Continuing Care Retirement Communities

Continuing Care Retirement Communities

The Maryland Department of Aging is the agency charged with administering the continuing care laws. Currently there are 38 operating continuing care retirement communities in Maryland, which are known as CCRCs.

Although the legal definition of “continuing care” is complex, in general, “continuing care” exists when all three of the following are present:

  1. The consumer pays an entrance fee that is, at a minimum, three times the average monthly fee;
  2. The provider furnishes or makes available shelter and health-related services to persons 60 years of age or older; and
  3. The shelter and services are offered under a contract that lasts for a period of more than one year, usually for life.

The CCRC contract is known as a continuing care agreement, and its content is regulated by the continuing care law. The continuing care agreement outlines the responsibilities of the provider and the resident with regard to continuing care. The agreements are legal contracts between the provider and that resident.

Because only a portion of the content of continuing care agreements is prescribed by the law, much of the content of continuing care agreements varies from community to community. As a result, the scope of the “continuing care” offered at different communities varies. For example, nursing care can range from full coverage in an on-site health center at no additional charge at some CCRCs, to simply priority admission to a nursing facility on a fee-for-service basis at other CCRCs.

There is an element of financial risk inherent in choosing a CCRC because large sums of money are paid in advance for services to be provided in the future. Another risk is that most continuing care agreements with refundable entrance fees require the unit to be reoccupied with payment of another full entrance fee before the refund is paid. In challenging housing markets these continuing care units may not be reoccupied in a timely manner.

As of the end of 2014, Maryland had 37 CCRCs, both operating and under construction, containing 16,226 continuing care units, of which 11,782 were independent living units, 2,108 were assisted living beds and 2,108 were nursing care beds. Entrance fees range from $12,000 to over $1,000,000. Monthly fees range from under $1,000 to over $12,000. Generally these fees are based on the level of care (independent living, assisted living, or nursing), size of the apartment and the number of residents living in the apartment and, depending upon the provider, may or may not cover a wide range of services.

The principal continuing care laws are located at Title 10, Subtitle 4, of the Human Services Article (“HSA”), Annotated Code of Maryland, and Code of Maryland Regulations (COMAR)32.02.01.

Information Services

The Maryland Department of Aging provides a comprehensive consumer information packet for persons interested in learning more about these communities, the law and the regulations.

Providers of Continuing Care

Providers of Continuing Care in Maryland must complete the CCRC Development Process as specified in Human Services Article, Sections 10-401 - 10-499 of the Annotated Code of Maryland. As the regulatory authority for Continuing Care, the Maryland Department of Aging provides an information packet for a potential provider that describes the Development and Application process.

List of CCRC's

Currently, there are 38 Continuing Care Retirement Communities offering continuing care in Maryland. View CCRC list here.

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