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Every Lady, I appreciate your posting about your friend. Even if she had been living inside the CCRC, it’s still, possible there wouldn’t have been a bed for her in rehab/nursing. Most facilities only have a small number of such beds. Nothing is guaranteed. ...
Quote:
Originally Posted by Lizap
It's possible the CCRC may have a room available when she is discharged from rehab. Typically, a Type A contract would provide an accommodation at a similar facility if a bed is not available at the CCRC. With that said, these contracts are all different; without seeing the contract she signed, it's hard to say exactly what the arrangements are. My guess is the 'age in place' Type A contract probably had a smaller entrance fee as well as monthly fees. As a result, she may not have had the same priority as someone who was in independent living at the CCRC paying higher fees.
Most likely both (what I've bolded) are the case: few beds available with priority going to CCRC residents. Eventually she should be admitted to the CCRC in accordance with the terms of her specific contract. The CCRC does send a representative to the meetings held every two weeks at the current outside rehab center. Her attorney and someone from the rehab center also attend. The rehab facility has a skilled nursing wing. The friend who was most involved in assisting her at home and who has contact with her attorney seems to think she'll be transferred there next, but nothing is certain and like everyone at this point he's only guessing.
My personal takeaway is that while, of course, backup plans are a positive they can result in being financially stretched between two options, not fully committed or invested in either. This left her home an increasingly inadequate and unsafe place for her to live while she is not in a position to receive the immediate CCRC care she expected. For example, my friend had reached the point at home where she really needed to hire a personal geriatric care manager (she has no family) to help with the multiple needed daily living arrangements that she'd hoped (probably unrealistically) her CCRC "personal concierge" would do.
Most likely both (what I've bolded) are the case: few beds available with priority going to CCRC residents. Eventually she should be admitted to the CCRC in accordance with the terms of her specific contract. The CCRC does send a representative to the meetings held every two weeks at the current outside rehab center. Her attorney and someone from the rehab center also attend. The rehab facility has a skilled nursing wing. The friend who was most involved in assisting her at home and who has contact with her attorney seems to think she'll be transferred there next, but nothing is certain and like everyone at this point he's only guessing.
My personal takeaway is that while, of course, backup plans are a positive they can result in being financially stretched between two options, not fully committed or invested in either. This left her home an increasingly inadequate and unsafe place for her to live while she is not in a position to receive the immediate CCRC care she expected. For example, my friend had reached the point at home where she really needed to hire a personal geriatric care manager (she has no family) to help with the multiple needed daily living arrangements that she'd hoped (probably unrealistically) her CCRC "personal concierge" would do.
I don’t know of any CCRC that offers free, personal concierge services. Many CCRCs have employees who offer their services during their off time at an hourly rate. I’m skeptical of the age in place contract offered by a few CCRCs.
I don’t know of any CCRC that offers free, personal concierge services. Many CCRCs have employees who offer their services during their off time at an hourly rate. I’m skeptical of the age in place contract offered by a few CCRCs.
I have wondered about that for if and when I might actually need a little extra help. I am wondering if nursing home aides would be willing to come to my home for an hour before and/or after their shift if I were to pay double what their hourly rate is at the nursing home.
I have wondered about that for if and when I might actually need a little extra help. I am wondering if nursing home aides would be willing to come to my home for an hour before and/or after their shift if I were to pay double what their hourly rate is at the nursing home.
My guess is that you likely wouldn't be able to get someone to come to your house for just one hour after they finish their regular job. When you count the time they spend traveling from their regular job to your house, and then from your house to their house, they would likely have at least two or perhaps three hours tied up in spending one hour with you... and this doesn't count their extra automobile expense in detouring to your house.
Yes, I get why people buy into CCRCs. If someone decided to go this route I don't understand why they would choose anything other than the Type A guaranteed continuum of care. The whole purpose of being there in the first place is to make sure that your care is established.
I've been researching independent living at CCRCs quite a bit lately. I'm interested primarily in two communities within an hour of my home, with the possibility of moving in a year or so. Though I have not yet decided whether I can afford a CCRC...
The CCRC I really like, that I've visited, did not, when I spoke to the sales agent, seem to know what a Type A contract was. So far, no CCRC whose agents I've spoken to has had a guaranteed continuum of care or Life Plan. The CCRC's I've investigated all offer aging in place for people who enter independent living, then transition to assisted living at higher rates.
Most CCRC's that I've checked out do not feature monthly rates that I can afford, anyway, not to mention that some of them have huge entrance fees.
The best reason for my going to the CCRC I liked is that they have a 6-year lock on the monthly rate for new residents and they may continue it; and their rates are pretty low, under $3000 for a studio and a small one-bedroom; and their entry fees are relatively small.
One reason I could make a CCRC work is that although I'm in my late 60's, the probability of my living to my 80's and thus outliving my financial assets (and getting kicked out of the CCRC and into some less pleasant Medicaid dump, or on the street) is not high, given that I have metastatic breast cancer stage 4, diagnosed nearly five years ago (under control and behaving itself so far).
I'm not sure where to find a "Type A guaranteed continuum of care" - maybe they exist at higher rates? Does 'guaranteed continuum of care' ever mean that the CCRC won't move you out if you go through your money over the years, or was I kidding myself? (actually, it was a friend who told me, but I was naive enough to believe her)
I've been researching independent living at CCRCs quite a bit lately. I'm interested primarily in two communities within an hour of my home, with the possibility of moving in a year or so. Though I have not yet decided whether I can afford a CCRC...
The CCRC I really like, that I've visited, did not, when I spoke to the sales agent, seem to know what a Type A contract was. So far, no CCRC whose agents I've spoken to has had a guaranteed continuum of care or Life Plan. The CCRC's I've investigated all offer aging in place for people who enter independent living, then transition to assisted living at higher rates.
Most CCRC's that I've checked out do not feature monthly rates that I can afford, anyway, not to mention that some of them have huge entrance fees.
The best reason for my going to the CCRC I liked is that they have a 6-year lock on the monthly rate for new residents and they may continue it; and their rates are pretty low, under $3000 for a studio and a small one-bedroom; and their entry fees are relatively small.
One reason I could make a CCRC work is that although I'm in my late 60's, the probability of my living to my 80's and thus outliving my financial assets (and getting kicked out of the CCRC and into some less pleasant Medicaid dump, or on the street) is not high, given that I have metastatic breast cancer stage 4, diagnosed nearly five years ago (under control and behaving itself so far).
I'm not sure where to find a "Type A guaranteed continuum of care" - maybe they exist at higher rates? Does 'guaranteed continuum of care' ever mean that the CCRC won't move you out if you go through your money over the years, or was I kidding myself? (actually, it was a friend who told me, but I was naive enough to believe her)
The vast majority of sales agents know what a Type A or lifecare contract is. If they don't offer one, it's possible they're having a 'memory lapse'. You just have to directly ask what type of contract they offer, explaining what a Type A is, if necessary. You may not qualify for a Type A contract in some CCRCs given your medical condition; you would need to be upfront and ask. Some Type As only require you to be able to live independently upon entering while others have tougher health requirements. Type As are going to be more expensive than Type Cs (both entrance and monthly fees). Most non-profit CCRCs will not kick you out should you run out of money, but this is a question you should ask.
I've been researching independent living at CCRCs quite a bit lately. I'm interested primarily in two communities within an hour of my home, with the possibility of moving in a year or so. Though I have not yet decided whether I can afford a CCRC...
The CCRC I really like, that I've visited, did not, when I spoke to the sales agent, seem to know what a Type A contract was. So far, no CCRC whose agents I've spoken to has had a guaranteed continuum of care or Life Plan. The CCRC's I've investigated all offer aging in place for people who enter independent living, then transition to assisted living at higher rates.
Most CCRC's that I've checked out do not feature monthly rates that I can afford, anyway, not to mention that some of them have huge entrance fees.
The best reason for my going to the CCRC I liked is that they have a 6-year lock on the monthly rate for new residents and they may continue it; and their rates are pretty low, under $3000 for a studio and a small one-bedroom; and their entry fees are relatively small.
One reason I could make a CCRC work is that although I'm in my late 60's, the probability of my living to my 80's and thus outliving my financial assets (and getting kicked out of the CCRC and into some less pleasant Medicaid dump, or on the street) is not high, given that I have metastatic breast cancer stage 4, diagnosed nearly five years ago (under control and behaving itself so far).
I'm not sure where to find a "Type A guaranteed continuum of care" - maybe they exist at higher rates? Does 'guaranteed continuum of care' ever mean that the CCRC won't move you out if you go through your money over the years, or was I kidding myself? (actually, it was a friend who told me, but I was naive enough to believe her)
It's possible fewer CCRCs are now offering the Type A contracts that offer that guaranteed continuum of care? The expectation is they will provide lifetime care for the contracted monthly fee after buy-in costs. That fee normally does not remain constant, however, but is adjusted upward to account for inflation. It is not, however, raised - in theory - as the client progresses from independent living to skilled nursing care.
For a Type A contract, the CCRC will evaluate the applicant assets to ensure they will be able to afford the increased costs over time since health care inflation may reasonably be expected to be higher than, for example, social security COLAs. The applicant would also need to demonstrate they have sufficient assets to cover expected price increases for items not covered by the CCRC.
What happens if the applicant experiences a future financial reversal and cannot at some point pay the contracted monthly fee? That almost certainly varies by the CCRC, perhaps depending on changes in management. Some apparently have 'scholarship' programs.
Along with demonstrating financial adequacy, the applicant will be required to pass both medical and memory screening for a Type A contract. IDK that your medical condition would automatically disqualify, or perhaps not even be a major issue? Most if not all CCRCs - I would assume - require that their clients maintain Medicare Part B and possibly even Medigap insurance?
Skilled nursing including rehab and hospice care provided by the CCRC would first be billed to Medicare then to secondary insurance policies. The CCRC would then take on the role of final insurer and include the custodial care that is not typically reimbursable on a LT basis by Medicare or other insurance policies including any LTCi after it is exhausted.
The patients who have the highest risk of using extensive non-reimbursable nursing and custodial care - and thus constitute the highest financial risk to the CCRC - would be those with neurodegenerative diseases, strokes, dementias etc. not necessarily medical conditions like cancer.
I don’t know of any CCRC that offers free, personal concierge services. Many CCRCs have employees who offer their services during their off time at an hourly rate. I’m skeptical of the age in place contract offered by a few CCRCs.
My friend did not anticipate the personal concierge services to be free but apparently expected her CCRC personal concierge to arrange for them - personally, by phone. Based on the sheer number of outside members that also struck me as unrealistic but the CCRC online literature did give that general impression. She said she was told this concierge would allow the outside members to get more personalized services than the members living within the CCRC - whatever that means.
The disconnect between her hope and what happened - the services consisted of her being given a list of approved vendors she herself could call and negotiate with - may come from there also being several levels of outside independent care, and she may have selected a less expensive service level? It's possible she could have bought her way into access to CCRC-contracted drivers, again for a per-ride fee. IDK
What I did see was someone perhaps in the very early stages of dementia who was not able to herself fully evaluate situations - hence this seeming overnight post-fall decline into dementia? My friend did not have a family member or apparently a very close personal friend able to take on the role of advocate - nor did she particularly solicit 'opinions.' Her personal attorney holds her health and financial POA. He appears to have reviewed documents only for legal sufficiency not helped with decision making.
However 'rough' on several fronts that first year in the independent living-at-home program turned out to be the important thing is she signed a contract that should - eventually - result in her being transferred into the CCRC to receive what's considered to be highly competent care.
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