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Continuing Care Retirement Community (CCRC) Checklist

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First Impression

  • Do you like the facility's location and outward appearance?
  • Is the facility convenient for frequent visits by family and friends?
  • Is the facility near a shopping, and entertainment complex?
  • Can the resident access a medical complex easily?
  • Is public transportation available/accessible?
  • Are you welcomed with a warm greeting from the staff?
  • Does the staff address residents by their names and interact with them during your tour?
  • Do you notice the residents socializing with each other and do they appear content?
  • Can you talk with residents about how they like living there and about the staff?
  • Is the staff appropriately dressed, friendly and outgoing?
  • Do the staff members treat each other in a professional manner?
  • Are visits with the residents encouraged and welcome at any time?
  • What percentage of the apartments has been rented and is occupied?
  • Is there a waiting list? If so, how long do they estimate it will take to be admitted?
Living Area and Accommodations

  • Is the floor plan well designed and easy to follow?
  • Are doorways, hallways and rooms accommodating to wheelchairs and walkers?
  • Are elevators available for those unable to use stairways and handrails to aid in walking?
  • Are floors of a non-skid material and carpets conducive for safe walking?
  • Does the residence have good lighting, sprinklers and clearly marked exits?
  • Is the residence clean, free of odors and appropriately heated/cooled?
  • What is the facility's means of security if a resident wanders?
  • Are the common areas in general attractive, comfortable and clean?
  • Is there an outside courtyard or patio for residents and visitors and can they garden?
  • Does the residence provide ample security and is there an emergency evacuation plan?
  • Are there different sizes and types of units/housing available with optional floor plans?
  • Are single units available and/or double occupancy units for sharing with another person?
  • Does residence have furnished/unfurnished rooms? What is provided or what can they bring?
  • May they decorate their own rooms? Is there adequate storage space?
  • Is a 24-hour emergency response system accessible from the unit with own lockable door?
  • Are bathrooms private with handicapped accommodations for wheelchairs and walkers?
  • Do all units have a telephone and cable TV and how is billing handled?
  • Does kitchen unit have refrigerator/sink/cooking element and can food be kept in their units?
  • May residents smoke in their units or are there designated public areas?
Moving in/Contracts and Finances

  • What's involved with the moving in/out process? How is the initial needs assessment done?
  • Does assessment process include the resident, family, facility staff along with the physician?
  • Is there a written plan for the care of each resident and is there an ongoing process for assessing a resident's need for services and how often are those needs evaluated?
  • Inquire as to what kinds of contracts are available to you. The CCRC contract is a legal agreement between you (the consumer) and a continuing care retirement community. This agreement generally secures living accommodations and services, including health care services, over the long term. Determine what fee structure and contract option best suits you.
  • The three most common types of CCRC agreements are:
  • Extensive contract: This offers unlimited long-term nursing care for little or no substantial increase in your usual monthly payments.
  • Modified contract: This includes a specified amount of long-term nursing care beyond which you are responsible for payment.
  • Fee-for-service: You pay full daily rates for all long-term nursing care required.
  • Find out what the payment schedule is and if the residents own or rent their unit?
  • What is the basic entrance charge, and what is included for that fee? What charges are extra?
  • How much is the monthly fee? How often can it be increased and for what reasons? Is there a limit on the amount of increase per year? What is the history on monthly fee increases?
  • Are refunds or rate reductions ever granted? Under what conditions?
  • Are any portions of the charges covered under long-term care insurance that the resident may already have or be eligible for? Are there charges that are duplicated?
  • What happens if a couple moves into an apartment and then one of them must go to the nursing home and/or dies? Will the other one be allowed to stay in the same apartment and how will this effect rates?
  • What happens if someone wants to leave after just a few weeks or months, or if they die? Is any portion of the entrance fee refunded to their estate?
  • What type of health and medical coverage is included in the entrance and monthly fees? Are dental work, vision exams and routine wellness checkups included?
  • What determines when a resident is moved to a nursing care facility and who decides?
  • Will the facility guarantee that nursing home care will be available on the premises, or nearby, when needed? What rates will residents be charged for such care?
  • Do billing, payment and credit policies seem fair and reasonable? May resident handle his/her own finances with staff assistance if able? Must a family member/outside party be designated?
Health/Personal Care/Services

  • What type of healthcare and personal care services are available? Does the facility have both short and long-term services, such as routine physical and dental examinations and pharmacy services, as well as skilled nursing and therapy services?
  • Can the facility provide a list of available services and are residents and families involved in developing the service agreement? Who provides these services/what are their qualifications?
  • Is staff available to provide 24-hour assistance with activities of daily living (ADLs) if needed? ADLs include dressing eating, mobility, hygiene, grooming (bathing, toileting, incontinence)
  • Does residence have programs for Alzheimer's, other dementias and other specialized areas?
  • How are medical emergencies handled? Does the residence have a clearly stated procedure for responding to medical emergencies? Is there an arrangement with a nearby hospital?
  • Will the staff dispense medication to able residents? If so, what are the dispenser's qualifications? Will they monitor residents taking medications?
  • Are housekeeping, linen service and personal laundry included in the fees, or are they available at an additional charge? Are on-site laundry facilities available and convenient?
  • Does the residence provide transportation to doctors' offices, the hairdresser, shopping and other activities desired by residents and can it be arranged on short notice?
  • Are pharmacy, barber/beautician and/or physical therapy services offered on-site?
Social and Recreational

  • What kinds of group/individual recreational activities are offered and who schedules them?
  • Is there an organized activities program with a posted daily schedule of events?
  • Does the facility schedule trips or other events off premises?
  • Are the resident activity (social) areas appropriate and desirable to the prospective resident?
  • Do residents participate in activities outside of the residence in the neighboring community?
  • Are there supplies for social activities/hobbies (games, cards, crafts, computers, gardening)?
  • Are religious services held on the premises? Does the residence arrange for nearby services?
  • Do volunteers and family members come into the residence to participate/conduct programs?
  • Does the residence create a sense of community by allowing residents to participate in certain activities or perform simple chores for the group as a whole?
  • Are there fitness facilities, as well as regularly scheduled exercise classes?
  • Are residents' pets allowed in the residence? Does facility have pets and who cares for them?

  • Do the staff members have professional backgrounds in continuing care and geriatrics field?
  • What are the hiring procedures and requirements for eligibility? Are criminal background checks, references, and certifications required?
  • Is there a staff-training program in place and what does it entail?
  • Is staff courteous to residents and to each other? Are responses for assistance timely?
  • Is the administrator or appropriate staff person generally available to answer questions or discuss problems and would you be comfortable dealing with them on a daily basis?
  • Does the facility have a volunteer program or is it affiliated with any student clinical program?

  • What are the different meal programs offered? Does the residence provide three nutritionally balanced meals a day, seven days a week, and how does the menu vary from meal to meal?
  • What about special diets; does a qualified dietitian plan or approve menus?
  • Are residents involved in menu planning and may they request special foods?
  • Are common dining areas available and when can residents eat meals in their units?
  • Does dining room environment encourage residents to relax, socialize, and enjoy their food?
  • Are meals provided only at set times or is there some flexibility? Are snacks available?
  • How many meals are included in the fee? If a resident becomes ill, is tray service available?
  • Can residents have guests dine with them for an additional fee? Is there a private dining room for special events and occasions, if desired?
Licensure and Certification

  • Is the facility accredited by the Continuing Care Accreditation Commission? Accreditation is not required and not all CCRCs are evaluated.
  • Is the nursing center Medicare and/or Medicaid certified?
  • What reputation does the facility have in the community? How long has it been in business? Is it in good financial health? Does the facility follow generally accepted accounting procedures?
  • If the facility is sponsored by a nonprofit organization and managed under contract with a commercial firm, what are the conditions of that contract?
  • Is there a resident council or organization through which residents/family have a means of voicing their views on the management of the community?