I’m quite new to this question, so take my level of expertise with a grain of salt. But here’s how I’m approaching this possibility going forward:
What am I most hoping to gain in a CCRC, or facility with similar acronym?
If the goal is security and predictability no matter what turns my physical or cognitive health takes, that goal is probably an illusion. CCRC’s are a tricky business, with lots of pitfalls. To get in on any favorable terms, you need to be healthy and have stable finances. But how long and how intensively the facility will have to provide you and fellow residents with care is based on actuarial assumptions, and priced accordingly. Assumptions are just that: assumptions. If they are off by a little or a lot, places like this can and do go bankrupt. Short of that, a contract is only as good as the ability of the facility and its owner to deliver the goods. If the owners come to you and say, “Look, we can’t give you what we promised and what you thought you were paying for. We can give you X. Or, we can file for bankruptcy and you take your chances with other creditors”, you’re likely to accept a reduction in amenities and service as the best of two bad options. There are several points in the operation of a CCRC that are difficult financially, such as the shift from taking outside patients into skilled nursing at market rates — which happens in the early years of a facility — to filling all the beds with insiders who, contractually, get a much lower rate. Skilled nursing care isn’t going down in cost, it’s going up. How do the financial projections propose to pay for that shift?
As I said in an earlier post, CCRC’s and the like kind of facility are basically self-insured health care pools, with a very small N on which to base the projected shared burden. If you have long term care insurance, you’ve already joined a pool with a much larger N. If not and you have the assets to self-insure, great. If neither of those are true, you probably don’t have the balance sheet to get into one of these places anyway.
Maybe we have to give up on the notion that we can ever construct predictability and certainty into life, even as we age and feel more vulnerable and wish we could.
Tomorrow: What if the primary goal is social?