One type of assisted living, the continuing care retirement community (CCRC), offers residents a contract that provides for independent living units, residential care, personal care, and skilled nursing care — usually in one location, and usually for a resident’s lifetime. Most CCRCs also require an entrance fee upon admission.
In California, three basic types of CCRC contracts are available, as discussed below. Each should provide clear information about the care and services covered.
Life Care or Extensive Care
A life care contract is an arrangement in which the facility must agree to:
- Provide all levels of care, including acute care and doctors’ and surgeons’ services not covered by other public and private benefits for the rest of the resident’s life
- Provide a continuum of care, including skilled nursing at the facility or nearby
- Keep the monthly fee at a set amount, based on the level of care or service, with only annual increases allowed
- Subsidize residents who become financially unable to pay monthly care fees
This type of contract is best suited to those who are most concerned that their health care and medical needs will be taken care of for the rest of their lives — and who can afford to pay the high cost of that reassurance.
Modified or Continuing Care
In this arrangement, residents are entitled to receive the same housing, services, care, and amenities as those who sign on for life care. But health care, personal care, and nursing services are restricted to a given total number of days; after that, the resident must pay for the additional care required.
This type of contract is suitable for people who have sufficient cash or other assets to cover the costs of care that are considered outside the bounds of their general housing commitment — generally, those who are in good health who do not expect their health care needs to increase.
Fee for Services
In these contracts, best suited for those who are willing and able to assume the risks for paying for needed medical care and long-term costs, residents are entitled to all housing and amenities but must pay the full cost of all care they require in the future.
For more information, see the California Department of Social Services’ FAQ about continuing care contracts.