Most retirement community checklists tell you to think about location, amenities, and whether a place feels welcoming. These considerations are vital, of course, and touring a community is a great way to judge them for yourself.
But there are other things to think about that aren’t always obvious from a tour, such as how these communities are priced and regulated, what happens if your care needs change over time, and what to look for in staffing (beyond “they seem nice”). Before you choose a life plan community to call home, here’s what we think is important to know.
Contract Types Aren’t All the Same
All life plan communities give residents access to a full continuum of care: independent living, assisted living, memory care, and skilled nursing or rehabilitation, typically all on one campus. However, their entrance fees and monthly fees — and what they include — vary, and the differences add up to real money over time.
Life plan communities generally offer one or more of these contract structures:
- Type A (Life Care): The highest entrance fee and monthly fee, but higher levels of care like assisted living and skilled nursing are included at little to no additional cost if you ever need them. This is the most predictable contract option for long-term budgeting.
- Type B (Modified): A lower entrance fee, with access to all levels of care, but you’ll typically pay extra for assisted living or skilled nursing, often at a discounted rate for a set period.
- Type C (Fee-for-Service): The lowest entrance and monthly fees, but you pay full market rate for higher levels of care if and when you need them.
Some communities may offer additional contract options. Be sure to review them carefully to understand which services will be provided. Also, ask for a community’s annual disclosure statement, which includes information about its financial health and a description of its fees and charges. In Pennsylvania, life plan communities are regulated by the state Insurance Department and are required to file this statement.
Before you commit to a contract, get clear answers to three questions people often forget to ask:
- Is any portion of the entrance fee refundable, and under what conditions?
- How often do monthly fees increase, and by roughly how much historically?
- What happens financially if you leave the community or if you pass away — how is the entrance fee handled for your estate?
A life plan community’s contract options is one of the first things worth asking about. Before you get attached to a floor plan or a view, it’s important to make sure the community suits your budget and that you’re comfortable with the availability of escalated care offered.
What Happens When Care Needs Change?
The continuum of care offered by life plan communities is what sets them apart from many other senior living communities. It sounds simple enough: If you’re in independent living, for instance, and your care needs change, you can move to a higher level of care without leaving the community you’ve grown to love.
But there are two things to consider that can catch people off guard:
- First, moving between levels of care isn’t automatic. Ask specifically how the transition process works, how much notice is involved, whether there’s a waitlist for higher levels of care, and how your cost changes when you move between levels of care. This varies more between communities than most people expect.
- Second, spouses sometimes require different levels of care. If one spouse eventually needs a higher level of care than the other, what happens? A well-designed community should have a clear answer — for example, letting one spouse stay in independent living while the other moves to assisted living or memory care nearby on the same campus. This is one of the single most important questions a couple can ask, and it’s rarely on a standard checklist.
Regarding Staff, Their Training, and Community Accreditations
Just as one community’s residences and amenities set it apart from another, so too do the people who work there. It’s important to feel confident in its staffing, from the leaders at the helm to the nurses providing care, to the teams responsible for dining and housekeeping. When you visit a community, you will likely interact with some of these people, and your first impressions are valuable. But a few questions can give you a more in-depth view.
- What types of training or certifications are the community’s staff required to have?
For many roles, Pennsylvania regulates life plan community staffing through its Department of Human Services and Department of Health, so there’s a real, verifiable standard behind the term “trained staff.” Employees are required to meet specific education, licensing, and other criteria set by the state to ensure they’re qualified to provide senior living care and services. Individual communities may have additional requirements as well.
- Does the community hold any accreditations?
Accreditation isn’t a requirement to be a good community. Plenty of excellent ones don’t pursue it. But if a community you’re considering does have it, that’s a meaningful, independently verified sign that it’s committed to meeting high standards. For example, accreditation from CARF International, the only accrediting body for life plan communities nationwide, requires an internal review and an on-site survey against rigorous quality and financial standards, with ongoing improvement plans required to keep it.
- How long do employees tend to stay with the community?
- Is the community part of a larger nonprofit or corporate system?
Both of these questions can provide insight into the consistency of care you might expect from a community. High turnover and frequent ownership changes could point to inconsistent service or unexpected changes in programs or care.
If you’re feeling unsure, ask to see a community’s licensing records or accreditation certificates yourself. See if it’s possible to speak with residents or their families — those who have lived the experience will have insights that can help guide your decisions.
Questions Worth Bringing to Every Tour
Exploring where to start the next chapter of your life is an exciting time. As you visit life plan communities, asking these questions will help you make an informed decision about which one is right for you:
- What are the contract types offered, and how do they affect what I pay if my care needs increase?
- Can I see the community’s current financial disclosure statement?
- What happens if one spouse needs a higher level of care than the other?
- Is the community accredited?
- How long do staff typically stay, and how much turnover has there been in leadership?
If you’d like to learn more about retiring in the Lancaster County area, contact us today. Or, attend the Explore Retirement Living Open House, where you can experience up to 17 different life plan communities for yourself.