Choosing a continuing care retirement community (CCRC), also known as a life plan community, offers an important advantage: a contractually guaranteed continuum of care. Most CCRCs provide a range of living options from independent living to assisted living and skilled nursing, which gives residents and their families the reassurance that appropriate care will be available should needs change. Residents can enjoy a maintenance-free lifestyle today while knowing future care needs have been anticipated.
Over the years I have visited more than a hundred CCRCs across the country. The majority deliver excellent service: staff are attentive, residents report satisfaction, and meaningful relationships form within the community. Still, as with any sector, quality varies among providers. While many CCRCs uphold their commitments, some fall short — sometimes dramatically — in areas such as care, management, or financial oversight.
High-profile stories about neglect or mismanagement tend to grab attention, but such problems can occur in other senior care settings as well. The difference with CCRCs is that residents often make a substantial financial and personal commitment. That makes it reasonable to expect a high standard of care and long-term reliability from these communities.
With that in mind, here are two central questions to consider:
- How can I choose a CCRC I can trust to honor its commitment to provide care over time?
AND
- What actions can residents or families take if a CCRC fails to deliver on its promises?
Choosing a reputable CCRC
An ounce of prevention goes a long way when selecting a CCRC, so thorough research before you move in is essential. There are several practical steps you can take to evaluate a community’s reputation, quality of care, and long-term financial health.
Review their scores
There is no single, centralized ranking system for CCRCs, but several resources can provide useful data:
- CARF (Commission on Accreditation of Rehabilitation Facilities) offers voluntary accreditation for CCRCs, assessing whether a community demonstrates consistent progress in efficiency, fiscal health, and service delivery.
- If a facility is Medicare or Medicaid certified, the Centers for Medicare and Medicaid Services (CMS) posts inspection-based ratings for the healthcare components of a CCRC.
- About two-thirds of U.S. states have some form of oversight or regulation specific to CCRCs; the level of oversight varies by state.
Review the financials
Financial transparency is a strong indicator of good management. Ask to see recent financial statements and reports. Look for sustained positive cash flow from operations and evidence that financial covenants are being met. A financially stable community should be willing to share financial information and answer questions about its fiscal health.
Talk with the local ombudsman
Long-term care ombudsmen are volunteer advocates who handle complaints and work to resolve issues on behalf of residents in care settings, including CCRCs. Contact your local ombudsman to learn about any complaints or regulatory actions involving communities you’re considering. Obtaining this information may require a phone call, but it’s a valuable step in your research.
Spend time on-site
Visiting a community in person offers insight you can’t get from brochures or websites. Tour at different times of day, eat in the dining room, and speak with residents about their experiences. If possible, stay overnight in a guest suite to get a realistic sense of daily life. Observing staff-resident interactions and the general atmosphere can reveal much about the quality of care and community culture.
When promises are broken
Most CCRCs are responsive when concerns arise, but when a community fails to honor contractual guarantees related to care or services, the consequences can be serious. If you encounter problems, take these steps to protect the resident’s interests and seek resolution.
Alert management
Begin by raising the issue with the community’s management. Directors and administrators should be willing to hear concerns and take corrective action. If the response is unsatisfactory, escalate the matter to the community’s board of directors and document all communications and outcomes.
Notify your local long-term care ombudsman
If management channels don’t resolve the problem, contact the local ombudsman. These advocates can assist with issues involving residents’ rights, inadequate services, management disputes, or financial concerns and can guide you through the complaint process.
Inform the state
In states that regulate CCRCs, you can file a complaint with the appropriate oversight agency. Procedures differ by state, so check with your state’s regulatory body to learn the correct steps for reporting problems and seeking remedies.
Next steps
If you want to explore CCRCs in your area, use reputable search tools and community directories to compare entry and monthly fees, contract types, and the healthcare services offered. Research, on-site visits, and conversations with residents, staff, and ombudsmen will help you select a community that meets your needs and gives you confidence in its long-term care commitments.