Anonymous wrote:There's a reason they are so expensive. I would definitely consult with an eldercare attorney. I think they probably anticipate all members will need intensive care. Everything has risk, you just need to work with a professional to properly assess risk and make your decision.

Pick one that has been around for awhile. Also, you want a higher entrance fee. It's those fees that pay for when one spouse ends up in "higher level care" and the other stays in the 2 bedroom/2bath apartment, all for the same cost overall.

My parents are in a higher end CCRC. The entrance fees start at 400K and go up (proportionately for the unit you start in). The only additional costs for "higher level care" is the additional meals costs (independent living includes about 30-40 meals per month, more if you choose cheaper options, but you pay $300 more for the 2 extra meals in HLC). For the last 2 years, there are 4 female residents who are "out of money" and do not pay anything. All are over 95, 2 over 100 and widowed. Those 4 are ones where the CCRC is "loosing money". But for every one of them there is someone who spend 5-10 years in, paid $450K entrance fee and only spends 1 year or less in "higher level care". The CCRC makes money on those people. Fact is outside of "memory care", most people do not spend more than 1-2 years in higher level care--they typically deteriorate quickly once they leave independent care.

The reverse is also true. In an area of the country that isn't so populated, if the facility has space, you don't have to be a previous resident. You have the money and they have the space. You're in. Our parents 88 were able to go right into: one to dementia care and the other to assisted living w/out living there the years leading up to it.

Most are non profit and should have 990s or other public disclosure documents. Look at CARF reports too. It’s the fancy private ones that seem sketchy.

Many CCRCs address what would happen if skilled care was needed and space is not available in their contract. Some have agreements with close by facilities, or own another facility. Ask questions, look at the contract/agreement for the types of situations you are concerned about. Ask what the availability is "today" - as in if my parent were a current resident in independent living and needed assisted living today, what is the availability? Ask how frequently people need to make alternate arrangements or be put on a waitlist. I'd be more concerned about skilled care than assisted living -- you usually have some flexibility on timing from independent to assisted; but if there is a fall or medical issue and skilled care is needed after a hospital stay, that's harder to cover with home health care.

Your insurance is going to pay for the care. Or not pay, and patient pays. The CCRC is providing the room, the appropriate physical space so the resident doesn't have to up and move to another living facility. Unless beds are filled. If there's no more space, there's no more space, and the patient has to find some other facility for the meantime or be accommodated best they can.

There's a reason they are so expensive. I would definitely consult with an eldercare attorney. I think they probably anticipate all members will need intensive care. Everything has risk, you just need to work with a professional to properly assess risk and make your decision.

How do CCRCs ensure theyll be able to pay for nursing care etc. if more residents need intensive care than were anticipated ? What should we look for to assess their financial health? What happens if a CCRC goes bankrupt?