for more than one year, or the balance of
their lives. Usually, it is a wise idea for
seniors to move into a CCRC sooner rather
than later, as most CCRCs require that new
residents be capable of living independently
when they first move in.
There are a number of contract options
offered by CCRCs to seniors and their
families. An extensive care contract is the
most expensive, but affords the least risk,
providing unlimited long-term nursing care
at little or no additional cost for as long as
nursing home services are needed by the
client. A modified care contract comes
with medium financial risk, and provides
long-term health or nursing services for a
specified period of time, after which, the
senior or their guardian is responsible for the
additional cost. A fee-for-service contract
offers an a la carte approach, requiring that
residents pay separately for all health and
medical services provided by the facility, as
well as long-term care. While a fee-for-service contract is the least expensive contract,
it does have the highest risk, as costs can run
very high for seniors who require unanticipated extensive care later in life.
The most common element in a CCRC
contract is an entrance fee, where regardless of whether the contract is an extensive,
modified or fee-for-service contract, the
resident pays a lump sum entrance fee,
plus monthly fees thereafter. Another
CCRC contract option may require an
equity agreement where seniors purchase
a condominium or co-op apartment on the
property instead of paying an entrance fee.
Less commonly found are CCRC contracts
where residents pay monthly fees only.
Seniors and their families are advised to be
sure to read the fine print on the contract
carefully to ensure that they are signing
an agreement that guarantees the lifetime
of services and support over an extended
period of time that they are looking for.
There are so-called copycat senior-care residences that claim to offer all the benefits of
a CCRC, but in reality the services guaranteed by the actual contract fall far short of
the claims made by management.
Before signing a contract with a CCRC,
seniors should conduct a thorough review
of the facility’s services, operations and
finances, and determine that the CCRC
is appropriate to their needs, lifestyle and
expectations. It’s also a good idea to ask
a family attorney or accountant to review
the contract as well. If the contract is found
agreeable, ask to spend at least one night
and two days at the facility, to test drive the
community and make sure it is a good fit.
Some points to consider include:
• Are pets allowed in your residence?
• What social, recreational and cultural
activities are offered?
• Is food prepared onsite? If so, how is it?
• Are there fitness facilities onsite?
• Is the staff friendly and knowledgeable?
• What healthcare and personal care
services are available?
• What preparations have been made for
handling medical and evacuation emergency situations?
CCRCs are an excellent option for those
who are independent and in good health,
but might need some assistance with daily
living needs or require skilled nursing care.
The variety of housing offered by CCRCs
is varied as well, ranging from ultra-urban
high-rise apartment communities to cottages,
townhouses, duplexes or even single-family
homes located in a beautiful, natural setting.
An Assisted Living Community (ALC)
bridges the gap for seniors who need assis-
tance with daily activities as a nursing
home might offer, but wish to live as inde-
pendently as they are capable of living for
as long as possible. Residents in an ALC
are unable to live by themselves, but do not
require constant supervision. An ALC offers
its residents assistance with eating, bathing,
dressing, laundry, housekeeping, and keeping
track of medications. They often have centers
for medical services, but typically do not
offer the extensive medical services provided
by a nursing home. An ALC is not a substitute
for a nursing home, but rather is a stepping
stone between complete independence and
service provided by a nursing home.
Often, an ALC will create an individualized service plan for seniors upon
admission, detailing personal services
that will be provided to the resident. This
plan is periodically reviewed and updated
to provide the correct care each resident
receives. Housing in an ALC may be studio
or one-bedroom apartments with small
kitchen facilities. Typically, ALC housing
units have group dining facilities and
common areas where residents gather to
enjoy social and recreational activities.
An ALC may be licensed as a “Type A” or
“Type B” facility, says Martinez. “A facility
with a Type A licensing means that the
residents are mentally and physically able
to vacate the building without assistance
within 15 minutes,” says Martinez. “A
Type B certification means that residents
require assistance to vacate the building
within 15 minutes. Our facility is licensed
for Type B, as we are also certified to care
for residents with Alzheimer’s.”
“Your first impression of an Assisted Living
Community is the most important,” says
Martinez. “What do you see when you get
out of the car? How do they take care of the
lawn? What is your first impression of the
staff? Are the residents properly dressed?
How’s the lighting inside the buildings?
What activities are available? Are staff
members all in the same uniform? Scrubs
are not appropriate for an Assisted Living
Community, but nametags are important.
NURSING CARE FACILITIES
A Nursing Care Facility (NCF) is a state
licensed, private-care facility that provides
24-hour skilled hospital care for residents
who do not require hospitalization but
cannot be cared for at home. Also called
Long Term Care Facilities, the majority of
nursing homes are staffed by caring, trained
persons who provide an excellent level of
service for their residents.