✨ Assisted Living & Skilled Nursing

I live in a relatively small CCRC that is part of a 5-CCRC (plus other senior IL housing via HUD) non-profit senior living corporation in North Carolina. Of the 5, we're neck-and-neck with one other of the 5 for being the smallest. Our corporation has CCRCs from the center of the state (in/around Greensboro) and then 3 more to the east and southeast. The other "small one" is about 120 miles southeast of us. We're located in a city of a population of 57,000. I provide this info saying that for those desiring a smaller CCRC, we're not close enough geographically to compete with our "sourtheast sibling."

We have about 200 residents in IL cottages and apartments and have 24 AL beds; 24 Memory Services beds; and 48 SNF beds.

Our Marketing Department always had a modest Wait List, and we're at 100% occupancy now, counting the empty units that are spoken for.

Maybe the Babyboomers are starting to shop around (as a leading edge Babyboomer, I came into the CCRC life earlier than my peers, because I anticipated long Wail Lists), because Marketing tells us our Wait List is growing -- average wait is 3.5 years --- but of course it can vary by size of unit and cottage vs apartment living. In order to further "boost" the Wait List number and reach their 2025 goal, Marketing just told us of a new "perq" they conceived to encourage people to go on the Wait List. Since there's currently space available in our SNF, if someone is on our Wait List and needs short-term in-patience rehab, they can be admitted into our SNF.

The facility social worker works with the patient/family to find the best possible solution. Transferring a patient to another facility is more complex than it sounds. In addition, the patient's specific medical condition may warrant the move. The other facility will have to evaluate and agree to accept the patient. Of course this requires a physician's order. In each case, the process should be totally transparent so patient and family fully understand the process. Management tries to accommodate to keep families together, but that might not be possible for a variety of reasons. I am aware of several instances where such placements worked out and where patient/family were pleased with the outcome once their initial fears were resolved.

Most contracts cover such a move, so be sure to check what yours says first.

Here is an article on the subject that should be of interest:

"What If There's No Space in the CCRC Healthcare Center When I Need It?"

https://mylifesite.net/blog/post/theres-no-space-ccrc-healthcare-center-need/

Maura Conry

NaCCRA Board Member

Forum Monitor

Actually, at Westminster Canterbury of the Blue Ridge in Virginia, we residents in Independent Living who are on the Resident Marketing Committee learned at a meeting in July that a new category of Early Acceptance Program members would be entering our CCRC. These were people who intended to remain at home but could enter healthcare, assisted living, or the memory care unit directly.

The pitch was that, despite now taking short-term patients from the hospital (Medicare), we still have quite a few beds open. The unsaid part was that we do not have the staff to take care of all the people in those beds now.

This was run by the Board in March of last year and approved by them in May.

Residents only heard about it in July.

As a member of our Finance Advisory Committee, I am well aware of the importance of having virtually full occupancy in each of the Healthcare units. However, I understand there have been several recent instances where an independent resident was unable to be placed in Skilled Nursing because it was completely full. One of the strongest reasons we moved into a life plan community was the example of my parents. When my mother had a stroke, my father, who used a scooter for mobility issues, was able to visit her every day down in memory care in the same building. We’re in an apartment rather than a cottage for the same reason. Sooner or later one of us will have to move out of independent living into the Healthcare facility

Unquestionably, circumstances may arise when a bed is not available in Healthcare (an “outbreak”, for example). But the disclosure statement and contractual promise of “contentment of knowing that certain additional supportive services and care are available, if ever needed,” by “priority admission/access to the Healthcare Center over individuals who are not residents of xxxxx” is not fulfilled when the Healthcare Center is fully populated by admitting non-residents.  

Do you know of any CCRC/life plan community which has adopted a policy that some or all of the Healthcare beds not be filled by patients from outside who are not independent living residents?