I talk regularly with people across the country who are considering a move to a continuing care retirement community (CCRC), also known as a life plan community. When I present to groups exploring senior living options, I learn a lot about how people evaluate this major decision and the questions that commonly arise. One frequent question is where to find reliable ratings or rankings for CCRCs.
There is no single independent source that ranks all CCRCs, but several reputable resources can help you evaluate communities. Below is a concise guide to the most useful sources and what each one does — and does not — tell you about a community.
Commission on Accreditation of Rehabilitation Facilities (CARF)/Continuing Care Accreditation Commission (CCAC)
CARF acquired the Continuing Care Accreditation Commission in 2003 and is the only national accreditation organization focused on CCRCs. A CARF accreditation indicates a community has undergone an in-depth review of its services and quality. The accreditation process includes an assessment of financial practices, although the precise weight given to financial review is not publicly detailed.
Keep in mind that CARF accreditation is voluntary and paid for by the provider. Not being accredited does not automatically mean a community is low quality; some communities choose not to pursue accreditation because of the time and expense involved.
>> Related: The Long-Term Care Ombudsmen Program: Advocating for Seniors
Centers for Medicare and Medicaid Services (CMS)
CMS publishes ratings for skilled nursing facilities on medicare.gov/nursinghomecompare, using a five-star scale based on inspections and reported data. These ratings can be a helpful indicator of the quality of skilled nursing care within a CCRC, but they apply only to the skilled nursing portion of a campus and only to providers that participate in Medicare and/or Medicaid. Private-pay-only facilities will not have a CMS rating.
>> Related: How to Analyze the Quality of a CCRC Healthcare Center
Standard & Poor’s (S&P) and Fitch Ratings
Credit rating agencies such as S&P and Fitch evaluate the creditworthiness of organizations that issue public debt. Their ratings offer insight into a community’s financial strength and its ability to meet obligations. This financial perspective can be useful when assessing long-term viability, but there are two important caveats:
- Only CCRCs that issue public debt are rated, which means these ratings cover a minority of communities.
- Credit ratings are one tool among many and are not a definitive measurement of operational quality or resident satisfaction.
>> Related: 4 Key Factors of the CCRC Decision Process
Other consumer feedback-based web resources
Consumer review sites and platforms that collect resident and family feedback can be another useful source of information. These sites are similar to Yelp or TripAdvisor in that they display firsthand reviews from residents and adult children, often focusing on care experiences and customer service. Be aware that some directories feature communities that have paid for placement or referral arrangements, and reviews can be subjective. Still, reading multiple reviews can reveal recurring themes about staff responsiveness, quality of care, and daily life at a community.
Making an informed CCRC decision
Choosing a CCRC involves many factors beyond a single rating: accreditation, skilled nursing inspection results, financial strength, and firsthand reviews are all pieces of the puzzle. Because there is no one-stop ratings source for all CCRCs, use a combination of these resources to build a well-rounded view of any community you are considering. Visit communities in person, review contracts carefully, speak with residents and families, and consult independent financial and legal advisors when appropriate. Doing thorough research will help you narrow your options and pick the community that best matches your needs and priorities.