Continuing care retirement communities in the United States

A continuing care retirement community (CCRC), sometimes known as a life-care community, is a type of retirement community in the U.S. where a continuum of aging care needs - from independent living, assisted living, and skilled nursing care - can all be met within the community. These various levels of shelter and care may be housed on different floors or wings of a single high-rise building or in physically adjacent buildings, such as garden apartments, cottages, duplexes, mid- and low-rise buildings, or spread out in a campus setting. The emphasis of the CCRC model is to enable residents to avoid having to move, except to another level of care within the community, if their needs change.

Typically, all of the living options (independent living, assisted living, and skilled nursing) of a Continuing Care Retirement Community (CCRC) are on a single campus. The average CCRC in the United States contains just over 330 units, made up of 231 independent or congregate living units, 34 assisted living beds, and 70 skilled nursing home beds. On average, an older resident in the United States will live in the congregate living facility for just over three years, the assisted living facility for one year, and the skilled nursing facility for nine months (America Seniors Housing Association, 2002).

In 2010, there were approximately 1,900 CCRCs in the United States, located in 48 states and the District of Columbia; Alaska and Wyoming had none. The top ten states with the greatest number of CCRCs are Pennsylvania, Ohio, California, Illinois, Florida, Texas, Kansas, Indiana, Iowa, and North Carolina - in that order.

Typically, seniors move into a CCRC while still living independently, with few health risks or healthcare needs, and will remain there until end of life. Most CCRCs require both health and financial assurances for admission. As seniors progress in age, and medical needs change, the level of nursing care and service increases proportionally in response. In such a way, the needs of seniors are consistently monitored and catered to, particularly as those needs become more intensive. If greater illness or injury warrants hospitalization (not available in CCRCs), the senior may return to his or her CCRC residence after recovery, and should receive appropriate rehabilitative care.

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