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Old 11-20-2017, 10:33 AM
 
Location: Mount Pleasant, SC
2,206 posts, read 3,286,287 times
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Just curious after visiting friends' parents in their new home, an independent living community, part of a larger continuing care community.
The location's website states $710,000 buy in for their particular 3 bedroom flat. Then $6,500 a month for the 2 of them. Beautiful place; excellent food; many social opportunities they can choose.
But it seems that after just under a year, the parents will need to be separated soon with one into the memory-care housing (sad). The other probably will need to leave the flat due to inability to be truly independent physically.
So nosy me wonders if they get to sell their place/flat or get any rebate as they move to a room situation, albeit with perhaps upgraded costly skilled nursing care added in to the equation.
Just how do these places work? Any informative websites you can share on the business model of CCC's? Anyone have a family experience to share per the value/financial risk?
I need to educate myself for my future, I realize. Thanks.
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Old 11-20-2017, 11:15 AM
 
Location: Columbia SC
14,217 posts, read 14,638,950 times
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Quote:
Originally Posted by joyeaux View Post
Just curious after visiting friends' parents in their new home, an independent living community, part of a larger continuing care community.
The location's website states $710,000 buy in for their particular 3 bedroom flat. Then $6,500 a month for the 2 of them. Beautiful place; excellent food; many social opportunities they can choose.
But it seems that after just under a year, the parents will need to be separated soon with one into the memory-care housing (sad). The other probably will need to leave the flat due to inability to be truly independent physically.
So nosy me wonders if they get to sell their place/flat or get any rebate as they move to a room situation, albeit with perhaps upgraded costly skilled nursing care added in to the equation.
Just how do these places work? Any informative websites you can share on the business model of CCC's? Anyone have a family experience to share per the value/financial risk?
I need to educate myself for my future, I realize. Thanks.
They all vary. Best to ask the specific one you are interested in. One big question is does any of the down stroke (up front money) get refunded upon death?
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Old 11-20-2017, 12:09 PM
 
Location: Mount Pleasant, SC
2,206 posts, read 3,286,287 times
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Quote:
Originally Posted by johngolf View Post
They all vary. Best to ask the specific one you are interested in. One big question is does any of the down stroke (up front money) get refunded upon death?
Thanks, johngolf. I just thought that there may be an industry standard
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Old 11-22-2017, 09:58 AM
 
10,600 posts, read 12,059,835 times
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IF they're in a CCC like the ones I've sort of been curious about (and a couple of friends parents or aunts moved into) -- the couple should get to stay. (as long as they pay)

That's part of what the buy-in was about -- getting them a place in a nursing or long term care wing/building that's part of the CCC grounds or campus. One spouse goes to the dementia wing. The other spouse stays in a smaller unit (for a monthly fee of course).

The CCC (or CCRC) -- stands for Continuing Care (Retirement) Community.
That's the main reason my friends' relatives (in PA another in AZ) chose they're CCRC.
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Old 11-24-2017, 05:04 AM
 
Location: Columbia SC
14,217 posts, read 14,638,950 times
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One of the main questions is if a couple has different requirements and needs to be split up (as in one living independently and the other needing skilled nursing care), what would be the costs then?
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Old 11-24-2017, 06:21 AM
 
Location: S-E Michigan
4,268 posts, read 5,911,115 times
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Quote:
Originally Posted by johngolf View Post
One of the main questions is if a couple has different requirements and needs to be split up (as in one living independently and the other needing skilled nursing care), what would be the costs then?
At least one CCRC near us has per person pricing. The Buy-In ranges from ~$200K to ~$450K depending on unit style/size selected, the monthly fee is ~$2500, and the asterisk below the pricing table alerts you that an additional person will cost an additional ~$2500 per month.

I assume the first $2500 is for one person not a couple, and the second $2500 is for a second person not a third.
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Old 11-24-2017, 06:44 AM
 
10,599 posts, read 17,843,083 times
Reputation: 17352
Quote:
Originally Posted by joyeaux View Post
Just curious after visiting friends' parents in their new home, an independent living community, part of a larger continuing care community.
The location's website states $710,000 buy in for their particular 3 bedroom flat. Then $6,500 a month for the 2 of them. Beautiful place; excellent food; many social opportunities they can choose.
But it seems that after just under a year, the parents will need to be separated soon with one into the memory-care housing (sad). The other probably will need to leave the flat due to inability to be truly independent physically.
So nosy me wonders if they get to sell their place/flat or get any rebate as they move to a room situation, albeit with perhaps upgraded costly skilled nursing care added in to the equation.
Just how do these places work? Any informative websites you can share on the business model of CCC's? Anyone have a family experience to share per the value/financial risk?
I need to educate myself for my future, I realize. Thanks.
They didn't purchase a "flat", they "purchased" long term care "insurance". (in other words).

Living accommodations and care - regardless of whether they required Independent Living, Assisted Living, Memory Care and most likely Skilled Nursing (but I can't say for sure since I don't know the CCRC involved). Some people pay their equity payment, get their Independent Living unit completely renovated and can stay for life because their health stands up OR they eventually need to move to a different level of care, later.

Also, they are all marginally different offering you different options when you make your equity payment or whatnot. So in some cases, if you leave entirely - there could be refunds if you had chosen that option.

This is the one I work in (below link) - I would move there in a quick minute - they've been established for decades. One of my clients stayed behind in Independent while his wife went to Memory Care four years ago and he goes and visits her daily. (a couple blocks away on campus)

It's explained here. Skilled Nursing is a big bonus because that is the biggie that is the main challenge for seniors. In this one, Memory Care is located with and operated as Skilled. REMEMBER - just because you can afford it when needed...doesn't mean you can get a placement in a "good facility" when that time comes. My mother needed Skilled Nursing and regardless of all the resources she had...there was only an opening available in a crappy one. It was a nightmare.

My clients are in Independent Living and if they need additional help that doesn't require Assisted Living yet, they can also contract privately for home health aides or CNAs to come into their Independent Living unit as needed. There is criteria for living in Assisted (ALF). A certain amount or type of Activities of Daily Living you can no longer perform. Or even, say getting macular degeneration and losing your sight.

So let's say someone has a hip replacement. After rehab they go home to Independent but still need some additional help while getting home rehab but can't be independent enough to do something ....like showering or meal prep. (besides the meals you get as a resident)....or go shopping driving themselves. They can get a private agency or one that the CCRC operates separately - to come in and help until their help is no longer needed. Generally you pay per hour for that service over and above your monthly expense. Just like you'd do if you lived in your own condo that wasn't part of a CCRC. Now if for some reason a resident doesn't have the ability go live Independently after some medical event....they just move to an Assisted Living unit...or Memory Care or Skilled. Which are simply smaller units with 24 hour on site care being done daily versus 24 hour care "available" to you in Independent. For example, if you fall and can't get up in Independent you just call Security or "the office" who rushes over to help you. If you were in Assisted, the caregivers are right there in your building...down the hall, so to speak.

My client with the wife in Memory Care pays PRIVATE over and above his monthly payment for 24 hour care in his Independent unit because he's lost his mobility - was increasingly falling when he was alone and needed to call for help - but refuses to move to Assisted or Skilled because they don't take his dog in this particular CCRC's ALF so he wants to stay in Independent but can't so so safely.The CCRC said: Fine, but you need to pay for aides 24 hour because you refuse to move to Assisted, where help would be INCLUDED in your existing monthly fee but we can't do that for you in Independent.

So he is happy to pay above his fixed payment just to keep his dog. He has an aide come help with hygiene in the AM and breakfast, they change shifts at 2, and again at bedtime through overnight. Not cheap but he's fortunate to be able to spend big bucks to stay in Independent to keep his dog. He could simply move to Assisted without the dog and not pay all that extra money but he won't. He goes to the Nursing Office every day, too, to have some basic care such as eye drops and vitals checked, etc, which IS included in his Independent Living contract. His private paid aide wheels him down the hall for that wherein most mobile people just can WALK down to the office. In Assisted, he'd be part of their rotation for no additional charge.

I would say living in Independent is exactly like living in a 55+ HOA with a bunch of activities available but usually includes meals (in this particular one) and onsite immediate help as needed. I worked for one lady who had a serious UTI problem and was too weak to shower and walk her dog while under doctor's care so she was able to just ask the nursing office to arrange help instead of having to search for, qualify, vet, and contract for that help herself until she recuperated. She always had her meals delivered instead of going to the dining room anyway, but most people go TO the dining room IME. Also in Independent, they offer a little "sign" you put on your door that you remove the next morning saying "You're 'OK'' so if the staff who's wanding the halls or assigned to check on you know there's something wrong if that sign is still up say, by 10 AM in Independent which is certainly NOTHING like living in a regular HOA condo. I know several women who are YOUNG, who moved to the CCRC because they have no family or way to have peace of mind living in a regular condo versus all the resources available in the CCRC. And they love it. Their units are beautiful and they live normal lives, being out and about all day or going on vacations in other states etc.

ALSO, in this one you can vacation in other communities, for example if you live in PA, you can go stay in another one in Florida for vacation.

Last time I looked into it, you could make an equity payment for around $80,000 and your monthly was around $2300 for a condo unit.

https://www.actsretirement.org/

Last edited by runswithscissors; 11-24-2017 at 07:24 AM..
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Old 11-24-2017, 03:53 PM
 
31,679 posts, read 40,965,089 times
Reputation: 14424
Quote:
Originally Posted by johngolf View Post
They all vary. Best to ask the specific one you are interested in. One big question is does any of the down stroke (up front money) get refunded upon death?
a very true Bada Bing! Depending on your financial profile what works for one person may be very different for another.
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Old 11-24-2017, 11:15 PM
 
1,994 posts, read 1,248,513 times
Reputation: 863
Quote:
Originally Posted by runswithscissors View Post
They didn't purchase a "flat", they "purchased" long term care "insurance". (in other words).

Living accommodations and care - regardless of whether they required Independent Living, Assisted Living, Memory Care and most likely Skilled Nursing (but I can't say for sure since I don't know the CCRC involved). Some people pay their equity payment, get their Independent Living unit completely renovated and can stay for life because their health stands up OR they eventually need to move to a different level of care, later.

Also, they are all marginally different offering you different options when you make your equity payment or whatnot. So in some cases, if you leave entirely - there could be refunds if you had chosen that option.

This is the one I work in (below link) - I would move there in a quick minute - they've been established for decades. One of my clients stayed behind in Independent while his wife went to Memory Care four years ago and he goes and visits her daily. (a couple blocks away on campus)

It's explained here. Skilled Nursing is a big bonus because that is the biggie that is the main challenge for seniors. In this one, Memory Care is located with and operated as Skilled. REMEMBER - just because you can afford it when needed...doesn't mean you can get a placement in a "good facility" when that time comes. My mother needed Skilled Nursing and regardless of all the resources she had...there was only an opening available in a crappy one. It was a nightmare.

My clients are in Independent Living and if they need additional help that doesn't require Assisted Living yet, they can also contract privately for home health aides or CNAs to come into their Independent Living unit as needed. There is criteria for living in Assisted (ALF). A certain amount or type of Activities of Daily Living you can no longer perform. Or even, say getting macular degeneration and losing your sight.

So let's say someone has a hip replacement. After rehab they go home to Independent but still need some additional help while getting home rehab but can't be independent enough to do something ....like showering or meal prep. (besides the meals you get as a resident)....or go shopping driving themselves. They can get a private agency or one that the CCRC operates separately - to come in and help until their help is no longer needed. Generally you pay per hour for that service over and above your monthly expense. Just like you'd do if you lived in your own condo that wasn't part of a CCRC. Now if for some reason a resident doesn't have the ability go live Independently after some medical event....they just move to an Assisted Living unit...or Memory Care or Skilled. Which are simply smaller units with 24 hour on site care being done daily versus 24 hour care "available" to you in Independent. For example, if you fall and can't get up in Independent you just call Security or "the office" who rushes over to help you. If you were in Assisted, the caregivers are right there in your building...down the hall, so to speak.

My client with the wife in Memory Care pays PRIVATE over and above his monthly payment for 24 hour care in his Independent unit because he's lost his mobility - was increasingly falling when he was alone and needed to call for help - but refuses to move to Assisted or Skilled because they don't take his dog in this particular CCRC's ALF so he wants to stay in Independent but can't so so safely.The CCRC said: Fine, but you need to pay for aides 24 hour because you refuse to move to Assisted, where help would be INCLUDED in your existing monthly fee but we can't do that for you in Independent.

So he is happy to pay above his fixed payment just to keep his dog. He has an aide come help with hygiene in the AM and breakfast, they change shifts at 2, and again at bedtime through overnight. Not cheap but he's fortunate to be able to spend big bucks to stay in Independent to keep his dog. He could simply move to Assisted without the dog and not pay all that extra money but he won't. He goes to the Nursing Office every day, too, to have some basic care such as eye drops and vitals checked, etc, which IS included in his Independent Living contract. His private paid aide wheels him down the hall for that wherein most mobile people just can WALK down to the office. In Assisted, he'd be part of their rotation for no additional charge.

I would say living in Independent is exactly like living in a 55+ HOA with a bunch of activities available but usually includes meals (in this particular one) and onsite immediate help as needed. I worked for one lady who had a serious UTI problem and was too weak to shower and walk her dog while under doctor's care so she was able to just ask the nursing office to arrange help instead of having to search for, qualify, vet, and contract for that help herself until she recuperated. She always had her meals delivered instead of going to the dining room anyway, but most people go TO the dining room IME. Also in Independent, they offer a little "sign" you put on your door that you remove the next morning saying "You're 'OK'' so if the staff who's wanding the halls or assigned to check on you know there's something wrong if that sign is still up say, by 10 AM in Independent which is certainly NOTHING like living in a regular HOA condo. I know several women who are YOUNG, who moved to the CCRC because they have no family or way to have peace of mind living in a regular condo versus all the resources available in the CCRC. And they love it. Their units are beautiful and they live normal lives, being out and about all day or going on vacations in other states etc.

ALSO, in this one you can vacation in other communities, for example if you live in PA, you can go stay in another one in Florida for vacation.

Last time I looked into it, you could make an equity payment for around $80,000 and your monthly was around $2300 for a condo unit.

https://www.actsretirement.org/
Hi. Of course it is commendable and encouraging that you would live where you work. I think the buy-in payments are more now than 80,000. But perhaps I'm not reading it correctly. Is the equity payment you speak of the initial payment they require? I have some money saved (not $130,000) and can possibly afford 2300 for a studio, but I have looked into holidaytouch places which are not continuing care and are more affordable for me.
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Old 11-25-2017, 03:11 AM
 
11,181 posts, read 10,501,904 times
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Quote:
Originally Posted by runswithscissors View Post

This is the one I work in (below link) - I would move there in a quick minute - they've been established for decades.
Excellent writeup that exactly describes the two "nonprofit" CCRCs (in TX and AR) that dh & I have considered, researched, and visited.
For us, a major plus is, as you state, the well-established ability to elect to stay in an Independent unit and pay for extra care as needed. This is the most common arrangement, once ADL assistance is needed, in the CCRC we are currently considering. Transferring from Independent to AL units is rare there, usually only done in cases where dementia + mobility require a more confined environment.

We've checked out a couple of for profit CCRCs, both newish, also. Although both said this is an option, they've yet to establish a successful track record with partnering with caregivers.

Re the substantial buy-ins being refundable, for the two we've considered: the short answer is yes, the longer answer is like all "investments", real estate and otherwise, there's no absolute guarantee. Our approach is to consider that money spent and not part of our estate.
Being nonprofits, both CCRCs "encourage", i.e., require, initial and ongoing donations above and beyond the buy-in and monthly fees. Upside of that is these donation requirements are modest (1k-3k a year), tax deductible, and can be directed toward one's interest, e.g. gardening, birdwatching, education, fitness, community outreach, etc.

You are exactly right in saying CCRCs and long term care policies are essentially the same. They're for a niche market, i.e., for those not on a budget.

Very different from ALFs (assisted living facilities) not associated with CCRCs, which can be accessible to middle-class people on SS and/or pensions. i've posted many times about my mother, MIL, aunts, and uncle, who prove the point.

Last edited by biscuitmom; 11-25-2017 at 03:48 AM..
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