a life care property is to me is one of the most difficult decisions to make in this option. Early is probably better than later since you wont get in if you are too late. Early also has the benefit of being able to enjoy the benefits while healthy (increasing your return on your entry fee) but then again you may no longer care when you are dead.

Do they require looking over your finances and basing the entry fee on that?

 

[braumeister]

If a "Life Care" CCRC is your target, don't forget that most properties will require you to be in reasonably good health mentally and physically before allowing you to enter. After-all, they are agreeing to give you care for the rest of your life. Both of us had to pass a comprehensive physical and cognition assessment prior to our admission at out CCRC.
Timing to enter a life care property is to me is one of the most difficult decisions to make in this option. Early is probably better than later since you wont get in if you are too late. Early also has the benefit of being able to enjoy the benefits while healthy (increasing your return on your entry fee) but then again you may no longer care when you are dead.

Thanks, this is a very important point. The places I'm familiar with will only allow you to enter if you qualify for the "independent living" category. No problem on moving to more care later on, but they won't take you if you're not in reasonable health to start with.

 

[nwsteve]

Do they require looking over your finances and basing the entry fee on that?

I can only speak with authority regarding our move. We looked at four different properties (limited number of life care in WA). In every case the entry fee was determined by unit you wanted to live. The amount you actually pay can also vary based on what percentage of your entry fee you want refund at end of occupancy. Residents usually come into Independent Living. Units were pretty much the same as condos. Some properties have duplex/4 plexs but pricing is explicit.
All the properties did require complete financial disclosure so they could confirm you had enough resources to pay the monthly fees. for the rest of your life. The entry fee is locked in but monthly fees reset annually to cover inflation increases. This fee never changes (except for annual inflation adjuster) regardless of the level of care you are receiving. Monthly fees vary widely among properties depending on size of unit and services included. For example, some CCRC include meals while others are ala carte.

 

[explanade]

What do you mean the percentage you want refunded at end of occupancy?

You mean what your heirs would recover?

So the entry fee is probably 5 or 6 figures?

What do they look for income tax returns or they want financial assets statements?

 

[nwsteve]

What do you mean the percentage you want refunded at end of occupancy?

You mean what your heirs would recover?

So the entry fee is probably 5 or 6 figures?

What do they look for income tax returns or they want financial assets statements?

Yes, heirs are the usual beneficiaries of the refund amount. But if for some reason you needed to relo somewhere else, you also could get. In our short time here, we have already seen one couple move because their kids wanted them closer. Apparently walking away from 25-50k not a biggie.
Each CCRC offers their own mix of refund options. When we were deciding, we had a 95%, 75%, and 5 yr amortized to zero . We only have one heir and she is not likely to care. Biggest reason we chose the 5 year amortized is our entry cost was 40% less. ;-)

 

[harllee]

In my county there have been 2 nursing homes (not CCRCs or assisted living facilities but skilled nursing homes) with a substantial number of COVID-19 deaths. Both of these places mainly have Medicaid patients and in the past have had many state violations. They are not the kind of place I would want to live in or have any of my family live in. One lesson to learn from all of this is to plan for where you may eventually end up and definitely try to not end up in a nursing home that has a lot of violations. Personally I plan to move into a very highly rated CCRC.

 

[gayl]

This thread is exactly why I'm self insuring. My invested assets, pension, and SSA should cover 150% of aging in place. If I have to go to a senior housing place, I am planning on moving to a senior community and aging in place in a townhouse .... renting this place out. Our local one, Rossmoor, has a reasonable rec center with restaurants, social workers, home maintenance, etc. And I still get my own 3 bedroom / 1 bath / full kitchen / private patio & parking .... but I won't drive. I have a friend who moved there and it's relatively nice. I just am no where near wanting a 55+ community now. I like multiple generations but it is an alternative

 

[audreyh1]

In my county there have been 2 nursing homes (not CCRCs or assisted living facilities but skilled nursing homes) with a substantial number of COVID-19 deaths. Both of these places mainly have Medicaid patients and in the past have had many state violations. They are not the kind of place I would want to live in or have any of my family live in. One lesson to learn from all of this is to plan for where you may eventually end up and definitely try to not end up in a nursing home that has a lot of violations. Personally I plan to move into a very highly rated CCRC.

Right.

Hopefully infection control will improve everywhere, but obviously the less well heeled places are going to have more limited resources and infection control will probably always be a challenge.

Simple things such as routinely testing staff is obvious now, but at the beginning very few realized how vulnerable nursing homes were, and that you could have community spread going on for a long time undetected before it suddenly manifests are a major nursing home outbreak.

 

[audreyh1]

This thread is exactly why I'm self insuring. My invested assets, pension, and SSA should cover 150% of aging in place. If I have to go to a senior housing place, I am planning on moving to a senior community and aging in place in a townhouse .... renting this place out. Our local one, Rossmoor, has a reasonable rec center with restaurants, social workers, home maintenance, etc. And I still get my own 3 bedroom / 1 bath / full kitchen / private patio & parking .... but I won't drive. I have a friend who moved there and it's relatively nice. I just am no where near wanting a 55+ community now. I like multiple generations but it is an alternative

Just FYI - a typical 55+ community does not include long term care options. You have to find a CCRC for that.

 

[MichaelB]

I think LTC facilities are showing they can keep their residents relatively safe - when they try - but we’ve yet to see the additional financial cost, and I expect it to be substantial. It also comes via total lockdown, and we’ve yet to see if they can keep residents safe while allowing visitors.

 

[explanade]

I think LTC facilities are showing they can keep their residents relatively safe - when they try - but we’ve yet to see the additional financial cost, and I expect it to be substantial. It also comes via total lockdown, and we’ve yet to see if they can keep residents safe while allowing visitors.

The different types of places, including CCRC, let residents go out right, drive their own car and so forth right?

So maybe they would have to institute regular testing or offer it, though there may be a payment issue unless Medicare covers it.

Or at least institute strict PPE and infection prevention measures between residents and staff.

 

[Nemo2]

I have no idea what I will do if/when I can't care for myself any more.

DW & I discuss this more frequently lately.....more so, I guess, because her 94 1/2 year old dad is getting closer to expiration.

We both feel, if the other one isn't around........"Get me outta here!"

 

[harllee]

The different types of places, including CCRC, let residents go out right, drive their own car and so forth right?

So maybe they would have to institute regular testing or offer it, though there may be a payment issue unless Medicare covers it.

Or at least institute strict PPE and infection prevention measures between residents and staff.

My mom (age 88) is in a CCRC --independent living apartment. Until last week no visitors were allowed and if she left the campus she was required to self quarantine for 14 days. When she leaves her apartment she must wear a mask. All common areas like dining hall, game room, fitness center are closed. Her CCRC is taking the virus very seriously and I am glad

 

[HI Bill]

...doesn't it financially benefit some of these businesses if the people in their care die earlier?

No. They want to keep their residents in place as long as possible, as each resident brings in ~$6K+ per month. When my mom was dying two years ago, they obtained special permission from Medicare to order appetite-enhancing drugs to keep her eating. They kept bringing her to the hospital to keep her alive and in their care. They said "she has a good two years left", but were wrong. It was more like 7 days.

 

[explanade]

My mom (age 88) is in a CCRC --independent living apartment. Until last week no visitors were allowed and if she left the campus she was required to self quarantine for 14 days. When she leaves her apartment she must wear a mask. All common areas like dining hall, game room, fitness center are closed. Her CCRC is taking the virus very seriously and I am glad

What happens to meal service?

Housekeeping?

 

[harllee]

What happens to meal service?

Housekeeping?

Meals are delivered to my mother's apartment now(she gets 10 meals per week under her plan). Before the virus, meals were served in a large dining room. She has a kitchen and gets groceries delivered and cooks her other meals. She has housekeeping once per week but if she left the campus and went under the 14 day quarantine she did not get housekeeping during that time. Since our state went on Phase 2 there have been changes--she can now have visitors (but she has asked our family not to visit yet--some of our family has not been careful about the virus and she is afraid to have them visit her and I don't blame her) and she no longer has the 14 day quarantine after leaving the campus.

 

[explanade]

That sounds like fair rules by that particular facility. Good considering nobody probably had plans to deal with a pandemic.

 

[athena53]

Dad, age 89, is in a rehab facility after a stroke and will be moving to a skilled nursing facility. The rehab place immediately took his clothes and sanitized them before letting him wear them. He was just tested a week or so ago- negative. It was actually worse in his Independent Living Facility- no socialization, meals all delivered to his door in styrofoam.

Having seen Dad's slow slide downhill over the last few years as various bodily systems pass their "sell-by" date and having seen everything my siblings in the area have done for him- taking him to their places for dinner, bringing home-cooked food, taking him to the doctor, getting him to give up his car.... I cannot imagine expecting DS and DDIL to take me in or to do everything for me that I can't do for myself when I can no longer live independently. My primary financial goal is to provide for whatever care I need through the end of my life.

And if something like COVID-19 takes me out when I'm in the shape Dad is in, that's OK with me.

 

[harllee]

Dad, age 89, is in a rehab facility after a stroke and will be moving to a skilled nursing facility. The rehab place immediately took his clothes and sanitized them before letting him wear them. He was just tested a week or so ago- negative. It was actually worse in his Independent Living Facility- no socialization, meals all delivered to his door in styrofoam.

Having seen Dad's slow slide downhill over the last few years as various bodily systems pass their "sell-by" date and having seen everything my siblings in the area have done for him- taking him to their places for dinner, bringing home-cooked food, taking him to the doctor, getting him to give up his car.... I cannot imagine expecting DS and DDIL to take me in or to do everything for me that I can't do for myself when I can no longer live independently. My primary financial goal is to provide for whatever care I need through the end of my life.

And if something like COVID-19 takes me out when I'm in the shape Dad is in, that's OK with me.

I am so sorry about your Dad. I am so lucky my mom, age 88, is still in very independent and in good shape, still driving her car, before the virus was very active going out every day and doing all the activities at her CCRC. I hate she has been on "lock down" as has everyone but I am grateful her CCRC has taken such proactive steps. I speak to her every day for at least 30 minutes on the phone and sometimes by FaceTime.

 

[timo2]

I hope one of the outcomes of Covid is a thorough reform of how we care for older needy people.

+1

 

[audreyh1]

And if something like COVID-19 takes me out when I'm in the shape Dad is in, that's OK with me.

Yeah, basically when I’m at the point where I’ve lost my mobility and am bed bound and require a skilled nursing facility, longevity will not be a priority for me.

 

[explanade]

About a month ago, someone noted that the deaths were mostly over 65 and so on.

But even with underlying conditions, many of the ones who perished still had a life expectancy of 10 years if not for C19.

Or what if you were fortunate enough to survive it but you lost a lot of pulmonary function which might take years to recover?

Or renal failure?

Now if your mental faculties aren't completely there, like you had Alzheimers, then you may be oblivious to what's happening.