Right now I am broke, DH is not expected to live much longer, and then I will transition to being more involved with my 92yo father. When dad passes, there will be a nice inheritance (unless something happens to change things from what they are now). At that point, I plan to buy into a Continuing Care Retirement Community so that I will never put the expectation on my children that our parents have had of us or the worries that our parents caused us.
I don't know where I want to be yet. Part of my plan, if I am still capable of doing so, is to hit the road for a year or so and see the people who have helped me through life since making connections via internet became a thing, and to see all the beauty throughout the US. In my travels, I hope to find an area to settle in permanently, and buy into a CCRC there.
Now my question, if I end up changing my mind about where I am living, do CCRCs allow you to transfer to another one in their "chain" of CCRCs? And if it isn't a chain CCRC, are you able to end your contract at one and move somewhere else without a great financial cost?
We had friends who bought into one locally, then their daughter moved several states away, leaving them "stuck" here with their cottage. They tried to talk us into buying out their contract, but with no golf course available, DH wouldn't consider it. They eventually just had to take the loss and move to where their daughter now lives (their son-in-law bought them a new house in a senior community, but not a CCRC). I'd really like to avoid that kind of thing happening.
Staying somewhat active and functional is important, at least to me. If I can't do anything at all, I might as well just shuffle off and be done with it. So, even though making a physical effort has definitely gotten harder, it's not impossible yet. Remaining functional for as long as I can seems like a reasonable objective.
Ahhh! the casinos and their tiered ceilings on timed lighting so that you never ever really know what it is like outside or what time it is either. Our big land based is getting a full face lift and will have an elevated outdoor terrace dining experience facing the French Quarter. Although whomever ok’d this did it before this Summer of Heat (Dome). I’m sure it looked fabulous on paper.
It's working for now, but it's getting harder for me to "manage" a household (even of 2-persons + cat), do the grocery shopping/food prep, laundry, light cleaning and yard care, ensure that the bills get paid, etc. Up until the last couple of years I was on-task, but my back has decided it's done its duty long enough. Physical work, including walking which I do of necessity and for exercise, have become more difficult. My husband has minor (so far) short-term memory issues and can't do many household/yard maintenance tasks anymore, which is entirely understandable since he'll be 94 in a couple of months. So, sustaining our living arrangements and finding help are largely on me (86), and that is a source of ongoing concern as I experience age-related decline.
There are several IL/AL/SNFs near us, and if we end up living much longer, I suppose we may end up in one. I don't relish the prospect at all. However, we decided long ago that we would make every effort not to become a care burden on our family should we reach old-old age--which, to be clear, neither of us thought would happen for a number of reasons. In retrospect it's actually O.K. that we didn't have $1M to buy into the CCRC we visited some years ago. I think it was mostly bright and shiny marketing that initially attracted us--and undoubtedly many other older adults as well. I do wonder if those who qualified have realized all the benefits and amenities so glowingly advertised.
Reality tends to be sadly quite different, especially if it’s a casino that allows for smoking.
communal living for seniors in the us
Base your decision on having amenities close by that you need as you age in place.
For example, don't choose a really rural location that doesn't offer appropriate services should you need transportation to doctor appointments or even grocery delivery services.
That being said: There are various CCRC plans. This is a link to a pretty good article outlining them: https://mylifesite.net/blog/post/primer-ccrc-residency-contracts/
There are other good articles out there.
As for moving among those under the same umbrella ownership - that is a question for them, and MUST get codified in your contract. Most are set up as separate LLCs managed by one organization; they do this to conceal ownership and liability - because they are lovely people (kind of like the addiction promoting Sackler's, on a smaller scale).
Three last suggestions:
(1) Look for ones that are more rural, or in towns and smaller cities. The care providers will more likely be people who have lived in the area and are connected to some of the residents, thus tending to provide more personal and compassionate care.
(2) Look for ones that are run by spiritual organizations, such as the Brethren. If you are deeply and traditionally Christian (not part of the evangelical anti-Christ hate-full bunch), look at the Penney Retirement Community.
(3) When you visit, make sure to visit the care facilities and talk to a wide range of people who live in the community.
Personally, I would avoid CCRCs to maintain choice.
I went for a tour/interview and came away feeling as though it would be financially impossible to leave. They wanted me to hand them a million dollars cash to live in a cottage and pay rent. The song, "Hotel California," came to me and the words, "you can check out, but you can never leave" haunted me and still does. Now I live in a 55+ community that offers caretaking options through a business that can be used if and when needed. The CCRC plan sounded real safe and comforting, but what if I was unhappy there? No escape? I'm too suspicious to get entangled.
She could have left AL at any time with a 30 day notice to the facility. If you wait til you need AL and can afford a higher monthly fee this may be a more flexible option than a buy in.
She went to SN one more time after a hospital stay for pneumonia. Medicare/Medigap paid for SN and she continued to pay for her AL room to hold it while in SN.
When passing she was in her AL room with hospice visiting and she paid for full time private caregivers ( in addition to her apartment) as required by the facility. When I mentioned I was worried about her funds lasting 'til she passed to an administrator, she whispered to me that they had a non-advertised "benevolent fund" and she would not be put out if she ran out of funds.
Additionally, even though the facility said they didn't accept medicaid, her experienced elder-law attorney who also acted as guardian for some of his clients assured me that a facility would prefer medicaid payments to no payments for empty SN beds even though they said they didn't accept medicaid. They had a number of empty SN beds and as a resident she would have had priority over non-residents to be able to leave AL and go to SN if she had to.
Worst case scenario is she would have had to leave and apply for medicaid at another SNF. At that point it would not have made much difference to her as she didn't know where she was anymore during the majority of her hospice care.
Just telling you all this so that you can see it is possible to be in some CCRCs without buying in. Hers went through a bankruptcy while she was there and those who bought in were very scared. Fortunately for them after 9 months there was a buyer and not a foreclosure. My Mom would have been able to just pick up and go and we did not have to worry about her havng to get her money back out of the place.
She was there for almost four years which I think if you research it is an average timeframe for needing care before passing. She was able to deduct from her federal income taxes the medical expenses part of her AL rent/fee (the percentage/amount each year as determined by the facility and notice given to the residents). This can be done according to her accountant as long as the facility has a "plan of care" in place for the resident. The plan of care was adjusted annually or as needed.
Don't know if this is feasible for you but is something to consider before you commit to buying in. I know I will if/ when my husband or I need to find a place for ourselves.
Also, my experience with A Place for Mom and the nursing homes they connected me with was that they were very happy to talk to me and answer questions without asking a lot of questions about finances. They do ask how soon you anticipate needing placement but I didn’t get the impression at all that they wouldn’t be interested if our need wasn’t immediate.
The “buy-in” is Almost always a 6 figure amount depending upon the amenities. CCRC have a baseline $ amount that is non refundable. $ amount 500k lower end, over 1M in many. Folks sell their homes and do a CCRC. It’s a retirement lifestyle that they are buying into
If your mom is in a place that she pays monthly rent, it can market itself as “community”, as providing “continuum of care” as “tiered health” whatever….. it can but it is so not what a CCRC that has a big buy-in is.
here’s my experience with them: my Dads “Aunt”, no kids, named me Executor. Came as a surprise, but I was up for it and very much a learning experience. She had a home but had moved into a CCRC; a patio duplex within big property; slowly downsizing. It was all cash buy-in low mid6 (1990’s). Was touted as full buy in for carefree lifestyle. CCRC had patio/ garden duplexes, apts, AL sector, nursing care. Dining, pools. Mo. maintenance and security billed for her only as she didn’t need extra help. CCRC makes all decisions on grounds, access. Lots of scheduled outside activities. She moves in and arranges to have work done (painting, some patio concrete stuff, cabinets). All this b4 I’m ever a part of this drama. She has a fall, dies at around 4 mo in. Her attorney calls me to tell me I’m named Executor and do I want to, yeah sure.
Total hot mess. Learned a lot. CCRC was beyond difficult & controls everything. Worse than a HOA imho. All the work which hadn’t been started had to be completed but as she wasn’t there to do oversight, a staff had to be there and paid to be there. I could not stay there as not a resident. Or stay late. Ditto for any heirs. I’m still salty about it! And trying to sell it, CCRC footdragged on any buyers. They and only they determine if a buyer meets qualifying requirements. This part totally glossed over in how marketed imo. Nevertheless you have to do all to have it be market ready or they will and bill. And they were absolutely in zero hurry to review buyers. Every month billed maintenance, fees. Attorney had to send testy letters to get this ended. Apparently quite common, as empty units mean less work / less costs but still billed monthly fees. They have your buy-in. And getting a % of the unused buy-in was most difficult, basically you will have to be willing to litigate. But the big surprise was finding out paperwork to do her transfer from hospital to the nursing sector was declined. That it did only basic custodial care. Did referrals to SNFs and if better then could go back under basic custodial care with a La carte charges as needed. Not equipped for beyond that. That really it was a retirement community for those healthy and active or still pretty good on their ADLs and once your needs go beyond that, they will find a reason to have you exit. She died at the hospital. On retrospect, beyond fortunate.
Nowadays, decades later, buy ins are closer to $M and there will be set monthly charges and the speciality fees once on higher level of care. There really is no way, they can provided services from independent to nursing based on just the initial buy in $. You want to have someone knowledgeable review the contract and in detail, like an attorney.
Sinking your life’s savings and then finding there's an increasing monthly fee of 4-8% atop may not be manageable. Ask what the NH residents currently are averaging in their additional charges. Could be more than what a NH out in the countryside costs. I think there’s alot of smoke & mirrors in the marketing of them.
Continuing care communities (CCCs) are a great concept for those who can afford them. Unfortunately, like my spouse and me, many Silent Generation and older Boomers who retired from long careers in modestly compensated professions will find that they cannot.
Why not? Well, because, overall, we likely do not have enough resources to sustain $100K+/year for long term care, especially if needed for more than 2-3 years. (As a group, we'd better not spend much of our retirement savings before needing care or--worse yet--live too long!) We do NOT expect our adult kids to pick up any slack.
As we discovered when checking out facilities some years back, most CCCs have a hefty entrance fee, as well as a monthly fee and possibly additional fees for any "extra" care services. At one we liked, the introductory conversation was quickly concluded when we were told that we would need close to $1 million in convertible assets to qualify. Bye-bye CCC!
We found that for my mom, renting her a place in an Atria Independent Living facility was a good choice.
It provided 24/7 monitoring and someone always at the desk, planned activities and trips, restaurant style food, housekeeping and laundry.
If mom had continued to need only that level of "care", she could have picked up and moved. Sadly, she had a stroke and needed far more care
Have you looked at CCRCs that DON'T require a but in?
Honestly, I thought all CCRCs required buy-in. See, I have a lot of homework to do!
Buy-ins sound a lot like purchasing a home; I did read a few months back that many finance their CCRC purchase by selling their existing home - there's a way a seller can hold the sale proceeds to transfer to the CCRC company. Or something...
Given the level of paperwork involved, I would doubt one location could easily be swapped for another. And the article mentioned that many CCRCs are privately owned, so there might not be an option to transfer to another state/location. And considering the cost, would Medicaid even cover anything?? I thought these were self-pay all the way.
The article is Continuing Care Retirement Communities Explained*. Happy researching and I hope you get to take that road trip!
I would not enter into a contract with any of them without a lawyer involved. A friend was POA for a SIL in one of these places. She went right from IL into LTC. Friend got a bill for her care. The contract said something about 90k of the by in going towards the LTC or 90% going to LTC. So there should be no bills until that 90k/
90% is spent down then Medicaid is applied for. They messed with the wrong person. She knew what her SIL signed.
I do know that A Place For Mom, which owns this Forum and site, does help with explorations of CCRC community living, but I imagine only when one is ready for placement. I do wonder if they might be willing to help with the answer if you give a call. CCRC won't be interested in talking with you NOW flat broke, but once the inheritance is in (lest, as you say, something changes) they will be VERY INTERESTED in talking to you.
As you can imagine, interest in seeing you, helping you, providing answers to you grows with every dollar stuffed in your pocketbook. Once you are more ready everyone will give you all the answers you need whereas right now, once you say "flat broke", you will not be terribly attractive any more.
Will be interested in following this thread and seeing what you find out Gray. For myself, I often think that time between when you need independent living and when you need MORE is to short to bother with. I might consider locating myself in a nice, accessible studio where I can easily shop nearby and where I have access to transit to medical at some point until there is a need for ALF itself.
Alvadeer
This sounds like the BEST idea. I’m going to keep it in my idea bank!