Continuing Care Retirement Communities
Continuing care retirement communities (CCRCs), or "lifecare" communities, are residential campuses consisting of independent apartments and cottages and a variety of social and health services in one setting. Usually a nursing home is on or near the campus. In exchange for often large entry and monthly fees, CCRCs agree to provide care to residents for the rest of their lives.
CCRCs are simultaneously residential settings, health and social service providers, and insurers. They offer housing that enables older Americans to live close to their peers in a setting with services available. 1 CCRCs guarantee access to, and usually provide, nursing home care and other health care services, and have strong incentives for cost containment. By providing the kinds of services that elderly people need at different stages of disability, this arrangement may shorten or eliminate their stays in nursing homes. 2 At the same time, some CCRCs act as insurance mechanisms, since they guarantee to provide at least basic long-term care services in exchange for the entry and monthly fees. These CCRCs pool their residents' financial risks of long-term care.
In 1987 there were about 680 lifecare communities, each with an average of 245 residents. 3 The combined facilities serve less than 1 percent of the aged population. Almost all CCRCs are nonprofit organizations, although more for-profit CCRCs have entered the market in recent years. 4 Most do not provide full health care guarantees. The majority of facilities require substantial out-of-pocket payments for nursing home use and do not cover home health care in their contracts.