NaCCRA Forum: General

CARF provides expertise and standards of practice to produce a quality product for the vulnerable older populations. CARF makes competence possible, measurable, clear, and implementable. Otherwise, we are in the nebulous world of “goodwill.” As Dennis states above, “the facility leaders assure us to” just trust us, we will be financially able to keep our promises to you over the course of your lifetime.” What could possibly go wrong???”

In all but a few states, the Independent Living part of retirement living, where residents will spend the bulk of their time, is unregulated which means that standards of practice do not have to be met, nor do levels of education, expertise, and training of employees. Most retirement communities do not have resident feedback loops for process improvement, but rely on complicated, cumbersome, residents councils that are not private. Would this make sense in any other industry?

The grueling psychological process of coming to terms with our mortality, divesting of possessions, moving leaves us with irrational, ill-thought-out expectations, and a fear of speaking out. There is reason to be concerned as ageism is alive and well and well engrained in every facet of our society, including retirement living. Residents are members of a vulnerable population and denial of this all too obvious fact is not helpful.  

Refer to my article: “Ageism: The Last Socially Acceptable Discrimination” which is available on this site. LifeLine Issue No 1 2023.

A well run organization is buoyed up by systems of accountability and expertise that created their success. Not uncommonly, a decision is made to save money by getting rid of those pesky requirements for training and hiring of skilled workers in the thought that the bottom line will be improved if we train our entry-level employees to do the same thing. This works for a while because the struts are still in place initially, but over time, the process inevitably grinds down as expertise slowly erodes.

Our organization gave up CARF over a decade ago and the work product is not the same. Well trained, skilled workers are able to maintain a higher level of performance. Eliminating CARF might appear to be beneficial in the short run, but not in the long run.

As a resident of a Goodwin Living facility, I lament not renewing our CARF accreditation. It was a key component in our decision to select this facility. Without CARF accreditation, we would have selected a different facility.

CARF accreditation had the value of an outside independent fiduciary audit offering an expert opinion on the internal financials - and the ability of the facility to honour the promises made during the sales presentations over the long term.

With high current occupancy rates, residents living longer/healthier lives and the Boomer generation retiring in record numbers, we have little hope that the business leaders will devote time and money to renewing CARF accreditation instead of expanding their current facilities or acquiring new facilities.

However the demographics involved will not last, and when the occupancy rates drop, CCRCs will be looking for competitive advantages beyond expanded facilities. At that point the value of a CARF accreditation may re-emerge.

Until then, as residents, or prospects, who are not CPAs or financial analysts, review the CCRC’s financials, they will be left with the assurances of the facility’s leaders…”just trust us, we will be financially able to keep our promises to you over the course of your lifetime.”

What could possibly go wrong???

Goodwin Living also gave up CARF for many of the reasons cited by the previous responder. Having used it for decades the feeling was that the facilities had adopted the CARF best practices and the time and money needed to continue could be spent in more productive endeavors. Our CEO mentioned that fewer and fewer CCRC’s are using CARF, so your facility is not an outlier.

I'm chair of the Finance Committee of the RAC at Wind Crest, an Erickson community in Colorado. I was surprised to discover that Wind Crest has not sought CARF accreditation. I would personally find it reassuring to have such an accreditation because it would provide various operating and capital ratios that would help residents and prospects compare our CCRC to others.

My understanding of the reasons for not seeking accreditation: (1) it's time-consuming and costly, (2) Erickson/NSC communities are the largest network of nonprofit CCRCs in the country and therefore have a recognized reputation without needing the CARF endorsement, (3) there is intense demand for Wind Crest units among prospective residents so the certification is not perceived to be necessary to stimulate market demand, and (4) Wind Crest (and several other developing Erickson communities) have an unusual financial structure that uses Capital Lease financing instead of the more-common type of tax-exempt bonds to finance the development of the campus and which therefore might raise special analytic issues in the accreditation process.

These are my own (educated) guesses, without confirming those assumptions with management.

I'm a member of a task force of residents looking at why our administration at Westminster Canterbury of the Blue Ridge gave up CARF accreditation nearly 2 years ago.

Please share reasons why or why not accreditation is important for your life care community.

Thanks.

i live at Covenant Woods CCRC, Richmond, VA, and we proudly display our CARF accreditation. Having worked with Sales to engage with prospective residents, i have learned that CARF is a sought after level of care. CARF differentiates Covenent Woods from our competitors.

In 2018, five years ago, 11 of Maryland's 36 CCRCs had CARF accredtation. Today, only 2 continue to be accredited.

My CCRC, Collington, has chosen not to re-up. Not clear yet why. All will be explained at next month's Community Meeting.

I am interested in other CCRC's reasons for a) never bothering to get CARF accreditation, or b) having had it but choosing not to re-up when the 5-year term is up, or, c) alternatively, choosing to continue to reapply (an expensive, time-consuming process).

Lorrie