A challenge to CCRCs that's going largely unnoticed

John O'Connor
John O'Connor

Continuing care retirement communities are some of the most successful long-term care operators around.

The traditional CCRC model can be identified by two characteristics: a large real estate footprint and care that encompasses both senior living and long-term care services.

Much has been made about recent efforts to replace the CCRC moniker with “life plan communities.” The thinking is that the new description is more accurate and sounds a lot better. Point taken.

It remains to be seen how successful the push to rebrand CCRCs will be. But as the marketing discussion continues, a more subtle — and potentially more profound — change is quietly taking root.

What I am referring to is the emergence of home-based CCRCs. As the name suggests, this option allows people to remain at their current address while tapping into the myriad services that CCRCs typically offer.

This option could become a game-changer for at least three reasons.

The first is that improving tech tools are letting people receive health-related services at home in ways that were previously not feasible. For example, telehealth appointments now allow “virtual” doctor visits. Then there's the new generation of monitors and sensors that are delivering up-to-the-second vitals. This is happening as companies dedicated to converting homes for use by seniors are popping up. Moreover, emerging businesses are bringing caregivers and other health professionals directly to seniors' homes. Collectively, these and other advances are making it less necessary for many people to leave their residence in order to get needed assistance.

The second reason is choice. Let's not forget that for most old people (and their children), the decision to move into a senior living setting is not based on a lifestyle upgrade. More often, it's driven by necessity. And if given the option, most people would gladly stay at home. Sorry marketing directors, but that reality has been repeatedly documented in various surveys.

Am I saying that existing CCRCs are bad and should be avoided? Not at all. There is no debating the tremendous health and social benefits CCRCs provide. But what I am saying is that conditions are changing.

Already, some states are licensing CCRC at home programs. There are some variations on the theme, but in general, most require members to pay an initial enrollment fee and monthly fees in order to tap into future services. Typically, applicants must also meet age and health requirements.

The laundry list of available at-home CCRC services includes care coordination, routine home maintenance, in-home caregiver access, transportation, meals and, ahem, social and wellness programs. Some operators provide these services directly, while others rely on a network of subcontractors.

As for the third reason why the stay-at-home option may be preferable to brick-and-mortar CCRCs? It can cost a lot less.

Is this to suggest that the home-based CCRCs will make standalone CCRCs obsolete? Hardly.

But if I were a CCRC operator, I'd be less concerned about the signage on my door than the army of service vans that seem to be taking over the neighborhood.

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McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Emily Mongan.

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