Housing: Alternative Options

Continuing care retirement communities (CCRC), also referred to as life-care communities, are planned communities that combine housing and a range of services (including independent living, assisted living, and nursing home care), and serve primarily the middle- and upper-middle-class elderly. There were close to 2,000 CCRCs, housing some four hundred thousand to five hundred thousand residents, operating in the United States at the end of the 1990s.

Nearly all CCRCs charge an entry fee plus a monthly fee, a structure which appeals to facility operators because it links revenue to the resident's longevity as well as to the rate of inflation. There are two basic types of contracts. An all-inclusive plan provides an independent living unit, residential services, amenities, health-related services, and long-term nursing care in return for a specific price (paid as entry fee plus monthly payments). A fee-for-service plan provides an independent living unit, residential services, and amenities. It guarantees access to nursing care—for which residents pay a per diem rate, except for minimal services such as twenty-four-hour emergency care. Between these two plans are various other arrangements known as modified plans.

Besides possessing educational and economic advantages, CCRC residents represent a relatively healthy segment of the older age group. This is not surprising, because CCRCs have health status entrance requirements for persons applying for independent living units.