Saturday, April 20, 2019

CCRC and Life Care - Which contract is right for you?

The thriving advanced care market introduces a host of new concepts and terminology that are confusing. For example, many people believe that the life care and continuous care communities are the same and they can use these terms interchangeably. However, life care is actually a subset of ongoing care. Although the product looks at a glance, don't be fooled. Let's take a look at the difference between the two, starting with the Continuous Care Retirement Community [CCRC].

CCRC and Life Care Community

CCRC provides contractual agreements to people aged 60 or older to provide them with continuous services, usually on the same campus. These services include independent living, assisted living, skilled care and sometimes memory care. While all CCRCs provide ongoing care, some rely on contracts with other care providers to manage higher levels of care, which may be off campus. This means that residents who live on an independent or assisted standard of living can get a higher level of care as their needs progress, but they may need to leave the campus to get these services. Most contracts require an entrance fee [sometimes called a "buy" or "purchase" fee] and a monthly fee. Some contracts include the purchase of real estate [ie residential apartments in the community], which can be rejected or handed over to the heirs like any other real estate purchase. However, not all contracts involve the purchase of real estate. Under these terms, older people will become community residents but will not own any real estate under the contract. Buy or enter fees can range from $10,000 to 500,000+.

Life care communities provide the same care for residents for life, but the biggest difference is that residents who are financially unable to pay monthly care will receive community subsidies, receive the same services, and have no interruptions in care or priority changes. In other words, regardless of the financial situation of the individual, residents can enjoy the same quality of care and medical services from the first day to the end. In addition, most life care communities provide all health care services on the same campus. The idea is that, after qualifying through the health and financial application process, residents will never have to move in addition to the level of care they need. Thus, for example, when his or her care needs to progress, residents may be required to switch from assisted living to skilled care, but the new place of residence will be on the same campus. However, some states allow the life care community to provide professional care outside the school as long as it is under the ownership and supervision of the life care provider, rather than through a contractual agreement. There is also a significant difference. In the life care community, residents do not own real estate under their life care contract. After the inhabitant's death, the apartment [or room] in which he or she lives will return to the community.

Because there are no federal agencies responsible for managing the CCRC and the life care community, the terms and requirements vary from state to state. However, an easy way to distinguish between a life-care community and a CCRC is by contract type: Category A is considered life care; Types B and C are considered continuous care.

Contract type: A, B&C

In general, there are three types of continuous care contracts: Category A [wide or comprehensive care], Category B [improved or continuous care], and Category C [service fees]. Each type of contract poses varying degrees of risk to residents and communities. The highest level of risk is borne by the community with a category A contract and the minimum risk is borne by category C. For residents, the opposite is true, with Category A having the lowest risk and Category C having the highest risk. Each type of contract has a different fee structure, which corresponds to the level of risk claimed by either party. Some continuous care communities offer only one type of contract, so please contact the community you are interested in to understand the contract it provides. Here is an overview of how each contract works:

Type A: extensive or life care contract

Through this type of agreement, consumers bear the least risk, but pay the highest dollar. Class A contracts provide housing, services and amenities, and in addition to regular increases in inflation, there is little or no additional cost of long-term care. The higher initial cost is based on the assumption that over time, these residents may need and utilize a higher level of care. Considering that Medicare does not include over $250 per day of supervision in a private room in a nursing home, this can result in considerable savings for the residents' lifetime. In addition, prepaid future health care costs allow these tenants to receive significant tax benefits [IRS medical deductions]. Usually, residents must maintain a minimum level of Medicare co-insurance.

For whom: People who want to make sure that they meet all of their health care needs will be reminded of their lifetime.

Type B: modified or ongoing care contract

Class B contracts also provide housing, services and amenities, but the use of long-term health care and care services is limited to the number of days specified. After this, residents should bear any additional care costs. Some contracts allow residents to pay for additional care at a discounted price after using the care included in the contract. As with category A contracts, residents are eligible for IRS medical deductions.

For those who are good: people who can pay for the care that are not covered by the contract, and those who don't expect their health care needs to increase dramatically over time.

Type C: Contract by service charge

Through the C contract, you can guarantee access to health care, but residents must pay the full cost of the services they use. Under this agreement, residents can obtain the housing, services and amenities specified in the contract. Some communities do not charge an entrance fee for a C-type contract, but only a monthly fee. However, other communities do charge an admission fee that subsidizes residents' assisted living or professional care. If the care fee is received from the admission fee, the resident will be charged the full cost of any services used. This can happen if residents need extended professional care. For those who need a higher level of health care in the future, the cost can be very high. At a cost of $250 a day, nursing home care costs are rising rapidly, putting a heavy financial burden on residents without long-term care insurance or substantial financial resources. According to the category C contract, residents are not eligible for IRS medical deductions.

For those who are good: people who are willing to accumulate all risks to health care costs.

The benefits of continuous care

Continuous care allows residents to easily access most of the services they need in one place. Except for category C contracts, the cost of these services is included in the fees they pay under the contract. Although the health care component is the basis of the contract, it is definitely not just about health care. Let's take a look at what is included in a typical continuous care protocol:

* Contact the on-site doctor by appointment every Friday.
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  * Call during the illness to assess the condition.
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  * Delivery during the illness.
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  * Daily van service to off-campus hospitals.
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  * Choice of services to be retained under a separate medical plan, including certain regulations.
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  * Three meals a day, weekly cleaning service, washed sheets and towels.
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  * Use of banking services, leisure outings and numerous on-site activities.

monitoring condition

Although the CCRC and life care communities are highly regulated in certain states, there are no federal agencies that oversee these types of retirement communities. However, there is a set of checks and balances to protect consumers. This is how it works. Life care providers must submit certified financial statements and retention reports to the State Department of Social Services each year. The Continuing Care Contract Regulations set out various financial and reserve requirements to help ensure that providers have sufficient financial resources to meet future obligations to residents. This protects residents from any financial difficulties that may affect life care providers. The supplier must recalculate the reserve every year. If the Department of Social Services determines that the provider's financial situation is not sound, it will exercise its statutory authority to require corrective action.




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