In the last few years, some new options for retirement living have been developed. One is the Continuing Care Retirement Community or CCRC. CCRCs are different from other types of senior housing because these communities provide housing, personal services, and health care, usually at one location. CCRCs offer an environment and the services necessary for residents to "age in place." In other words, as a person's personal and health care needs change, they are able to remain at the retirement community.

CCRCs often have a variety of housing on one campus, from townhouses or "cottages" for independent living to studio apartments for people in supportive living programs. In addition to providing housing, CCRCs provide or make available some combination of the services and amenities listed below.

  • Nursing and other health-care services
  • Meals usually in a community dining area
  • Housekeeping
  • Emergency assistance
  • Personal care assistance
  • Recreational and social activities
  • 24 hour security
  • Building and grounds maintenance

In addition to providing health services, CCRCs offer, usually for a set monthly fee, a package of services, activities, and amenities that are designed to maximize the resident's independence. The composition of service packages varies greatly by CCRC. It is important to be clear about which services are included in the monthly fee and which are available at an additional cost. At many CCRCs, the types and amount of services, both available and included in the fee, will depend on whether the resident lives in independent or supportive housing.

The variety and intensity of health care provided varies greatly by CCRC. Some offer pre-paid insurance as a part of their regular fees; others require residents to purchase insurance on their own. At some CCRCs residents pay the same monthly fee whether they are in an independent living unit or the nursing facility while at others, different rates apply to independent living, assisted living and skilled nursing care. If different rates apply to different types of housing then, monthly fees would increase over time. Other communities offer a partial pre-payment arrangement in which nursing facility care is guaranteed for a specific number of days and beyond that, the resident is responsible for all costs. Still others guarantee only the availability of care and residents pay for care on a fee-for-service basis.

Continuing Care Retirement Communities

In the last few years, a variety of supportive housing options for elders have evolved. One option is the Continuing Care Retirement Community or the CCRC. CCRCs are different from other types of senior housing because they provide various levels of housing, personal care services, and health care services - all usually in one location. CCRCs offer a supportive environment in which elders can live amongst their peers and receive services that will allow them to "age in place." As their personal and health care needs change, elders can receive increasingly comprehensive care while remaining in the familiar setting of the community.

CCRCs typically combine a variety of housing options on one campus, from townhouses or cottages for totally independent living, to apartments for elders who need some personal care assistance, to nursing home accommodations for elders who require more comprehensive care. CCRCs provide or make available, usually for a set monthly fee ranging from $700 to $3,000 per month, some combination of the services, activities, and amenities listed below.

  • Nursing and other healthcare services
  • Meals usually in a community dining facility
  • Housekeeping and laundry
  • Scheduled transportation
  • Emergency assistance
  • 24 hour security
  • Personal care assistance, for example bathing, grooming, dressing, and toileting
  • Recreational and social activities
  • Building and grounds maintenance

The composition of service packages varies greatly by CCRC. It is important to be clear about which services are included in the monthly fee and which are available at an additional cost. At many CCRCs, the types and amount of services, both available and included in the fee, will depend on the type of accommodations in which the resident lives.

Most CCRCs also require a sizable declining-refundable entrance fee, ranging from less than $100,000 to more than $300,000.

Conclusion

This Consumer's Directory provides a brief introduction to continuing care retirement communities in Massachusetts. It is not meant to rank communities but to highlight some of the issues and concerns that should be evaluated before making a commitment to invest in a CCRC. We hope this guide will take some of the mystery out of choosing a CCRC. Life is full of surprises but choosing a CCRC should not be one of them. If you have any questions or concerns about CCRCs, please call the Executive Office of Elder Affairs at (617) 727-7750, (800) AGE-INFO (or 800-243-4636) or TTY/TTD (800) 872-0166.