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What Is a CCRC?

These days, everything has an abbreviation. CCRC is short for a Continuing Care Retirement Community. These properties consist of an Independent Living Residence, Assisted Living Facility (ALF) and a Skilled Nursing Facility (SNF). The prevailing theory of a CCRC: seniors could have access to a continuum of care as they age – and their needs change over time. It’s an appealing concept on many levels, but let’s delve into these communities a bit more.

First of all, you need a good size parcel of land for three buildings. In addition, you need a large staff to care for all the residents. Sate licenses are also required for the ALF’s and SNF’s. Moreover, research has shown that many residents of the independent living facilities do not like the idea of ALF and SNF’s on the same campus. Instead, many seniors are choosing independent-only properties. As a result, there are not many CCRC being built today.

In terms of cost, the original CCRC’s utilized the “buy- in” model, not rentals. A large deposit was required (up to $250,000. which was 90% refundable when the apartment was resold) plus a monthly fee. The buy-in model is not used very often these days; most CCRC’s have changed to a monthly rental format.

CCRC’s were built for individuals and couples who wanted to move into a residence while they were still independent and would never have to leave the community. On paper, it is an attractive model. The reality, however, is that the overall expense and logistics have limited the number of CCRC’s in the country. Assisted Living Nationwide maintains a list of all the CCRC’s throughout the United States. This model of care is definitely an alternative to assisted living facilities and could very well be the best choice for some seniors.


Do You Qualify for Assisted Living?

There have been dramatic changes in the demographics and population of assisted living facilities (ALF). Today, ALF’s are accepting residents who –even five years ago — would not qualify for assisted living and, as a result, would need to be admitted to a nursing home. Let’s examine why this has happened and how you can find out if you or a loved one qualify for assisted living.

Today, the majority of assisted living residents are people who are residents in their 80’s, 90’s and even 100 years and older. Traditionally, individuals in this age group were only viewed as candidates for a nursing home.

ALF do not provide the 24 hour care level one would find at a nursing home, but all have a Wellness Director (RN) and a staff of non-medical home health aides to help you with activities of daily living. In addition, most have a Memory (Alzheimer’s/Dementia) unit for residents experiencing memory loss. Previously, the majority of people with memory problems were relegated to a nursing home. The advantages of living in ALF are many: an ALF enable residents to reside in private rooms or apartments; there are social activities as trips, events and concerts as well as on-site amenities such as salons, cafes and fitness programs; the ALF are about half the price of a nursing home.

ALF’s are not for everyone; there are the issues of private pay and a medical assessment (physical and mental) required for admittance. ALF’s are typically looking for two-to-three years of private pay available at admission. So even if you meet the Medical Assessment requirement, you still have to go to a Nursing home. On the other hand, Nursing Homes, will allow you, if you financially qualify, to become a Medicaid patient at admission.

Find Out If You Qualify for Assisted Living

Assisted Living Nationwide can help you find the appropriate ALF for you. We can prequalify you by letting you know the monthly rental rates for all the ALF in your preferred geographic location and find the most appropriate ones in terms of your budget, hobbies, interest and preferences. In addition, we can also arrange a medical assessment for you or your family member. This way, you will know if you qualify for an ALF prior to embarking upon tours. This can save you a tremendous amount of time and, most importantly, help you understand your senior living options.

 Assisted Living Resident Demographics

More than half of all residents are age 85 or older, and nearly 40 percent of residents require assistance with three or more activities of daily living. The median stay in assisted living is 22 months, and an overwhelming majority of residents are female.

What is the Cost of Assisted Living?

Assisted living costs vary with the residence, apartment size, and types of services needed. The basic rate may cover all services or there may be additional charges for special services. Most assisted living residences charge on a month-to-month lease arrangement, but a few require long-term arrangements. Assisted living is of often less expensive than home health or nursing home care in the same geographic area.

According to the National Investment Center Investment Guide 2010, the median rate for a monthly rental rates in an assisted living community is $3,326 per month. In comparison, the NIC Investment Guide 2010 also indicates the median rate of Nursing Care at $7,001 per month. The median is the midpoint, which means half of residences participating in the research have lower fees and half have higher fees. The rental rate includes the base rent and service fees charged by the assisted living community.

Information compiled from the ALFA (Assisted Living Federation of America ) website

Living At Home with Help Versus Assisted Living

A common scenario: what to do when one spouse needs the maximum amount of care due to memory loss and the other is able to live independently? Families often wonder whether it is better to have the couple continue to live in their home with a great deal of support services from home care agencies or place the couple in an assisted living facility. Let’s look at this issue from an economic, social and medical perspective:

 In-Home Care from a Private Agency


The average cost for an 8 hour day care at home on a daily basis is approximately $5000 a month.

(8 hours/day x $23/hour x 7 days/week = $1288/week or about $5000/month)

In addition to this cost, the couple would still assume the fees of associated with owning or renting a home (e.g. heat, electricity, water, taxes etc.) as well as necessities such as food, transportation, housekeeping and so forth.


The couple remains in their own home, where they feel comfortable and can maintain an independent lifestyle.


The spouse who can live independent assumes responsibility for such things as maintaining the house/apartment, shopping, errands and driving to medical appointments. Moreover, round-the-clock 24 hour care is extremely expensive, so there will be periods where no help will be available. He or she may also feel isolated from friends and every day social interaction.

Support and Care from an Assisted Living Facility


The average cost of ALF apartment for a couple in the US is approximately $5500/month plus $1500 (fee for second person) or approximately $7000/month.

This fee would include private apartment, three prepared meals daily, on-site fitness, beauty salons, recreational and social activities as well as maximum assistance (for one) in terms of activities of daily living (etc. eating, bathing, dressing, toileting, walking and medication assistance.)



Assisted livings generally provide better quality of care and residents have access to trained staff members 24 hours a day. Most ALF have specially designated memory loss residences. Additionally, there is a much higher level of socialization at an assisted living facility,


Higher cost than living at home with help, although one needs to add into the mix that cost of the apartment, food, amenities and activities are included into the monthly fee.

Most couples want to stay in their homes as long as possible — and that is understandable – and certainly desirable. The key is to figure out when it becomes too stressful for the couple to live alone and, even more importantly, when safety concerns arise.

Making the Right Decision

As individuals age and memory loss becomes more pronounced, assisted living facilities can offer support while maintaining independence. Assisted Living Nationwide helps examine the pros and cons of each situation and offer professional expertise to help families make this most difficult decision.

Is it Time for Assisted Living?

For many people, knowing when it is time for assisted living is a extremely difficult decision. Leaving one’s home and familiar surroundings is traumatic. It is, after all, human nature for all of us to want to stay in our own homes as long as possible.

Often, the elder’s families are the ones to facilitate the move. Families need to look for signs that an elder is no longer being able to live alone. Keep in mind that many of these issues are hard to discuss with a loved one. But it is very often the right solution for the elder and the family.

Here, from Assisted Living Nationwide (ALN), are tips to help you evaluate whether a senior should no longer live alone and, as a result, when it is time for assisted living.

Falls and Injuries

Typically, there are a series of falls or “incidents” that occur before loved ones realize that the elder in question should not live alone. Broken hips, broken knees and bruises are quite common. If the senior lives in another city/state, he or she may not mention these incidents on the phone. Holiday get-togethers such as Thanksgiving or Christmas are when families begin to realize that assistance in the day-to- day living are necessary and that it’s time for assisted living.

Loss of Appetite/Weight Loss

Proper nutrition and eating a balanced diet is a major concern for families of seniors who live alone. Assisted living provides three meals daily, in addition to the option of stocking the apartment with one’s favorite snacks and beverages. Many assisted living facilities have made a tremendous strides in offering healthy meals made with fresh, seasonal ingredients as well as a variety of menu options available.


Everyday activities such as cooking or gardening can cause fires and falls. Burns on the kitchen counters or table can be an early indication.

Memory Loss

Memory loss is a tell tale sign that it is time for an assisted living facility. Forgetting to take one’s medication, go to a medical appointment, or even forgetting how to drive home are all common signs that the memory loss is occurring in an elder. If one were living in an assisted living facility, there will be medication reminders and a trained staff to help with the activities of daily living.


Living alone can be lonely. The socialization and meal time interaction in an assisted living is an important advantage for seniors. Many residents don’t realize how much they have missed the day-to-day contact of others until they move into an assisted living residence. All assisted living facilities have a full schedule of activities available.

Housekeeping Issues

Cleaning, cooking, laundry, bed-making, grocery shopping and other daily chores takes its toll as one grows older. An assisted living facility takes care of all of these responsibilities, while still enabling an individual to live in the privacy of his or her apartment.


Assisted living has become the number one care option for seniors who can no longer take care of themselves according to the United States of Aging survey by the National Council on Aging.




Can an Assisted Living Program (ALP) Help You Afford Assisted Living?

An Assisted Living Program (ALP) can help a select group of seniors afford to live in an assisted living facility (ALF).  In general, an ALP provides daily assistance with personal care services (Activity of Daily Living  and Instrumental Activities of Daily Living. In short, an Assisted Living Program serves as the Medicaid program for the ALF’s.

Designed for those individuals who cannot afford the monthly rental at an ALF,   but otherwise qualify medically to live in an assisted living facility,  Assisted Living Programs are limited in availability. And not all ALF’s offer this program. However, for those individuals who qualify, an Assisted Living Program could be a tremendous resource.


  • Most ALF’s designate only 10% of the apartments to ALP.
  • These ALP apartments are often full and have waiting lists.
  • Ideally, ALF’s request the individual to pay privately for 2-3 years, and then if one runs out of funds, they resident can apply for ALP. Note that this is a general guideline and changes from one ALF to another.
  • The application process for ALP is not easy, is time consuming, and there are asset qualifications.
  • Often times there needs to be a spendown of assets to the amount allowed by ALP, before an individual can qualify for ALP.

What can one do to get into an ALP program?

If an assisted living residence is the best option for yourself or a family member, there are resources available to help you decide if this program would be appropriate.

  • Research the Assisted Living Program requirements by state and city. Most states have an Executive Office of Health and Human Services website that provides information on the ALP program.
  • Contact an assisted living placement service such as Assisted Living Nationwide to find out the best option in your desired location. Since ALP is a complex issue, industry professionals are usually the best resource. At Assisted Living Nationwide, there is no charge to the elder or family for consultations or services.
  • Consult an elder law attorney or a geriatric care manager who specializes in ALP.

Keep in mind there are many choice in residences for seniors today. It’s important to find the right solution based upon the individual’s needs, financial constraints, desired location and physical condition. Yes, finding the right living option is a complicated process, but talking to qualified professionals is the first step in making the best decision.

Medical Assessments to Qualify for Assisted Living

Let’s assume you find the perfect assisted living facility (ALF) for your parent. What’s more, you’ve found a place that meets all your criteria in terms of location, care support, activities and demographics. One would imagine that the next step would be to move in and become a resident. Not so fast!

A medical assessment for prospective residents is required by every ALF prior to move-in day. The assessment is usually administered by the Wellness Director (RN) and determines if the ALF is appropriate for the prospective resident. Both physical and cognitive abilities are evaluated in these tests. In most states across the country, these assessments must be completed no more than one month prior to the move-in.

Today, the majority of ALF’s now feature memory care residences. These medical assessments also determine whether the prospective resident is a candidate for these specially designated areas. Significantly, there are times where the assessment indicates that a nursing home would be a more appropriate choice.

Assessments are often used when a prospective resident lives out of area and is not be able to visit the ALF beforehand. Larger ALF groups that have many locations can utilize a RN from a “sister” ALF to process the assessment. Many home care agencies process assessments, along with companies that specialize in out-of-area assessments.  Assisted Living Nationwide works with companies, such as Long Term Solutions, to make sure these assessments are processed quickly. As with the entire assisting living selection process, time is always a critical factor.

What is Assisted Living?

The Assisted Living Federation of America defines assisted living as a long-term care option that combines housing, support services and health care, as needed. Assisted living is designed for individuals who require assistance with everyday activities such as meals, medication management or assistance, bathing, dressing and transportation. Some residents may have memory disorders including Alzheimer’s, or they may need help with mobility, incontinence or other challenges. Residents are assessed upon move in, or any time there is a change in condition. The assessment is used to develop an Individualized Service Plan. (Source:

Medical Assessments


What You Need to Know About Food at Assisted Living Facilities

The food at assisted living facilities is always a prime topic of conversation. Historically, assisted living facilities offered basic dishes with few choices. The good news: today’s assisted livings are focusing on healthy meals made with fresh, seasonal ingredients. Gone are the days when canned, frozen and salt-laden foods were the norm. Today, on-staff dieticians and professional trained chefs join forces to create meals that are both nutritious and delicious.

What should families expect in terms of dining options at an assisted living facility? Many feature 24 hour cafes, room service, experienced wait staff, formal dining rooms and causal gathering spaces. Holidays showcase traditional favorite foods and rituals.  Additionally, residents and families have the option of celebrating these special days at the resident’s home.

Food Plays A Key Role

Rick Weisberg, president of Assisted Living Nationwide , works with clients all across the country. He has found that food is one of the most important considerations for elders and their families. Weisberg advises clients to eat at least one meal at the assisted living prior to deciding whether to move-in. “Obviously, it makes sense to discover, first hand, the quality of the food,” notes Weisberg, “but it’s also important to observe the social interaction among the residents and the staff.”

When an elder is used to preparing his or her own food, it is definitely a transition to having to eat at specified time —  in the company of other people. But keep in mind that meal times at assisted living facilities are an integral part of the day. This is a time for all residents to come together and socially interact. And for those residents who choose not to participate in many of the scheduled activities, meals become even more important.

These days, many assisted livings pride themselves on a caliber of food service in line with a five-star hotel. The presentation of the food is as important as the taste. The menus change daily; there are amenities such as frozen yogurt machines, cappuccino offerings, make-your-own omelet bars and freshly baked cookies and cakes. Adjusting to meal times might not be such a difficult transition after all.

Making the Transition to Assisted Living

The first time you leave your mom or dad (or both) at an assisted living is similar to leaving your child at pre-school or daycare. It’s frightening. Even though you know in your heart that it’s the right thing to do, you feel anxious, indecisive and – in all probability – a bit guilty. Certainly, that’s a typical reaction, but there are things you can do to make those first days and weeks as seamless as possible. Below, from Assisted Living Nationwide, are a few tips to consider:

Visit the assisted living for lunch or dinner a few days prior to the move-in

Ask the staff to introduce your mom or dad to a few residents and other staff members. This allows you both to become familiar with the dining room and the residents. Plan your visit for a week day, when most residents are on-site.


Establish lines of communication with the Executive Director and Director of Resident Care

They will have first-hand knowledge of your family member and can address any concerns or monitor the transition. Determine whether email or phone calls are the best option; feel free to ask as many questions as need be.


Personalize the apartment so it’s warm and inviting

It’s important to mix prized possession s like photos, artworks and memorabilia with new accent pieces and decorative touches. Photo collages are the perfect wall décor, adding color and familiarity.


Check in with your mom or dad — within reason

Calling every few minutes or even hours will not help the residents during the transition. Set a schedule that works for both of your schedules during the first few weeks.


Don’t ask about the food!

You will hear about it no matter what. Food is the most popular topic on a daily basis.