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Top 10 Questions to ask a Continuing Care Retirement Community

If you or a loved one is considering a continuing care retirement community (CCRC) — also known as a Life Plan Community — for the maintenance-free lifestyle and peace of mind it offers, here are 10 of the most important questions you should ask:


What is the ratio of Independent Living residences to Assisted Living, Memory Care and Skilled Nursing residences?

Some CCRCs are mainly  Independent Living communities with a proportionately small number of Assisted Living or Skilled Nursing care units available. This is particularly concerning for newer communities, where very few residents require care now but may in the future. The question is whether there will be enough availability in the health care center for residents requiring care at that time. On the flip side, some CCRCs evolved out of established nursing care facilities that added a few Independent Living residences. In this case, you may find proportionately more residents requiring care services than living independently. On average, Independent Living residences represent 60-75% of the total residential units at a CCRC.


How have your monthly rates changed over the last 5 years?

This is important to ask for two reasons. First, it gives you an indication of what to expect going forward so you can plan accordingly. Second, it could also be an indication of the community’s financial viability. Average fee increases of 3-4% per year are common in the industry. If you find there have been years when the increase has been substantially more, you should find out why. Be sure you ask what the increases have been each year over the past 3-5 years, as opposed to an average. Averages can sometimes hide larger increases in a given year.

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What services are included in my monthly fee, and what will cost extra?

When a provider shares with you their monthly rates, be sure to find out what types of services and amenities are included, and which are extra. In some cases, you could ultimately spend considerably more than the published rate each month. This is particularly important if you’re comparing two communities and one operates under an à la carte model, while the other operates under an all-inclusive model. One example of this would be the number of meals per day included in the monthly rate.


What is the level of experience of your management team and board of directors?

An experienced management team is vitally important to maintaining high operating standards and diligent financial management. Ask whether the management team has a track record of managing other CCRCs. Also look for a board of directors that is culturally and professionally diverse. The board should have directors with strong backgrounds in health care, hospitality, finance, and real estate. You can learn more about LifeSpire of Virginia’s management team here.


What happens if I run out of money and can’t pay fees?

Most CCRCs, particularly nonprofit providers and even some for-profits, will do everything possible to help residents stay put and receive services if the resident runs out of money through no fault of their own. In fact, many providers maintain a financial assistance or endowment fund to help with this effort. Yet, there are some CCRCs that will ask you to vacate your residence if you’re no longer able to pay. LifeSpire of Virginia’s VBH Foundation raises funds to help Life Care residents who outlive their financial resources remain in their homes. In 2016, the VBH Foundation provided more than $1.1 million in benevolence to 59 residents across all four LifeSpire of Virginia communities.


How will my monthly rate be impacted if I require assisted living or skilled nursing care?

There are several different types of residency contracts offered by CCRCs. The key with each one is to understand what happens to your monthly fees if you ultimately require Assisted Living, Skilled Nursing, or Memory Care services. In simple terms, with a Life Care contract, you’ll have a higher entrance fee, but pay significantly less for care. The entrance fee with a Fee-for-Service contract is lower, but you’ll pay market rates for any needed long-term care. 


Does your published rate for health care services include a semi-private or private room?

The published rates for a room in the health care center may reflect only semi-private rooms. You may be required to pay the difference in cost for a private room. Some providers only offer private rooms.


What are the stipulations for receiving a refund (if the community offers a refundable entrance fee)?

If you’re considering a CCRC that offers a partially or fully refundable entrance fee, ask if your residence within the community has to be resold before the refund will be paid. Is there a maximum time limit whereby the refund will be paid regardless of whether or not the residential unit has been resold? Also, are you or your heirs required to continue paying the monthly fees during that time period?


What information can you provide to help assure me that the level of care provided in your health care center is of the highest quality?

Although it could be years before you require Assisted Living or other long-term care, you want to know that if and when that day comes, you’ll receive the best care possible. Ask to take a tour of the health care center, and closely observe the facilities and the care team. Does the staff seem happy and attentive to residents? Is the facility clean and without odor? Ask about staff turnover ratios. The industry average for skilled nursing centers is around 40% annually. A low turnover rate generally indicates a happy staff, which translates into better care for residents. If the health care center is Medicare-certified, you can also visit to find information on complaints, deficiencies, staffing, and more. All LifeSpire of Virginia communities have received either a 4- or 5-Star CMS rating.


What information can you provide to help assure me that your community is financially positioned to meet its long-term commitment to residents?

To fulfill its long-term obligation to residents, a CCRC must maintain a strong financial standing. A financial professional who is well versed in the financial operations of CCRCs can help you analyze key financial ratios, such as operating margins and debt service coverage, but a few things to look for initially are a willingness by representatives of the community to share their audited financial statements, positive net worth, strong demand (usually indicated by occupancy ratios above 90%), well-kept facilities, and an experienced management team. Also consider whether the community is located in a state that regulates CCRCs. If so, the state may have minimum financial requirements that must be met on a year-to-year basis. Read more about LifeSpire of Virginia’s current financial standing.

Enjoy Freedom and Peace of Mind at The Chesapeake

Ready to explore your options? Check out our gorgeous Independent Living options and pricing. We’re sure to have something to fit your lifestyle and your budget. If you want to know more about your community, one of our friendly retirement counselors is available to answer all these questions and any others you may have. Or you can schedule a personal tour to see our community for yourself. Contact us today at 757-223-1600!