Understanding Continuing Care Retirement Communities (CCRCs)
In Southwest Florida, Continuing Care Retirement Communities (CCRCs) also known as Life plan communities are very popular. There are many quality CCRCs in this area and because of this, much is needed to increase your understanding about what is a CCRC, and if they are right for you.
These resort-style communities require a significant up-front investment and on-going monthly fee. The basic premise of a CCRC is to allow you to age in place within the community. You move to an independent living residence when you are healthy and active and should your health decline, there is a contractual commitment to provide care and services for you as your needs change. Normally, this care is provided on-site. People select a CCRC since they want the peace of the mind of knowing that they have planned for their future health care needs while enjoying a vibrant lifestyle.
Peace of Mind for your future
People move to CCRCs for the peace the mind of their future. Once all the “what-if” scenarios have been solved, residents are able to enjoy a life filled with friendships, social activities, fitness and cultural programs. Many couples choose to live in a CCRC since they know they are protecting each other should their health change. Lifelong friendships are made since the people living at a CCRC are less transient than other types of senor communities. Since the continuum of care is located either within the main building or on the campus, couples are easily able to be with each other as their needs change. There a feeling of community within a CCRC. Residents can be part of resident council committees (finance, dining, programing, health care, etc.), social groups or sporting activities. Residents also maintain an active life in the greater community as well.
There are CCRCs on large campuses or within single or multiple buildings. Floor plans range from one bedrooms up to spacious three bedrooms. There are even free-standing homes at some CCRCs in the area. Many people elect to personalize their own residences with upscale finishes and appointments similar to what they currently have in their homes.
Better to be 5 years too early rather than 5 minutes too late!
Since CCRCs are obligated to provide care for their residents, CCRCs require a medical and financial assessment for acceptance to the community. Unfortunately, there are times when someone waits for a crisis to occur before deciding and in many cases, they are not accepted to the community of their choice. As I always say, “it’s better to be five years too early rather than five minutes too late.”
Similar to applying for life insurance, the CCRC will require detailed medical information about you. In most cases, a one-one meeting is conducted with the community’s nurse to determine a risk factor. Medical criteria do differ from community to community. Again, the key is to not wait for your health to decline before applying for residency.
A financial application is also required. The CCRC wants to make sure you can sustain yourself financially for many years. The general rule is you should have at least 2 to 3 times in assets of the entrance fee and annual income of the monthly fee. Many communities have a benevolent fund established to help someone should they deplete their assets and can no longer pay the monthly fee.
CCRCs require an upfront entrance fee and an on-going monthly fee. Depending on the specific community, a percentage of the entrance fee could be refundable upon death or when the residency agreement is terminated.
The entrance and monthly fee at a CCRC are based on the residence size and the number of people under the contract. Couples pay an additional amount for the second person. Depending on the community, services and amenities included in the monthly fee vary. Typically, they include meal plan, housekeeping, social programming, transportation and maintenance services.
Office of Insurance Regulation (OIR) Oversight
CCRCs in the State of Florida are strictly regulated by the Office of Insurance Regulation (OIR) through Florida Statute Chapter 651. Within this Statute, there are requirements refund provisions, liquid reserve requirements, financial disclosure, resident rights and reporting guidelines. All residency agreements must be approved by the OIR. The OIR is the consumer watchdog to make sure the CCRC is fulfilling its obligations to its residents. For more information, go to: https://www.flsenate.gov/Laws/Statutes/2018/Chapter651
Types of Residency Agreement
There are different types of residency agreements within CCRCs. The Type A contract is most traditional type. The Type A contract stipulates that should assisted living, memory care or skilled nursing be needed, the monthly fee will remain a constant and not be increased due to the care being provided (ancillary services and products as well as two additional meals will be extra). Normally, the Type A has the strictest medical criteria to move in. The Type B contract either includes assisted living and memory care or provides a discount on care when needed. In the Type C contract, all care-related charges are out of pocket with no discount provided. The Type C has the least medical acceptance criteria to move in.
Refund provisions at the CCRCs vary as well ranging from a 0% refund up to 90 and even a 100% refund. Normally, the higher percentage refund equates to a higher entrance fee. It is important to note that a CCRC contract is not a real estate transaction, therefore you do not have equity in the community. The fees you are paying are paying for care and services over your lifetime.
Because CCRCs are not real estate, there are no HOA dues or assessments, closing costs, or the worry about your estate selling your residence. In most cases, real estate taxes are paid by the community and not individually.
Possible Tax deduction
A portion of the entrance fee and monthly is considered a pre-paid medical expe
nse so the IRS does allow you to deduct this percentage providing you itemize your taxes. The percentage varies from community to community and year to year. Each CCRC should be willing to share with you the percentage so your accountant can plan accordingly.
As mentioned, the continuum of care is main component to a CCRC; therefore, much due diligence needs to occur to understand which health care components are available should care be needed in the future. Not all CCRCs are the same in this regard.
Demographics vary from community to community. There are CCRCs that are not for profit religiously focused and others that are managed locally or through national corporations. Finding a CCRC where you can live with ‘like-minded” people is an important part of the research process.
Senior Housing Solutions
As Senior Housing Advisors, we understand the differences and the complexities of this decision and educate you on which plan best fits your needs. For more information, go to. www.seniorhousingsolutions.net
The Leadership Coalition on Aging (LCA), sponsored by Collier Senior Resources (CSR) was established in 2012 as a means for local health and human service providers to collaborate toward enriching the lives of Collier County Seniors and their caregivers. The coalition seeks to foster a community environment that promotes well-being through resource sharing, education, advocacy and community outreach.
The coalition members are local health and human service providers who:
Meet monthly and seek new solutions to serve seniors in our community
Host the annual Collier County Conference on Aging
Sponsors an Empowerment Series for seniors and caregivers with programs offered throughout the year including Alzheimer’s and dementia, death and dying (advanced directives, living wills, hospice, DNR)
Educates local candidates on senior-related issues
In 2013, the Leadership Coalition on Aging with the support of Collier Senior Resources and other local organizations sponsored the FGCU Study on Senior Needs Assessment, and hosted the inaugural Collier County Conference on Aging.
Selecting a senior living community is not an easy task. These are common questions we get asked.
My children live up north, should I move to be with them?
As a son whose mom lives nearby, I truly understand the importance of having family close. Fortunately, we both live here in Southwest Florida, and we can be part of each other’s lives. The idea of moving out of state to be nearer to children is a big decision that involves many factors and changes. First and foremost, is the question of whether you are ready to give up your current lifestyle? Do you have friends or a social network in their area, or will you be depending upon your children to provide you with the socialization you need? Will you live with them, or will you find a place of your own? You will need to think about changing your primary care physician and specialists, your bank, and your church. How comfortable will you be driving during winter conditions? Will the winter weather hamper your activity level and lessen your independence? Are your children committed to continuing to live in that area, or could their careers take them to another location? What happens if they retire, will they want to stay in that location? As you can see, there are many factors involved in deciding to move closer to your children. I would recommend before making that decision, to visit the senior living communities in this area. You may be able to fulfill yours and your children’s desire for security and peace of mind without such a drastic change.
If I move to a senior living community, do I need to change doctors?
When you live at a senior living community, you can continue the relationship you have with your primary care physician and specialists. As a convenience to the residents, many communities do have relationships with physicians and these doctors maintain clinic hours at the senior living community. You are under no obligation to use these doctors; however, residents find it time saving and worthwhile to establish a relationship with a physician on site. If you decide to keep your physician, most senior living communities provide transportation to and from your medical appointments to make life a little easier for you.
I want to move to a senior living community, but my husband does not. What should we do?
It is very common for one spouse to not be on the same page as the other when considering a senior living community. Many times, it is hard for someone to think forward and contemplate scenarios when they are less independent. Most likely, your current residence will not be suitable as you advance in age. It is not sensible to believe your health will remain as it is for the rest of your life. Share with your husband that not putting a plan in place now would place the entire burden on your shoulders if something should happen to him in the future. It is easier to make the move when you are both able to select a community together, sell your home together, pack and move together, and make new friends together. Hopefully, he will recognize the importance of protecting you and creating a life which you both can continue to enjoy for many years.
There are so many senior living communities to consider in our area, where do I start?
Locating a senior living community that meets your needs and preferences is not easy, especially if you try to do it alone. As a senior housing advisor, this is exactly what we do. We get to know you and discuss which options best fit your needs and preferences. We are familiar with all the options in the area and the nuances of each. We help you narrow down the search and create a road map of places that meet your requirements. We are also familiar with the new communities on the horizon and have much insight about a community’s operational history. If desired, we can join you on your tour and ask questions you may not know to ask. We help you understand the terms of the contract and even negotiate the fees, as appropriate. Trying to do it alone is a monumental task. The last thing you want to do is move somewhere and be unaware that the community is experiencing financial or operational issues. Taping into a knowledgeable resource will help you avoid these pitfalls.
Please explain how the refund programs work at Continuing Care Retirement Communities (CCRC)/ Life Plan Communities?
CCRCs/Life Plan Communities offer a variety of entrance fee refund programs – 0%, 50%, 75% and even 95% refunds. The entrance fee is typically earned by the community at a rate of 1% to 2% per month. There is usually a 2% to 4% administration fee earned during the first month. Each month that you live at a CCRC, a percentage is deducted (earned) from the entrance fee that you paid. If you select the 0% refund plan, your entrance fee refund will decline over 4 – 7 years until your refund reaches zero. On the other hand, if you select the 50%, 75% or 95% plan, your estate will have a set amount refunded. If you opt for a higher refund program, you will pay an “up charge” for these plans as compared to the 0% refund program. Basically, you pay more upfront to be guaranteed a higher refund.
Some communities will offer different refund programs based on their health care plans. For example, a community might offer a 95% refund, but you would also be responsible for paying for higher levels of care as needed. It is wise to consult with your attorney and financial advisor to determine which plan best fits your needs.
Are there resources available for low income seniors in our area?
Collier Senior Resources at the Golden Gate Senior Center has funding to provide financial assistance to low-income seniors in need. Call Maritza for more information at 239-252-4550. The Area Agency on Aging for Southwest Florida is another valuable resource. The Area Agency on Aging is committed to connecting older adults and adults with disabilities to resources and assistance for living safely with independence and dignity. They can be reached at 239-652-6900.
Are there any upcoming educational seminars for area seniors?
The Leadership Coalition on Aging (LCA) is conducting their Empowerment Series Panel Discussion on Sept. 13 from 1:00 p.m. to 3:00 p.m. at the Collier County South Regional Library. The topic will be Advanced Planning – Getting your Affairs in Order. It will feature an attorney, a physician, an accountant, and a real estate professional. The event is free. For more information, please call 239-595-0207.
To have your senior housing questions answered in a future article, please submit your questions to: [email protected]
Senior Housing Expert and Advisor Bruce Rosenblatt is the owner of Senior Housing Solutions.
Do you think I will qualify to live in a senior housing community if I have a pre-existing condition?
Without knowing the specifics of your condition, it is hard to say. There are many senior housing communities that have medical criteria to be accepted for residency. The medical review process could include reviewing your medical history and a one-on-one meeting with a representative from the community’s medical staff. Someone who has a pre-existing condition may represent a higher than normal risk of requiring care and may not be accepted. Cognitive types of medical issues or progressive medical diseases are red flags and may disqualify you, so it is important to plan ahead. It is important to ask questions early in the process, so you don’t sell your home only to find out you did not meet the qualifications for residency. Medical acceptance varies from community to community, so you might find one that is more willing to accept you than another. If you are considering moving to an assisted living facility, the State of Florida requires a form called an 1823 to be completed by your doctor to verify that this is the proper living arrangement for you and to document the care levels you require.
What is a Life Plan community?
A Life Plan Community is a replacement name for the category known as a Continuing Care Retirement Community (CCRC). The name change from a CCRC to Life Plan Community switches the emphasis from passive care to active living and planning – a shift that appeals to younger, healthier senior adults.
A Life Plan Community is a residential community for people 62 and older that provides a variety of living options, along with services, amenities, and a continuum of care designed to address the changing needs of residents as they age. In exchange for these services, amenities and care, residents typically pay an upfront entrance fee and a monthly fee.
We are independent and not sure if we are ready to move to a retirement community. What are our options?
Basically, you have four options to consider. First, you can do nothing. You can continue to stay where you are living and wait for something to occur to force you into a decision. This option may seem to be the easiest but has many implications that you need to think through. By waiting for a medical incident or a change in health, you run the risk of not being medically accepted. You also place a great deal of responsibility on your spouse, your family, and your friends to provide daily assistance. Managing care at home is not easy and can be quite costly. Keep in mind that thinking nothing will change is not being realistic.
The second option is to find a community geared specifically for independent living. There are some rental apartment communities in this area that provide a “maintenance free” lifestyle. This might be a good first step to lessen the responsibilities of homeownership.
The third option is to move to independent living in a senior living community. Most people who choose this option claim it was the best decision they have ever made. They have peace of mind knowing they have made a plan for the future should they require care and services as they age, all the while enjoying a vibrant lifestyle.
The last option is to move in with your children. This is probably not the best solution; but, for some this may be the only option due to limited finances.
I am not a social person, are there senior living communities that will fit my lifestyle.
The lifestyle at many senior living communities is geared toward providing social opportunities for residents to enjoy. Most offer a wide variety of activities such as exercise classes, lectures, wine tastings and cocktail parties, art classes, and book discussions. However, choosing to participate is totally up to you. If privacy is a concern, ask questions up front to see how the community will respect your privacy.
Are there any tax implications to living at a senior living community?
Yes. It is wise to consult with your tax advisor for the specifics to your situation. If you live in a Life Plan Community (CCRC), a portion of your entrance fee and monthly fee may be considered a medical expense. This percentage varies from community to community and year to year. If you live in an assisted living or skilled nursing residence, your care may also be able to be deducted as a medical expense.
We have a small dog, are there senior communities that are pet friendly?
Pets are important in people’s lives. There are studies that show that people live longer and healthier with a pet. Some communities will permit pets while others will not. There are also communities that have designated “pet friendly” residential buildings within their campus. Size limits and number of pets allowed also exists at many communities as well as rules regarding acquiring a new pet after you move in. It is important to note that if you move with a pet, you must be able to properly care for your pet. Most communities have a pet policy, and your pet must be well behaved and not be a nuisance or threat to other residents or to the staff.
Are there any senior housing communities in our area for low income seniors?
Low income housing in SWFL is a major problem facing many seniors in our area. Unfortunately, many times people will need to relocate out
of the area to find affordable housing. It is advisable to fully evaluate all your personal resources prior to visiting senior communities and identify any outside assistance that may be available to you. This may include Veteran’s benefits and even unused life insurance benefits. Speak with your family and your church to see if they can offer any assistance.
What are some other senior housing researching tips?
Tour the health care facility. One of the main reasons you are considering a move to a senior housing community is to have the peace of mind of future care should you need it. Take the time to tour the health care facility to see for yourself if the residents are receiving good care and if the environment is clean and well-maintained. Speak with family members, residents, and staff to learn as much as you can about quality of care. It is also important to learn what type of care the facility is licensed to provide, and what charges are associated with that care. As a senior housing advisor, we research state violations, license types, and annual state survey results. We will join you on your tour to ask questions you may not know to ask.
Review policies and procedures. Understanding the Do’s and Don’ts of a specific senior housing community before you move should be a priority to you. The more you know up front, the better you will know if this community is the right fit for you.
Sample the lifestyle. Finding a senior housing community where you can live with like-minded people is very important. If possible, enjoying a dinner at a community or joining in on a social activity before you move in will give you chance to meet people and see you want these people as your neighbors and friends. There isn’t a “one size fits all” senior living community, so being able to experience the lifestyle will help you see if this community is right for you.
Senior Housing Solutions Has Earned SAGECare Platinum Credential to be inclusive to LGBT older adults
First organization in SWFL to receive this credential
Senior Housing Solutions has recently completed LGBT Cultural Competency Training through SAGECare to be inclusive to all individuals who are seeking senior housing placement advice and to be sensitive to locating care facilities that non-discriminatory and open to all people.
“The training program really opened my eyes to the discrimination people face as LGBT individuals age and require care, states Bruce Rosenblatt, owner of Senior Housing Solutions. “As an organization, we want people to know we are aware of these concerns and will help people find a senior living facility where they will feel comfortable and welcomed.”
SAGECare (www.sageusa.care) is a division of SAGE the country’s oldest and longest organization dedicated to improving the lives of LGBT older adults. SAGECare provides lesbian, gay, bisexual and transgender (LGBT) competency training and consulting on LGBT aging issues to service providers.
Together Senior Housing Solutions and SAGECare will continue our partnership to serve people with the best care possible and help all people age with dignity and respect, with the comfort of knowing they will be celebrated for who they are.
Statistics
By 2030, there will be approximately 7 million LGBT older adults in the United States. The LBGT market today has a combined purchasing power of 830 billion dollars. 72% of the LGBT market feel extremely/very important to purchase from “gay-friendly” companies.About Senior Housing Solutions
Senior Housing Solutions is a locally owned, personalized, highly specialized and 100% free resource and referral service that helps find the right fit financially, medically and socially to people about assisted living, memory care and other senior housing options in Lee and Collier counties. With more than 30 years’ experience Senior Housing Solutions understands all the nuances of all the facilities and stays current on pricing, availability, healthcare surveys, occupancy, significant staff turnover and operational issues. Learn more at https://seniorhousingsolutions.net/.
