Continuing Care Retirement Communities

Continuing Care Retirement Communities : an emerging—and ill-defined—model in senior housing.

By: Grant Milne

As the movement towards aging in place continues to pick up steam, alternatives to senior housing facilities offering a single level of care increase in popularity. "Continuing Care Retirement Community" is a rather nebulous term used to describe senior housing communities that provide a wide range of care levels on the same campus. CCRCs, as they are commonly known, generally offer a long-term contract for housing, care and services, sometimes stipulating care will be provided until the individual's death.

The benefits of CCRCs are numerous. Living in a community which can provide care for ones needs as they change, whatever they may be, lends a great deal of peace of mind. It also simplifies the disruptive transition to a nursing home or rehabilitation facility after an acute health event, and can keep couples with disparate care needs close together.

Unfortunately these benefits come at a cost, as many communities require residents to pay substantial "buy in" fees. These fees, coupled with relatively high costs of care and living, preclude most CCRCs from being viable alternatives for older Americans who are living on a modest nest egg.

Continuing Care Retirement Communities can also prove to be a confusing concept, as little is standardized across the sector. Both ownership and rental arrangements can be found, and care agreements range from fee-for-service plans to comprehensive coverage for life at set monthly rates. Even the phrase Continuing Care Retirement Community is inconstant, as some use names such as Life-Care Community or Continuum of Care Facility.

Further muddying the issue is that fact that most state licensing organizations have yet to catch up with the influx of these unique communities. Only 16 states have dedicated licenses for CCRCs, while others simply grant multiple licenses to the community, which can make identifying them difficult. What's more, there is wide variance among the definitions of CCRCs used by the states that do have explicit licenses for such communities.

In those 16 states, there are a total of 671 communities licensed as CCRCs. An analysis of SNAPforSeniors' comprehensive senior housing database indicates that it lists more than 3,000 senior housing communities that provide two or more types of housing or care (e.g., assisted living, skilled nursing or independent living) as indicated by their licenses. While this is an admittedly simplistic interpretation of what constitutes a CCRC, the figures indicate a major disparity between the number of documented communities and the likely total figure.

According to a report by the American Senior Housing Association (ASHA), CCRC properties exhibited the second largest growth percentage in 2007 of the six categories of senior housing tracked in 75 major markets. More CCRCs were built or expanded (53) than nursing homes (46) despite there being about 6.5 times more nursing homes currently in existence.

If these growth numbers are any indication, Continuing Care Retirement Communities seem poised to seize a larger share of the senior housing market over the coming years. Hopefully such a shift will bring with it more standardization in the definition of CCRCs, as well as widespread adoption of dedicated licensing for the communities.


This article is provided by SNAPforSeniors, the most current and comprehensive senior housing resource in the nation.