The Lure of a Life Plan Community

The beauty of life plan communities—also called continuing care retirement communities—is their offer of independence and housing choices commensurate with your wishes and your needs.

You’ve done the research and found the perfect North Carolina place for your post-work years. Perhaps the sandy coastline of the Atlantic. Maybe the forested mountains of the western part of the state. Or the inviting urban areas of the center.

No matter your geographic preference, there is the matter of continuity as we age. The solution for many couples is available in the form of continuing care retirement communities (CCRCs)—places to live that offer a continuum of independent living to full care, based on needs.

The continuum breaks into three general phases—independent living, assisted living, and skilled nursing care. Some facilities also offer a fourth phase—memory care, for those with dementia or other debilitating conditions. 

The independent living phase means just that—residents live in a home or apartment and move amid the community to take advantage of social, fitness, and other aspects. 

In the assisted living situation, help is provided based on need, in contexts such as bathing, dressing, medication management, and meals. 

In the skilled nursing phase, residents receive care within assisted living and are monitored on a 24-hour basis. 

According to U.S. News & World Report, there are about 62 CCRCs in North Carolina, and their fees are within the type and range of national figures. Entry fees range from about $300,000 to $400,000, and monthly charges average $5,000 to $10,000. 

CCRCs generally offer peace of mind for couples who want to continue to live together, even as health care needs may change. Living on the same campus or within the same development, one member of the couple may remain in independent living while the other may move to assisted living or even long-term care—relieving the more independent spouse of caregiving duties while still allowing them to be with the spouse on a daily basis.

There are many aspects beyond the region of the state in considering a CCRC:

Location. Especially as related to hospital and other health care proximity, and amenities such as public transit and shopping.

Staff. Investigate credentials, general manner of interaction, and availability.

The housing. Learn all you can about floor plans, appliances, grip bars, and common areas as well as exit and safety logistics.

Recreation and social activities. See if there are regularly scheduled events and gatherings, excursions, and any other offerings.

Health care and personal services. Learn what’s included in the monthly fee and which are not. Investigate pharmacy availability, as well as housekeeping and laundry services, to determine whether they are included.

Meals. Look into programs, entrée choices, and accommodations to special diets.

Payment methods and specifics can vary and generally fall into five categories:

An extensive life care contract (type A) typically covers all eventualities of CCRC care and is thus the most expensive. 

A modified life care contract (type B) includes many aspects covered in a type A contract (living accommodations, assisted living services, dining options) but does not cover expenses as individuals move into more extensive care needs.

A fee-for-service contract (type C) usually includes the entrance fees and monthly fees but excludes costs for services as more advanced care is needed. 

Monthly agreements (type D) cover the cost of the residence but exclude health care and support costs, which are added to the monthly fee as incurred. 

Equity contracts (type E) offer ownership of the home or apartment, with additional payments needed for things such as meals and health care.

Get to Know your Prospective CCRC

AARP, the nation’s largest nonprofit dedicated to retirees, and LeadingAge, a nationwide organization of nonprofit and government aging-services providers, recommend research into potential CCRCs. These 10 questions are adapted from their list:

1. Is the CCRC for-profit or not-for-profit, and what’s the financial strength of the retirement community?
2.  What is included in the monthly fee?
3. How does the community maintain freedom and independence?
4. What emergency response systems are in place?
5. How is residents’ satisfaction measured? Are examples of returned surveys available?
6. How may residents offer input and feedback?
7. What is the difference between independent and assisted living, and how is that transition made?
8. Can residents remain in independent living when needs change, and if so, how is aging-in-place supported?
9. What are the most popular programs in your community and who decides what programs and events are scheduled?
10. Is the CCRC’s residency agreement available for review?