Some retirees think that CCRCs are a great place for them to age gracefully, while others find them too restrictive or expensive. For those who do not want to give up their current lifestyle and want to continue living in their own home as they age, which per AARP is 90% of seniors, there is another option, CCaH.
Continuing Care at Home (CCaH)
CCaH, also known as a “CCRC without walls,” offers the comfort and security of staying at home with the amenities, assistance, and healthcare of living at a CCRC. This means the requirement to buy into or rent a residence on the CCRC's physical campus is eliminated. Advances in technology have made remote care coordination easier, allowing caregivers, such as physical therapists, aides, nurses, etc., to provide their services at a senior's home as needed.
CCaHs are not new
Although the CCaH concept has been around since the 1980s, it has had a surge of interest in the last few years in the states that support it. Research shows that a rapidly growing number of organizations and established CCRCs are offering CCaH programs and that others are considering it. CCaHs offered by established CCRCs, especially those that offer access to on-campus facilities and programs, act as feeder programs to bring residents into the CCRCs facilities. The growth of CCaH programs is not only driven by provider and consumer demand, but also by regulatory changes in states to allow their operation.
What is provided by a CCaH?
Like a standard CCRC contract, a CCaH contract includes an entrance fee and a monthly maintenance fee, but the fees are much, much less than those required to live at a CCRC. Just as with a CCRC, the monthly fee will increase annually.
A CCaH contract offers an alternative to increasing long-term care insurance costs. Unlike long-term care insurance, there is no elimination or waiting period. Whether it is a minor setback or a more complicated illness, once you sign the contract, all services begin as soon as you need them. They can be provided temporarily, or if your situation changes, permanently.
At Navigation by Salemtowne, a CCaH in Winston-Salem, NC, the entrance fee is less than $60,000 depending on your age and the monthly fee is $500 and up depending on your age. Your monthly benefits are capped at the monthly cost to live at the Salemtowne CCRC’s skilled nursing facility for a month (about $9,000 as of Jan 2018). However, there is no lifetime limit to your benefits and there are no limits on the years of coverage as there are with a long-term care insurance policy. Once you are accepted, you are covered for life.
Some typical services provided by a CCaH contract:
- Assigning you a personal coordinator who will coordinate any eligible continuing care services you may need. Your coordinator will work closely with you, your family, and your physician to ensure the right services are delivered to you in your home, or when necessary, in an associated CCRC or a participating facility.
- Assisting you in obtaining home maintenance contractors.
- Annual physicals and wellness programs.
- Transportation to medical appointments.
- Home inspections.
- Adult daycare.
- Companion or live-in care.
- Home care or home health care.
- A personal emergency response system (PERS) with 24-hour coverage.
- Meals, either prepared in your home or delivered.
- Access to activities and amenities at an associated CCRC, such as classes, outings, pool, or fitness facilities.
- Priority over non-members and discounted fees should you decide to move into a CCRC facility.
- Referral services when assistance is needed, such as handymen, a bathroom conversion, housekeeping, or transportation. Your coordinator may even contact providers directly to obtain estimates, schedule services, and schedule payments.
- Social and wellness programs, including exercise classes, arts and crafts classes, wellness seminars, speakers, day excursions, and more, to keep you healthy in mind, body, and spirit. Some programs are free for members while others may have a small participation fee.
- Services that start when you start to demonstrate a deficiency in one or more of the Activities of Daily Living (ADL’s), such as eating, dressing, grooming, transferring, toileting, bathing, walking, or mobility.
- If you need assistance with personal care a licensed, certified home health aide will be provided for you in your home under the supervision of a registered nurse.
- A companion/homemaker will be provided when you need assistance in your home in such areas as the supervision of activities of daily living (listed above) and medication reminders. This caregiver may also do the cooking, dishwashing, laundry, light housekeeping, and errands, as well as keeping you company with conversation and social activity, while they are providing these services in your home.
- When staying at home becomes unsafe for you, facility-based assisted living and nursing care are provided.
When your home is at a CCRC
A CCaH contract is an agreement to take care of you in your home. Your home could be almost anywhere in the service area, including in an independent living unit in a fee-for-service CCRC.
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