The Difference Between a CCRC and Assisted Living

The Level of Care

Assisted living facilities (or ALFs) offer one level of care: custodial care, or help with ADLs (activities of daily living). Assisted living facilities provide 24-hour supervision and care for residents who need help with activities like dressing, bathing, and meals. These facilities offer a home-like environment for people who don’t need constant medical monitoring or care but who do need more assistance than independent seniors. While ALF staff usually help supervise and distribute medication to residents, the facilities are not medical facilities.

A CCRC, or a continuing care retirement community, on the other hand, provides multiple levels of care in the same facility or on the same campus. CCRCs offer a continuum of care: independent senior living, assisted living, skilled nursing and memory care, and hospice care. The goal is to reduce the number of moves residents have to undertake as their medical needs change. Instead of moving from an assisted living facility to a nursing home across town, for example, residents simply move to a different area of the facility.

The Facility

Assisted living residents live in a private or a semi-private room, or sometimes an efficiency apartment with a kitchenette. Facilities feature shared areas for entertainment and social activities and common dining areas for meals. Residents have access to housekeeping and laundry services.

CCRCs feature several types of senior housing on the same campus. Healthy seniors needing no assistance can move into independent living units (or ILUs), which are usually apartments, condos, or townhomes. Married couples can live together in double occupancy units. Independent seniors can take advantage of the CCRC’s amenities like golf courses, walking trails, gardening areas, and swimming pools. Housekeeping, laundry services, and dining options are usually offered. When needs change, residents can transfer to the assisted living facility on the same campus, where they can get help with personal care tasks like bathing, dressing, eating, as needed. CCRCs also offer skilled nursing facilities when residents need more specialized medical care or rehabilitative services. Many also offer memory or dementia care units.

The Cost

Assisted living residents pay a monthly fee, which covers most of the services the facility offers. Some facilities may offer extra services, like therapies or activities, as add-on fees. An assisted living facility might charge an admission (or discharge) fee, but it won’t be as substantial as the entrance fee for a CCRC. According to the 2020 Genworth Cost of Care Survey, the average monthly cost of an assisted living facility in the United States is $4,300. This comes out to $51,600 per year. This cost does vary based on what part of the country you live in and the facility itself.

The payment model for a CCRC is different. CCRCs require an entrance fee, which can be steep. The average initial payment for a CCRC is about $329,000, but it can go as high as $1 million, depending on the area of the country and the facility itself. But that fee ensures that the resident will be cared for, with whatever level of care they need, for the rest of their life. After the initial entrance fee, residents pay monthly fees that range from about $2,000 to $5,000.

Fees also vary based on the type of contract residents sign with the facility. Type A contracts, or extensive life-care contracts, are the most expensive, but include a full range of services. This type of contract guarantees unlimited assisted living and skilled nursing care with little to no additional cost. Type B and C contracts (modified and fee-for-service contracts) are less expensive but offer more limited services, usually offering future assisted living and skilled nursing services at an extra cost.