Overview of CCRC Risks and Liability

A continuing care retirement community (CCRC) is a residential community that allows older adults to “age in place” as their health declines and their care needs increase. CCRCs differ from other types of continuing care options by providing housing, healthcare, and other services for independent-living, assisted-living, and skilled nursing residents on one campus (AAHSA). While many CCRCs are designed for long-term residence, some offer short-stay packages or rehabilitation or respite care.

This Risk Analysis provides an overview of CCRCs, discusses federal and state regulations and accreditation requirements, discusses risks related to admissions and transitions in care, and touches on some other risks in the CCRC setting. Risks specific to each type of care setting (i.e., independent living, assisted living, skilled nursing) are covered elsewhere in the Continuing Care Risk Management (CCRM) System. For example, Assisted-Living Overview covers risks specific to the assisted-living setting.

According to data from the American Association of Homes and Services for the Aging (AAHSA), there are about 1,850 CCRCs in operation in the United States, as of 2009. Of these communities, 82% are nonprofit, and almost half are faith-based; the remaining CCRCs may be sponsored by health systems, universities, or the military. About 56% of CCRCs are part of a larger health system, and 37% are single-campus organizations. (AAHSA “Continuing Care”)

Residents of CCRCs have various housing and healthcare options, including independent-living, assisted-living, and skilled nursing care. Independent-living units may be studio, one-bedroom, or multiple-bedroom apartments; cottages; townhomes; or single-family homes. Assisted-living units are typically studio or one-bedroom apartments. The CCRC model of care offers many...