Savvy Senior: Choosing a continuing care retirement community

Dear Savvy Senior,

Can you give me some tips on picking an all-inclusive residential retirement community that offers independent housing along with assisted living and nursing care? My husband and I are looking to downsize and simplify, but we want our next move to be our last.

Approaching 80

Dear Approaching,

If you want your next move to be your final one, an all-inclusive retirement community – also known as a continuing-care retirement community (or CCRC) – is a great option to consider, but they aren’t cheap.

CCRCs are different from other types of senior housing because they provide all levels of housing, services and care in one convenient location.

While they vary greatly in appearance and services, most CCRCs offer apartments or sometimes single-family homes for active independent seniors. In addition, they also offer onsite assisted living for seniors who require help with basic living tasks like bathing, dressing or going to the bathroom, and nursing home care for residents when their health declines.

CCRCs also provide a bevy of resort-style amenities and services that include community dining halls, exercise facilities, housekeeping, and transportation, as well as many social and recreational activities.

But be aware that all these services come at a hefty price. Most communities have entry fees that range from the low to mid-six figures, plus ongoing monthly fees that can range from around $2,000 to over $4,000 depending on the facility, services and the contract option you choose.

With more than 2,000 CCRCs in operation throughout the U.S. finding a facility that fits your lifestyle, needs and budget will require some legwork. Here are some steps that can help you proceed.

Make a list: Start by calling the Area Agency on Aging (call (800) 677-1116 for contact information) in the area you want to live for a list of CCRCs, or search websites like Caring.com.

Call the facilities: Once you’ve located a few, call them to find out if they have any vacancies, what they charge and if they provide the types of services you want or need.

Take a tour: Many CCRCs encourage potential residents to stay overnight and have a few meals in their dining hall. During your visit, notice the upkeep of the facility and talk to the current residents to see how they like living there. Also, check out the assisted living and nursing facilities, and find out how decisions are made to move residents from one level of care to another.

To check-up on a facility, call the state long-term care ombudsman (see LTCombudsman.org) who can tell you if the assisted living and nursing care services within the CCRC have had any complaints or other problems. You can also use Medicare’s nursing home compare tool at Medicare.gov/nursinghomecompare.

Review contracts and fees: Most CCRCs offer three types of contracts: Life-care, or Type A contracts, which have the highest entry fee but covers all levels of long-term care as needed; Type B, or modified contracts that have lower entry fees but limits long-term care services in the initial fee; and Type C, or fee-for-service contracts, which offer the lowest entrance fees but requires you to pay extra for long-term care if you need it.

You also need to find out what yearly price increases you can expect? How much of your entry fee is refundable to you if you move or die? And what happens if you outlive your financial resources?

Research the CCRC: Find out who owns the facility and get a copy of their most recently audited financial statement and review it, along with the copy of the contract with your lawyer or financial advisor. Also get their occupancy rate. Unless it’s a newer community filling up, occupancy below 85 percent can be a red flag that the facility is having financial or management problems.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.