It is somewhat ironic that when you choose to move into a continuing care retirement community (CCRC), also known as a life plan community, you hope you’ll never need one of its most important features: the on-site healthcare center. Still, many residents will require some level of care at some point, from assisted living to full-time skilled nursing. So how can you determine whether the healthcare center at a CCRC will meet your expectations?
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Researching for yourself
The healthcare center at a CCRC functions much like a nursing home on the community campus, though in some cases it may be operated off-site under contract. Residents who live in the healthcare center—temporarily or permanently—are typically cared for by a mix of certified nursing assistants (CNAs), licensed practical or vocational nurses (LPNs/LVNs), and registered nurses (RNs).
As you evaluate a potential CCRC, there are several steps you can take to assess the likely quality of care in its healthcare center.
CMS quality rating
A logical first step is to check whether the healthcare center is listed on the Centers for Medicare & Medicaid Services (CMS) quality rating system. Medicare’s Nursing Home Care Compare assigns facilities a rating from 1 to 5 stars and provides details about staffing levels, inspection results, and any fines or citations. Note that this information is only available if the healthcare center is Medicare-certified; being certified, or not, is not a definitive quality indicator but it does provide useful data when it exists.
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Long-term care ombudsman records
Every state has a long-term care ombudsman program that advocates for residents of nursing facilities. Ombudsmen handle complaints and can inform you about any regulatory violations or patterns of complaints associated with a specific facility. Contacting your state’s ombudsman can reveal issues that might not be publicly visible.
Community complaints
Complaints against CCRCs are relatively uncommon; many communities provide excellent care. Still, ask the community whether they maintain a record of complaints filed by residents or family members. How openly they share this information speaks to their transparency and willingness to address problems.
Staff satisfaction and turnover
Staff turnover in nursing care settings tends to be high—industry averages hover around 30 percent. Ask about the healthcare center’s staff tenure and turnover rates. Elevated turnover can indicate low staff morale or management issues, which may affect quality of care. Conversely, managers who readily share staffing information and demonstrate pride in their team are generally more trustworthy than those who avoid the topic.
Take a look for yourself
A personal visit to the healthcare center can be very revealing. During a tour, observe whether the staff appear engaged and professional, whether the facility is clean and free of unpleasant odors, whether the environment feels welcoming, and whether residents look well cared for. Even a short visit can give you a clear impression.
First-hand accounts
Hearing directly from current or former residents and their families is one of the most reliable ways to learn about a healthcare center’s day-to-day performance. If you can, speak with people who have received care there and ask about their experiences, responsiveness of staff, and the overall atmosphere.
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Questions to ask about the CCRC healthcare center
When comparing CCRCs, remember that a key part of what you’re paying for is the assurance of a full continuum of care if you need it. Ask specific questions about the healthcare center so you understand exactly what services are available and what the experience is likely to be.
Consider asking these questions during your visits and conversations with management:
- Is there an on-site medical doctor? If so, are they full-time or part-time?
- Are preventive and routine medical services available to independent living residents (for example, routine physicals or dental exams)?
- Is there an on-site pharmacy or a regular pharmacy delivery service?
- Are skilled nursing and rehabilitation services offered, and if so, are they provided on-site or off-campus?
- If skilled nursing is off-campus, is regular transportation available to allow spouses and other residents to visit? How frequently?
- Are private rooms available in the healthcare center, and is there an additional cost for a private room?
- If you require temporary care in the healthcare center, do you retain the right to return to your independent living residence, and for how long?
- For couples: if one partner requires permanent placement in the healthcare center, can the other partner move to a smaller or less expensive unit?
- What is the healthcare center’s CMS star rating, if applicable?
- Are healthcare and personal care services reduced or limited on weekends?
- Are assisted living and skilled nursing residents housed separately or in the same building?
- How does the community’s ratio of CNAs, LPNs/LVNs, and RNs compare to legal minimums and to local norms?
- What strategies does the CCRC use to recruit and retain qualified healthcare staff?
View and download our Ultimate CCRC Checklist to learn more about choosing the CCRC that is right for you.