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North Carolina Division of Aging and Adult Services

   

Continuing Care Retirement Communities

    Continuing care retirement communities (CCRCs) offer an attractive living alternative for retirement age individuals and couples. Also known as continuing care facilities and life-care communities, these communities differ from other retirement options by providing housing and health-related services either for life or for a period in excess of one year. “Continuing Care” is defined by North Carolina General Statutes as, “...the furnishing to an individual other than an individual by blood, marriage, or adoption to the person furnishing the care, of lodging together with nursing services, medical services, or other health related services pursuant to an agreement effective for the life of the individual or for a period in excess of one year.” Generally, prospective residents must be capable of independent living when they enter the community.

    The typical CCRC provides independent accommodations that may include full or efficiency apartments, villas, or cluster homes as well as community dining, social and recreational areas, and a wide range of services including meals, housekeeping, transportation, and health-related services. In North Carolina, CCRCs offer either nursing home or adult care homes level of care, and may provide both. Depending on the individual community, these accommodations, activities, and services may be paid for in a monthly fee or purchased as needed. Usually a substantial entrance fee is charged in addition to monthly fees. Entrance fees can be non-refundable, partially refundable, or fully refundable. The majority of CCRCs are private pay, although a few have some subsidized units.

    Continuing care communities typically offer one (or more) of four types of agreements or contracts, as defined below:

    Extensive, or life care, contracts provide independent living and health-related services in exchange for a price, usually consisting of an entrance and monthly fees. No additional fees are generally required as one moves from one level of service to another.

    Modified contracts provide independent living and a specified amount of health-related services in exchange for an entrance fee and monthly fees. Health-related services are provided at a subsidized rate or are free for a specified number of days.

    Fee-for-service contracts provide independent living and guaranteed access to health-related services in exchange for an entrance fee and monthly fees. Health-related services are provided at the going, full per diem rate.

    Equity contracts involve an actual real estate purchase, with a transfer of ownership of the unit. Health-related service arrangements vary.

    Because CCRCs include contractual requirements where, for certain fees, the facility agrees to provide health care coverage over a given period of time, they are considered an insurance product and are regulated by the N.C. Department of Insurance. They are also licensed by the state Division of Health Service Regulation for the adult care home or nursing home level of care they provide.

     

Last modified: November 20, 2007