Payment systems for continuing care. Continuing care payment arrangements vary quite a bit from one community to another, and these systems can be complex. In most cases, residents pay a large entrance fee -- or, in some CCRCs, they will purchase the unit they move in to -- and then a monthly fee after that. Continuing care is an expensive option; costs vary widely, but your friend or relative will likely be looking at upwards of $100,000 to move in and $2,000 or more a month after that. But if he can afford it, he can generally be confident that his needs will be met for the rest of his life once he moves in.
If he purchases a life-care contract, everything including housing, meals, medical care, and skilled nursing care will be covered, and the monthly fee shouldn't go up as he moves from one level of care to the next. He can also choose a modified or fee-for-service contract; this is generally less expensive at first, but additional fees will be charged as more care or services are needed. Costs will also vary based on the size of the unit he chooses.
Reading and understanding the contract is important in helping an older adult choose any kind of housing option, but when it comes to continuing care, it's a must. In fact, because a CCRC represents both a long-term commitment and a significant financial investment -- and because contracts can be long and complex as they detail what will happen as your friend or relative moves from one level of care to the next -- it may be worth it to him to have an elder law attorney go over the contract once he has selected a community or communities to consider.
Choose wisely. First, ask to see licensing reports. This will give you an idea of how any given community has fared on past inspections and whether there have been any substantiated complaints. Look at the activity calendar and see whether it matches your friend or relative's interests, and make sure you visit all three wings or areas -- independent living, assisted living, and skilled nursing -- to get an impression of whether they're clean and pleasant, whether residents seem content, whether enough staffers seem to be present for the number of residents, and so on.
As with any retirement or care community you and someone you've been caring for are looking into, there's no substitute for spending time there, joining residents for meals, and talking with them about their experience. (If administrators discourage you from talking to current residents, this may a red flag.) The whole idea behind continuing care is that this is a place your friend or relative will spend the rest of his life, so invest some time in getting to know a community and making sure he feels comfortable there before making a commitment.
