The 1818 Society
CONTINUING CARE RETIREMENT COMMUNITIES (CCRCs)
AN OVERVIEW OF FIVE CCRCs IN THE
WASHINGTON DC AREA
PREPARED FOR THE USE OF WORLD BANK GROUP
RETIREES
September 2004
Prepared & Distributed by:
The Retirement & Assisted Living Committee (RALC)
The 1818 Society
PO Box 27388
Washington DC 20038
Phone: 202 458 1956
Fax: 202 522 2417
Email: 1society@worldbank.org
The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
CONTINUING CARE RETIREMENT COMMUNITIES (CCRCs)
AN OVERVIEW OF FIVE CCRCs IN THE WASHINGTON DC
AREA
I. INTRODUCTION ....................................................................................................... 3
II. OVERVIEW OF THE 5 CCRCS ............................................................................. 5
III.
IMPORTANT DEFINITIONS............................................................................... 9
1. CONTRACT TYPES .................................................................................................. 9
A. EXTENSIVE AGREEMENTS ................................................................................ 9
B. MODIFIED AGREEMENTS .................................................................................. 9
C. FEE-FOR-SERVICE AGREEMENTS .................................................................... 9
2. PAYMENT OPTIONS ............................................................................................... 9
A. ENTRY FEE AND MONTHLY FEE PAYMENTS ............................................. 10
B. MONTHLY FEE ONLY OR RENTAL PAYMENTS .......................................... 10
C. OWNERSHIP OR EQUITY PAYMENTS............................................................ 10
3. TYPES OF FEES AND REFUNDABILITY .......................................................... 10
A. ENTRY FEES ........................................................................................................ 10
B. MONTHLY FEES.................................................................................................. 11
4.
OWNERSHIP OR EQUITY IN A CCRC: ............................................................ 12
IV. FINDINGS............................................................................................................... 13
ANNEXES ....................................................................................................................... 15
1. COLLINGTON ......................................................................................................... 15
2. HERON POINT ........................................................................................................ 19
3. INGLESIDE AT ROCK CREEK............................................................................ 23
4. MAPLEWOOD ......................................................................................................... 29
5. THE FOUNTAINS AT WASHINGTON HOUSE................................................. 33
6. BLANK QUESTIONNAIRE FOR CCRC ............................................................. 37
7. QUESTIONS TO SUPPLEMENT ANALYSIS OF CCRCs ................................ 41
8. CONTACTS AND ADDITIONAL INFORMATION FOR CCRCs ................... 42
This report has been prepared by Sandra Hadler for the Retirement & Assisted Living
Committee of The 1818 Society
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The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
GLOSSARY
AAHSA………………American Association of Homes & Services for the Aging
AARP………………...American Association of Retired Persons
AL……………………Assisted Living
CCAC………………..Continuing Care Accreditation Commission
CCRC………………...Continuing Care Retirement Community
IL……………………..Independent Living
LTC…………………..Long-term Care Insurance
NAIC…………………National Association of Insurance Commissioners
NC……………………Nursing Care
RALC…………………Retirement & Assisted Living Committee
Disclaimer
This report has been prepared for the exclusive, personal use of members of The 1818
Society. It is intended to assist in sharing information on Continuing Care Retirement
Communities in the Washington DC area. The information contained in the Annexes on
the facilities visited has been shared with each of the facilities. Neither they nor The
1818 Society bear responsibility for the information provided in the report. Information
contained in this report is subject to change.
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The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
AN OVERVIEW OF FIVE CCRCs IN THE WASHINGTON DC
AREA
I. INTRODUCTION
The Retirement and Assisted Living Sub-Committee (RALC) of The 1818 Society was
established in October 2003 to assist members with a factual assessment of phased living
options during retirement. In April 2004 a well-attended panel discussion was held for
members, with six Bank retirees presenting the decisions and processes they had
undertaken to ensure their well-being and that of their families. One outcome of the panel
was the realization that these decisions are extremely complex – emotionally, legally and
financially – and that their early consideration is essential. It was also apparent that few of
us knew much about the decisions or options involved in moving towards the allencompassing but costly Continuing Care Retirement Community (CCRC) path. A
decision was made therefore to look more closely into the CCRC option and, in the
process, to visit five communities in the Washington area. These were selected on the basis
of the personal recommendation of The 1818 Society members, location (DC, Maryland
and Virginia) to reflect the location of The 1818 members, and most importantly, the
diverse options offered by the five CCRCs.1
The objective of the report is not to provide advice - only to provide a source of objective,
factual information that the Committee hopes will be useful to members. The next step is
for each of us, with our spouses and families, to take actions appropriate for our life style.
Having completed this exercise, our main recommendations are:


for all of us, early on, to visit some facilities and begin to think through the process.
Most facilities take residents from age 60-65, but the average age on entry is closer to
75- 80 – by which time, we may not be able to enjoy fully what these communities
have to offer; and,
to consider carefully the health, financial, legal and estate implications for ourselves,
our spouses and our families.
Before reviewing the CCRCs, it is useful to note that the 2002 assumptions adopted by
the Pension Fund for the Bank Group retirees put life expectancy for a male retiring at age
60 at 86.3 years and 90.5 for a female; the percentage expected to survive to age 100, was
10.1 percent for males and 19.9 percent for females. And, according to the National
Association of Insurance Providers (NAIC) approximately 44% of people reaching age 65
are expected to need nursing care at least once in their lifetime and, of those needing
nursing care, about 53% will stay for one year or more.
The report briefly reviews the nature of CCRCs, summarizes the key features of the five
CCRCs visited and provides some necessary detail on terminology. Our findings are
1
They are in no way presented as a representative sample, but rather as a diverse group known to our
members.
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The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
summarized in Section IV below. Annexes 1-5 present summaries of the CCRCs visited.
Annex 6 provides a blank copy of the CCRC questionnaire we developed. Members
visiting a CCRC may find the questionnaire useful for themselves, but we would also ask
that, if you do visit an additional CCRC, please send us a copy of your completed
questionnaire that we can add to our files. Annex 7 provides some additional questions
for your consideration, and Annex 8 provides some useful additional institutional sources,
contact names, websites and reading.
Details on the CCRCs visited and some information on LTC insurance policies is on file
in The 1818 Society offices.
This report formed the basis for a Panel Discussion on the CCRC retirement living option,
sponsored by the RALC Committee of The 1818 Society on September 14, 2004 in
Washington DC. A Keynote speaker, Mr. Keesey Hayward of the Senior Hospitality
International was invited together with Representatives from each of the five facilities.
This event also provided an opportunity for members to discuss issues with
representatives and obtain information.
By virtue of the global nature of The 1818 Society’s constituent members, any
information readers may have on international CCRCs or similar communities overseas
would be welcome. In particular, the Committee would welcome hearing from any
member who would be willing to talk at a future event about such communities outside of
the USA.
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The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
II. OVERVIEW OF THE 5 CCRCS
The five CCRCs selected are:





Collington – semi-rural setting in Prince George’s county, but on Metro line; nonprofit.
Heron Point – rural setting on Eastern Shore along the banks of the Chester River;
non-profit.
Ingleside at Rock Creek – on edge of Rock Creek Park in DC; non-profit.
Maplewood – wooded setting within Beltway on Old Georgetown Road; cooperative.
The Fountains at Washington House – in suburbs of Alexandria; for profit.
The Summary Table, which follows page 6, provides a summary of important features for a
prospective resident of the five facilities. The communities visited cover a wide range of
characteristics:
 locations are urban, rural or suburban;
 non-profit and for-profit;
 full ‘lifecare’, modified and fee-for-service;
 non-refundable, rented or equity ownership;
 housing offered ranges from studios to 3-bedroom, 2-car garage cottages – and the
smallest and the largest are invariably the units in greatest demand.
All five CCRCs visited provide a full range of health care and two have significant
‘memory care’ facilities – the latter appears to be the fastest growing segment of the
industry. All facilities provide a wide-range of amenities, but also appear to aim at a
particular market segment of the elder population: one community, that we did not review,
provides champagne at 4 o’clock – daily. Many CCRCs are affiliated with a particular
church, but accept residents of all creeds. The CCRCs visited are in the Washington DC
area, and as such may be more expensive than communities elsewhere in the USA.
Stepping back, what is a CCRC? Many older adults find a campus-type retirement
community that offers several levels of care and services very attractive. A CCRC is one
type of community that offers a continuum of care: part housing complex, part activity
center and part health care system. It is not an ‘old folks’ home, a nursing home, a hospital
or simply a complex for retirees, but rather a mixed-use community. It differs from other
retirement options by the provision of a continuum of housing services and health care,
located and administered on-site. The services are coordinated by a team of health
professionals. A written agreement between the resident(s) and CCRC is signed and is
intended to last the resident’s lifetime. Emphasis is placed on quality of services and
lifestyle, and provides the benefit of remaining in a familiar, chosen location.
From the Summary Table below it is quickly apparent that CCRCs are an expensive life
option, and that cost and timing of entry will be major decisions in the selection process for
1818 Society members, over and above general healthcare and environment considerations.
Information on past cost trends is difficult to obtain, but a comparison of current rates with
those contained in recent issues of Retirement Living magazine suggests that trends in entry
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The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
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The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
fees in this area are more in line with real estate trends than with inflation indicators.
Monthly fee increases appear to be averaging twice the leading inflation indicators. With
Bank pensions increasing in recent years at 1.5% pa, retirement options that are feasible
financially now, may not be 10 or 20 years down the road, when movement into a
subsequent phase of living, including CCRCs, becomes a pressing concern. Entry and
monthly fees may be tax deductible, depending on the extent of facility operating costs that
are medical expenses (See Section III).
Beyond financial considerations, however, it is important to realize that individual CCRCs
defy comparison. The deciding factor for a member will be inevitably the chemistry
between a facility and the individual, within their feasible financial envelope at that time,
while remembering that this is a highly competitive industry, whether a facility is for profit
or non-profit.
Although this exercise considers five CCRCs, within the greater Washington DC area there
are some 50 CCRCs, in addition to similar numbers of ‘active adult’ communities,
independent communities, and various types of assisted living and nursing care
communities from which to make a choice. Across the United States, CCRCs alone can be
classified by some 30 different types of retirement needs. Besides active-adult CCRCs,
such as those with golfing or waterfront locations, there are more than 20 care categories to
choose from, including acute-care (hospital-like) places and behavioral/psychiatric
communities. Major groupings are under the headings of Active Retirement, Extended
Care, Golf Communities, RV Lifestyles and Rental Communities. Increasingly, CCRCtype communities are being established internationally, and particularly in Canada, Mexico
and the United Kingdom.
To help in decision-making, two organizations provide ‘seals of approval’ of CCRCs – The
Continuing Care Accreditation Commission (CCAC) and the Senior Hospitality Institute.
CCAC is an accreditation that goes above and beyond Government financial and health
regulations for CCRCs. It is costly (approximately $10,000 pa) and once obtained lasts for
5 years. For a relatively small facility, this appears to be an important ‘seal of approval’.
Non-profits with a strong reputation (for example, Maplewood) do not feel it is necessary,
and larger for-profits apparently believe that their standards and reputation are sufficient.
Since 1995, the Senior Hospitality Intstitute has been helping Seniors identify
outstanding communities for active retirement living – known as ‘Retirement Resorts’. It
does for the senior hospitality industry what other organizations do for hotels and
restaurants with 5-diamond and 5-star rating systems. To qualify as a Retirement Resort,
communities must have exceptional facilities and staff, and must offer a wide variety of
recreational, educational, cultural, spiritual and social opportunities in addition to quality
healthcare services. Each community is evaluated yearly through an on-site visit and
resident interviews.
With thousands of retirement communities worldwide vying for clients - and their money learning about them and choosing among them is an overwhelming task. The knowledge
gap is being filled by websites that categorize and rate retirement communities on the basis
of client needs or interests. Several of these are listed in Annex 8. Most of the websites
offer a brief description of a community and the types of services available, with a click-on
link to the company's site. Seniors who have no computer access at home or among friends
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The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
can ask the local library for online assistance. Reference librarians will often help to
download and print information.
Additionally, to help in the selection process there are now numerous consulting services
that for a fee will assist in the selection process by matching finances and location by state
or country. A few of these are included in Annex 8.
However, before proceeding further, it is important to understand key terminology in order
to be able to assess a facility. Section III below provides a summary of key concepts and
their definition. This Section might best be read before or in conjunction with the
Summary Table that follows page 6.
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The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
III. IMPORTANT DEFINITIONS
1. CONTRACT TYPES
A. EXTENSIVE AGREEMENTS
An extensive agreement (lifecare) includes housing, residential services, amenities and
unlimited, specific health-related services in Assisted Living (AL) and Nursing Care (NC),
with little or no substantial increase in periodic (monthly) payments, except for normal
operating costs and inflation adjustments. Extensive agreements provide for the prepayment of medical expenses, similar to an insurance arrangement, and are sometimes
known as ‘lifecare’ agreements. While an extensive agreement generally requires a higher
monthly fee than other types of agreements in the early years of residence in the CCRC, it
allows you to plan for future, unexpected health care expenditures with a steady stream of
monthly fee payments. In essence, you pay for tomorrow’s medical expenditures with
today’s dollar. It is important to note that the term ‘lifecare’ is used differently by
different facilities. Facilities offering an extensive lifecare contract will likely require both
a financial and medical examination prior to acceptance.
B. MODIFIED AGREEMENTS
A modified agreement includes housing, residential services, amenities, and a specific
amount of long-term nursing care with no substantial increase in periodic (monthly)
payments. For example, you may receive 30 days of long-term nursing care per year
without increased charges. After that period, you pay the standard daily market rate, or you
may pay a discounted daily rate for all nursing care. Some communities offering a
modified contract increase the monthly payments when assisted living or nursing is
required, but at a rate that is less than you would pay if you were not covered by a
continuing care resident agreement.
C. FEE-FOR-SERVICE AGREEMENTS
A fee-for-service agreement includes housing, residential services and amenities for the
fees stated in your agreement. Health related services, including long-term nursing care and
assisted living services are paid for at market rates as they are used. Under a fee-forservice agreement, you usually enjoy lower monthly fees in the early years of your
residence in a cottage or apartment but in turn must accept the risk of paying for care later,
should you need to transfer to a higher level of care. This option may be attractive if a
LTC policy is in effect to cover these expenses. In essence, you pay for tomorrow’s
medical expenditures at tomorrow’s costs. It is also relevant to note that approximately
23% of the US population that turned 65 in 2000 is likely to spend one year or more in AL
or NC.
2. PAYMENT OPTIONS
Continuing care agreements also differ in how you pay for the care. In the past, most
CCRCs offered one fee arrangement, but today's residents are often offered a choice. There
are advantages and disadvantages to each, depending on your financial situation. The three
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The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
general types of payment options are entry fee and monthly fee; monthly fee only or rental;
and ownership or equity (condominium, cooperative or membership).
A. ENTRY FEE AND MONTHLY FEE PAYMENTS
The one-time, up-front entry fee is combined with monthly fees to cover the living unit,
services, and care items specified in your resident agreement. This is the most common
type of fee arrangement offered by not-for-profit CCRCs. The entry fee may or may not be
refundable: if it is refundable, it may be only partially refundable. The entry fee may also
be partially tax deductible; monthly fees are generally partially deductible. However, the
extent of tax deductibility appears to be institution specific – varying on the extent of
operating costs that are a medical cost - and needs to be clarified with the CCRC being
considered2.
B. MONTHLY FEE ONLY OR RENTAL PAYMENTS
In some CCRCs, there is no up-front entry fee (or an option for rental). In this option, the
costs of your living unit, services and care are covered solely by your monthly fee. For
comparable living units, a “monthly fee only” option is likely to be considerably higher
than the monthly fee paid under the “entry fee plus monthly fee” agreements described
above3.
C. OWNERSHIP OR EQUITY PAYMENTS
(i.e. CONDOMINIUM, COOPERATIVE OR MEMBERSHIP)
These types of CCRC agreements involve the actual purchase of real estate or membership.
They are the least common type of agreement and their values are dependent on the trends
in the general real estate market. Ownership agreements have most of the characteristics of
property ownership found outside the CCRC industry, with the addition of entry eligibility
requirements that affect resale. The service and health care package transactions are
generally separate from the purchase transaction.
3. TYPES OF FEES AND REFUNDABILITY
A. ENTRY FEES
These are one-time, up-front fees you pay for the right to occupy an apartment, house, or
other type of living unit. Entry fees may cover health care services that you pay for in
advance. Entry fees vary, based on the type of living unit you choose, the refund option
chosen and the extent of services and care your resident agreement stipulates. Entry fees
that cover prepaid health care may be considered a medical expense by the IRS and
therefore may be deductible to a degree in your year of occupancy. Ask the CCRC about
this potential tax saving – the extent of the deduction is CCRC and individual specific. It is
useful to determine what has been the increase in entry fees in the past 3-5 years. Some
facilities will require a financial and health exam at time of application and subsequently, at
time of entry. If you enter a community under development, the entry fee may sometimes
be paid in installments during the development. These fees often are placed in escrow in a
bank or other safe place until the community meets specific development goals, such as a
2
It must also be noted that the IRS has repeatedly stated that the deductibility of medical expenses is a
question of fact specific to each resident.
3
For instance, the Fountains offers a monthly fee option.
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The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
minimum number of living units reserved.
There are four major refund options; these can be summarized as follows:

Nonrefundable: After an adjustment period, such fees are not refundable, either to you
if you decide to leave or to your estate.

Refundable on a declining scale: The agreement will specify a period of time in
which the entry fee may be refundable to you on a declining basis. For instance, if an
entry fee is refundable and declines at the rate of one percent per month, then 94
percent of the entry fee would be refundable to you after six months. Specific refund
circumstances are described in your agreement. Sometimes, a fixed amount is
deducted before the declining rate is applied.

Partially refundable: The agreement will specify the amount of refund available to
you - for example, 50 percent or 75 percent - and the time period during which the
refund will be available.

Fully refundable: You may receive a refund of the entire entry fee. A fixed charge
may be deducted before the refund is made. The agreement will state the period of
time in which a refund may be granted. In some states, the law says you can cancel
your agreement without penalty during what's called a "recission period," usually 7 to
30 days, and receive a full refund. Refund of the entry fee may be contingent upon a
new resident taking your place. Your resident agreement should specify the conditions
under which a refund is due. Refundable entry fees typically are significantly higher
than non-refundable entry fees.
Refund policies vary widely. It is important to check the exact refund arrangements of any
CCRC you consider. Also, refundable entry fees may have tax implications.
It should be noted that entry fees may not be refunded until the unit you vacated is
occupied by a new resident, or it may be refunded immediately once your unit is vacated.
CCRCs sometimes assess refund penalties, particularly for those who sign up for a CCRC
under development. CCRCs count on serious commitments before they can build or finish
projects. Withdrawal penalties are a way to ensure that a prospective resident seriously
intends to move into the community. Also, penalties can be required by law or by lenders.
However, such penalties are usually not applied if you are unable to enter the community
because of an illness or another serious circumstance.
B. MONTHLY FEES
These cover housing and designated services and, depending on the form of contract and
whether the resident is in IL, AL or NC, may also include health care services. Increases in
monthly fees are based on increased operating expenses of the community and inflation.
Fees can vary according to the type of unit occupied and the services and care promised in
the resident agreement. Like entry fees, monthly fees may be considered a medical
expense by the IRS and may be deductible to some degree. Check what has been the
increase in fees in the past 3-5 years.
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The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
4. OWNERSHIP OR EQUITY IN A CCRC:
CONDOMINIUMS, COOPERATIVES OR MEMBERSHIPS
Some CCRCs are set up to enable an individual to own their condominium, cooperative, or
membership (similar to country club membership). The purchase process is similar to
purchasing any other condominium, cooperative, or membership. However, the sale and
resale usually are limited to those who meet the community's entrance eligibility criteria.
Sometimes, the CCRC may share in the financial appreciation of the unit. An owner's
association usually governs the residential services and health care. Real estate taxes are
payable and generally included in the monthly fee. A firm specializing in the management
of retirement facilities often is in charge of day-to-day management. For an additional fee,
you may purchase service and health care packages.
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The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
IV. FINDINGS
The spectrum of facilities and services provided by CCRCs is extremely wide.
Comparison of one with another is extremely difficult and, within a given financial
envelope, individual chemistry is the critical issue in selecting a CCRC.
The average age of entry varies widely but, and given the upfront costs, there is much to
be said for making the move early and enjoying all the facilities, peace of mind and
security that they provide.
Perhaps the greatest concern is that of potential increases in costs – both of entry fees and
monthly costs - over the span of our retirement years. With respect to entry fees, these
appear to be rising quite significantly, often more in line with real estate trends. So, these
too also need to be factored in when deciding whether to make a move now or in 5,10 or 20
years. For those CCRCs where the contract is in the form of equity ownership, entry fee
increases appear steeper than in those that are a straight entry fee. Facilities undergoing
renovation or expansion seem to face difficulty marketing to new residents and may offer
temporarily significant discounts that can be attractive.
Monthly cost increases appear to have been increasing at 3-4% annually in recent years –
or more than double inflation; with an increasingly elderly population over the next 50
years and increasing difficulty of attracting CCRC employees, this rate of increase is not
likely to diminish. Nationally, the average length of stay in a CCRC (including AL and
NC) is approximately 6 years.
Perhaps the most difficult decision is to decide whether to opt for an ‘extensive’, modified
or fee-for-service. If an existing LTC insurance policy is in place, fee-for-service may be
adequate. If not, if AL or NC is needed under modified or fee-for-service arrangements,
market costs in the area are currently $4500-5500 and $6500-7500/per month/per person
respectively. This could therefore more than double the monthly expenditures of a couple
if one spouse needs such care. With both spouses in AL or NC, there may be a
quadrupling.
No attempt here has been made to review LTC insurance. However, ‘extensive’ CCRC
contracts essentially are equivalent to LTC insurance, so the two should be considered in
tandem. It is also useful to note that some LTC insurance has recently begun to cover AL
for the first time.
In summary:
 One rule of thumb that may be useful in assessing financial feasibility: – for an
extensive contract, you need twice the entry fee in assets and at least twice the
monthly fee in income to move into a facility;
 With an extensive contract you are buying tomorrow’s medical costs with today’s
dollars; with fee-for-service, you are buying tomorrow’s medical costs with
tomorrow’s dollars;
 Before deciding on a facility, go for the weekend, stay overnight – or at least stay for a
meal and see how staff interact with residents;
 If you like a facility, track its performance until you are ready to make a decision;
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The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004






Visit with residents;
Hang out in the parking lot on weekends when family and friends come to visit and ask
their impressions;
Have a lawyer review the contract;
Have a financial adviser review the contract;
Review in detail the schedule of supplemental charges and assess additional monthly
costs; and
Be certain you understand the terminology – different facilities use the same
terminology to mean different things; this is especially true of ‘lifecare’.
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The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
ANNEXES
1. COLLINGTON
Point of Contact/Sales Representative: Kassie Foundos, Marketing Director
Address: 10450 Lottsford Road, Mitchellville, Md. 20721-2734
Phone: 301 541 5003/800 540 1709
Fax: 301 925 7722
E-Mail: kfoundos@collington.com
Web site: www.Collington.com
Facility Operator/Parent Organization: Collington Episcopal Life Care Community Inc.
Setting: Rural Campus/Washington DC Suburbs – Mitchellville, Prince Georges County
11 miles from the White House – an approximately 35-45 minute drive from DC. The
community was opened in 1988, at which time there were relatively few CCRCs on the
East Coast and many early residents moved from New England. Managed by Life Care
Services and Marketing by Spectrum Consultants. Planned community of cottages and
apartments on 120 acres- wooded rolling countryside. Units range from studios to
expansive 3 BR-2 car garage cottages. Collington has recently completed a $50m.
expansion, which will accommodate an additional 100 residents in 55 apartments/28
cottages. The expansion includes a 35-unit state of the art Memory Care Center. Lake
& extensive walk paths/trails on grounds. Also, garden plots and greenhouse available.
CAPACITY
Independent Living
Total Number Number of Units
of Units
Available*
367
63
Apartment - Studio
19
7
Apartment – l BR
85
6
Apartment – 2 BR
55
20
Cottage/house
208
30
Assisted Living
66
10
Skilled Nursing
43
5
Number of
Residents**
330
Memory Care Center
36
3
* There is a waiting list for larger 2 BR and 3 BR units.
** Male/Female ratio: 1:2
Type of Ownership: Not for Profit
Registered as: Retirement Housing / Insurance Co / Health provider
CCAC Accredited: No – accreditation requires 90% occupancy rate and because of the
recent expansion occupancy fell, so it is currently not eligible. Collington has taken steps
to re-apply.
Form of Contract: Extensive CCRC contract (Lifecare) only
Refund Provisions: Three options, with varying entry fees, are offered.
- Fully Refundable (100% at any time);
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The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
-
Partially Declining (50%) Amount refunded declines by 2%/month for 25
months; after 25 months, the refund remains constant at 50%
Fully Declining (0% after 50 months) Amount refunded declines by 2% /month
for 50 months. At the end of 50 months, no refund is available. However, if a
resident leaves within the 50 months, Collington will refund the balance.
Range of Entrance Fees: $78,492 - $654,171 (2nd person, $15,750). Tax deductions are reassessed annually, but in 2003 were 37.08% of the non-refundable part of the entrance fee.
Range of Monthly fees: $2,048 - $3,948; (2nd person, $1191). As above, tax deductions are
re-assessed annually and in 2003, 37.08% of the monthly fees were deductible.
Typical additional costs to monthly fee: Insurance, food, telephone, cable
Sign Up Policy: $1,000 deposit plus $300 non-refundable administrative fee
On selecting unit, 10% down and given 90 days to finance balance; monthly fees begin after
90 days.
Types of Medical Insurance required: Medicare; LTC – not required
Type of Health Care Benefits included: AL & NC included as needed, no additional cost
(excepting meals); no limits. Home health care in Independent Living (IL) provided for
short-term, if after about 30 days choose to stay in IL, must contract out for services.
Medicare Certified:
Yes
Medicaid Certified:
Yes
Entry Requirements (Minimum Age): 60
Average age on entry: 75-80
Average Time on Waiting List: n/a
Average No. of years in facility: Collington is 16 years old, so this is difficult to gauge;
many residents there since facility opened; residents claim living in CCRC extends life
expectancy.
Religious Affiliation of Facility: Episcopalian, but accepts all races and creeds.
Type of Facility:
Multi-story: 3 for some apartments, with elevators.
All IL units have balcony or patio.
Single story: cottages.
Miles to Shopping: Convenience store on site; Cap Center Mall, 3 miles
Miles to Hospital: Closest – Doctors Hospital; distance 15 minutes
Access to Public Transportation: Yes – free hourly shuttle to Metro/Amtrak/Greyhound
Distance: currently 7 miles to Metro station; a new station opening this year is 2 miles away.
Return Home Policy After Acute Leave: Yes, if at all possible
Coordination/connection of Assisted Living with Independent Living facilities:
Spouse may stay in IL while partner in AL, NC or Memory Center – no additional charge.
16
The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
FACILITIES AND SERVICES ON-SITE
Avail- Additional
able
Cost
Comments
I. FACILITIES
Bank
X
Beauty/Barber Shop
X
Billiard Room
X
Bowling Green
Card Rooms
X
Chapel/Denomination
X
Coffee Shop
X
Dining Room – Guest policy
X
Dining Room, Seating policy
X
Private Dining Room
Number of meals per mo.
Required?
Alcohol in restaurant?
X
30
Convenience store
X
Courses/lectures
X
On-site or in local college.
Craft Rooms
X
Incl. flower shop
X
Restaurant-Style Dining & Seating
30 meals per month – flexible. Additional
meals, $5. Reimbursement for long absence
BYOB, or waiter brings from Bar
X
Dry cleaning/laundry
$10 per meal
X
Daily pick-up for dry-cleaning. Cottages have
W/D; apts – free laundry machines on each floor.
Exercise Facility/Spa
X
Parking - Indoor
X
Covered, $40/month
Parking - Outdoor
X
Free
Golf Course Access
Internet Access/Computer
Facilities
Library
X
Daily Newspapers
X
Extensive journal subscriptions
Pets
X
2 approved; no size limits
Putting Green
-
Storage Bins
X
Each Patio/balcony has storage
Swimming Pool - Indoor
X
Jacuzzi & lap-pool
Swimming Pool – Outdoor
-
Tennis Courts; how many?
X
Workshop
X
X
2
17
The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
Avail- Additional
able
Cost
Comments
II. SERVICES
7/24 Emergency Response
X
5 nurses around clock in AL/NC
Medication Management
X
Insurance forms processed
Wellness Clinic
X
Activities Program
X
9 visiting physicians on schedule; billed to
insurance. Nurse on duty; no charge for basic
services, e.g. BP check, dressings.
Extensive
Assistance w/taxes/bills
X
Resident volunteers
All Utilities except phone
X
Apartment maintenance
X
Basic Cable
Housekeeping, times per
month
Linens provided weekly
X
Personal Nursing/home care
X
Special Diets Available
X
Tipping policy
X
Included
Included
2
Included
X
Transportation – personal
In IL only for short-term; if need for LT, either
move to AL or resident contracts out.
Extensive menu; several ‘country’ kitchens to
different centers
Not permitted
X
9 vehicles; hourly shuttle to metro; for
entertainment; other – charge
Not to airports
Transportation - scheduled
X
Facilities for overnight guests
X
Individual Gardens
X
5 2-room suites available - $60/night.
Extra cots, $5.
Communal; may sell produce. New greenhouse
Telephone
X
Long Distance calls extra
Hadler/RALC/Collingtonsummary
18
The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
ANNEX 2
2. HERON POINT
Point of Contact/Sales Representative: Sandy Johnston, Marketing Director
Address: Heron Point, 510E.Campus Ave., Chestertown, Md. 21620
Phone: 410 778 7300/800 327 9138
Fax: 410 810 2915
E-Mail: sjohnston@pumh.org
Web site: www.heronpoint.com
Facility Operator/Parent Organization: PUMH of Maryland; managed by Peninsular
United Methodist Home.
Setting: Rural; on Chester River, Chestertown, Md. – 2 hour drive from DC and almost
equidistant from Baltimore, DC, Philadelphia & Wilmington. The community was
opened in 1991. All amenities, including all apartments, AL & NC units are
conveniently located in 1 building. The cottages are scattered over the 66 acre site,
which includes a 32 acre wetlands buffer. Apartments and cottages range in size from
625 sq.ft 1 bedrooms to 1340 sq.ft 2 bedrooms. Heron Point is undergoing an expansion,
which is to be completed in 2005. A central feature of the expansion is the development
of a new wing of 20 AL units adopting the ‘Social Model’ to accommodate couples in
both 1 & 2 bedrooms apartments. The existing ground floor AL units will be converted
into a dementia unit. Besides Washington College, the river is a central feature of life in
Heron Point. There are an additional 2 acres that are not yet developed.
CAPACITY
Total Number Number of Units Number of
of Units
Available
Residents*
295
Independent Living: 192
2%
Of which:
Apartments, 1&2BR 101
Cottage/house
91
Assisted Living**
16
Skilled Nursing**
36
* Approximately, 174 married couples, 124 singles. Male/Female ratio – 1:1.6.
** Occupancy changes daily. Will take from outside into AL, but rarely happens.
Type of Ownership:
Not for Profit
CCAC Accredited:
Yes
Form of Contract: Modified ‘Lifecare’
If subsequently move into AL or NC, costs increase quite significantly (currently $2859
for the person in need of care; no reduction in other fees unless downsize) but this is well
below market costs.
Refund Provisions: Traditional (more common) – depreciates at 2%/month: after 50
months zero refund.
90%: Refund 90% to owners/estate when unit is re-occupied and resident is no longer at
Heron Point.
19
The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
Range of Entrance fees: $118,500-447,500 including a spouse; not tax deductible.
Unit sizes range from 800sq.ft to 1340 sq ft; river view most desirable.
Range of Monthly fees: $1529 (single) – 3954 (couple) (c. 31% tax deductible)
Does not include meals; meal plans available (eg. Dinner only - $227/month, of which c.
31% tax deductible)
Upon movement to AL/NC - $2859 per person per month.
Typical additional costs to monthly fee: Car and ‘renters’ insurance; food, tel., cable.
Sign Up Policy: $1000 refundable per couple; non-refundable processing fee $150/per
applicant. When agree on unit, 10% down and work with residents to arrange move in
date. If want particular unit, may need to arrange bridge loan.
Types of Medical Insurance required: Medicare A & B plus supplemental; LTC not
required.
Type of Health Care Benefits included: On-site health clinic and visits to the resident
nurse. Visiting physicians/RX are billed to insurance.
Medicare Certified:
Yes
Medicaid Certified:
No
Entry Requirements (Minimum Age): 60
Average age on entry: 78-80
Average Time on Waiting List: For popular units, not more than 1 year.
Average No. of years in facility: Facility only 13 years old, too young to gauge.
Religious Affiliation of Facility: Methodist; accepts all creeds.
Type of Facility:
Apartments – 3-story Cottages - single storey with garage
Miles to Shopping: Chestertown – 3 blocks. Facility also provides transport to malls
Miles to Hospital: Chestertown Hospital, 3 blocks
Access to Public Transportation: No; many use bikes or own cars
Return Home Policy After Acute Leave: Try to keep couples together.
Coordination/connection of AL with IL facilities: AL and NC in same building as
apartments & all common facilities – so very comfortable and convenient.
20
The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
FACILITIES AND SERVICES ON-SITE
Avail- Additional
able
Cost
Comments
I. FACILITIES
Bank
X
Beauty/Barber Shop
X
Billiard Room
-
Bowling Green
-
Card Rooms
X
Chapel/Denomination
X
Coffee Shop
X
Delicatessen
Dining Room – Guest policy
X
Dinner - $13
Dining Room– Seating policy
X
Can choose at each meal; hostess seats
Private Dining Room
Number of meals a day
Required?
Alcohol in Dining Room?
X
Convenience/gift stores
X
Courses/lectures
X
Craft Rooms
X
Dry cleaning/laundry
X
Exercise Facility/Spa
X
Parking - Indoor
X
Parking - Outdoor
X
Golf Course Access
Internet Access/Computer
Facilities
Library
X
Daily Newspapers
X
Pets
X
Putting Green
-
Storage Bins
X
Swimming Pool - Indoor
X
Swimming Pool – Outdoor
-
Tennis Courts; how many?
-
Workshop
X
Meal plans available
-
BYOB; no liquor license
X
Chesterton College – 3 blocks
$
Arranged by front desk
Cottages have a garage
$
X
X
Approved
Included in cost for each unit
$
Arrangement exists with College
21
The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
Avail- Additional
able
Cost
Comments
II. SERVICES
7/24 Emergency Response
X
Medication Management
X
Not for IL
Health Center
X
No charge for nurse on duty; Visiting
Dr/RX charges billed to insurance
Activities Program
X
Assistance w/taxes/bills
-
All Utilities except phone
X
Apartment maintenance
X
Basic Cable
Housekeeping, times per
month
Linens provided
X
Linens Laundered
$
$65/m
Personal Laundry
$
$65/m
$
$
Weekly costs $74-84/month
-
Personal Nursing/home care
$
Special Errands
$
Special Diets Available
X
Tipping policy
Accountants in town
None
Outside AL/NC, available at cost but
not provided by Heron Point. For
short-term, will arrange for facility
nurse to help.
‘Ambassador Service’ $15/hour
At end year, take collection
Transportation – personal
X
Available at cost
Transportation - scheduled
X
Small charge for buses to cities
Facilities for overnight guests
X
3 guest rooms; $65/night
Individual Gardens
X
Hadler/RALC/Heron Point
22
The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
ANNEX 3
3. INGLESIDE AT ROCK CREEK
Point of Contact/Sales Representative: Ms. Angela Aloupis, Director of Marketing
and Admissions
Address: 3050 Military Road, Washington DC, 20015
Phone: 202-363-8310
Fax: 202-363-7076.
E-Mail:
Website: www.ircdc.org
Facility Operator/Parent Organization: The Ingleside Presbyterian Retirement
Community Inc. No current affiliation. Originally started as a mission of the Presbytery
of Washington D.C.
Setting Within the city of Washington DC, in wooded park setting bordering Rock
Creek Park. The Community has currently approximately 300 residents.
CAPACITY
Total Number of Units
1311
Independent Living
Apartment - Efficiency
Apartment - lBDRM
Apartment – 1BDRM + Den
Apartment - 2BDRM
Apartment – 2BD + Den
Assisted Living
60
Long Term Care
66
Skilled Care Unit
7
Approximately one quarter in each category, according to Marketing Department.
Male/Female ratio – 1:6
Type of Ownership:
CCAC Accredited:
Non-Profit
Yes
Form of Contract:
Life Care (“Extensive”), Fee-for-Service, Direct Admission
Life Care Contracts for those who move into Independent Living (IL). All costs are
covered as one moves from IL to AL to NC, with no change in the monthly fee. In IL,
fees are charged for additional medical services provided in the apartment.
LifeCare contracts are for those who meet medical and financial requirements.
Specifically, one must be medically independent at the time an apartment is offered.
23
The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
If the applicant has a pre-existing medical condition when an apartment is offered, that
person is not assured of full life care coverage. The person may be offered a variation of
life care known as “defined benefit”. This operates as follows:
One can move from the IL apartment to AL and receive two additional meals, additional
housekeeping, and nursing care at the same monthly fee. However, if one needs to transition
further to 24-hour nursing care the monthly rate remains at the IL level for a period of 3
years. After 3 years, the monthly rent shifts to the market rate. One should treat the 3 years
as a ‘bank’ – each visit to nursing care is deducted, until the 3 year limit is reached.
Assisted Living If one moves directly from outside into the AL, the monthly rent is
variable, depending on the needs of the resident. Three meals are provided plus whatever
nursing services may be needed, and additional housekeeping. The Life Care Contract is
not available.
Note: Monthly fees do not include medication, any stay in a hospital, and doctors’ fees.
Refund Provisions: 100%, 50% and 0%
 100% If this option is selected, it does not matter when the refund is selected. The
fee is refundable at any time for any reason.
 50%: Should one depart in less than 25 months, multiply the number of months’
residency x 2%. Subtract this from the entrance fee at the time one settled, not at the
time of departure. For example: If one leaves after 12 months, 12 x 2 = 24%, is
subtracted from the entrance fee and the balance is returned.
If one departs at any time over 25 months, multiply 25 x 2 = 50%. Note: If one
leaves in month 25, one gets back 50%; if one leaves in month 36, one gets back
50%, etc. In other words, after 25 months, the refund remains constant at 50%.
 0% The multiplier is 4%. If one lives there for, say, 12 months, 12 x 4% = 48%,
subtract 48% from the entrance fee. The difference is returned. After 25 months, 25
x 4 = 100%, and there is zero balance to return.
Range of Entrance fee: $102-283K non-refundable; $127-354K 50% refundable; and
$192-531K, 100% refundable. Second person: $28K, $35K, $53K respectively.
Range of Monthly fees: $1836-3234. ($1116 for second person, in apartments and
efficiencies; $103-105 per day for second person in AL).
Typical extra costs on a monthly bill in IL: Would likely be guest meals, cable TV
above basic service, telephone, excursions, and any extra housekeeping services such as
changing light bulbs and turning the mattress.
Sign Up Policy: $1000 per unit (for one or two person). There is no time limit. One
advises Ingleside when to call with an offer. It is fully refundable. Refund requests must
be in writing.
Types of Medical Insurance required: Must have Medicare (A & B) and a type of
health insurance that covers what Medicare does not cover. Will accept only residents
with Medicaid for direct admission into 24-hour Nursing Center.
Type of Health Care Benefits included: In-house health clinic, memory support unit.
Medicare Certified:
Yes
Medicaid Certified:
Yes
24
The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
Entry Requirements (Minimum Age): 65
Average age on entry: 79-82. IL average age on entry is about 79; 82 is the average
across the whole community.
Average Time on Waiting List: 5-6 years for IL, but varies widely.
Average No. of years in facility: Not available.
Religious Affiliation of facility: None. Population is diverse.
Type of Facility: Multi-story -- 2-5 stories, with elevators.
Miles to Shopping: 0.6 miles to Conn. Ave.
Miles to Hospital: Sibley (about 5 miles)
Access to Public Transportation: Yes – walking distance to bus route at 31st and
Military, and also to busses on Connecticut Avenue. Also two vans belonging to
Ingleside provide transportation.
Return Home Policy After Acute Leave: General Policy - “Keep couples together if at
all possible”. The Assisted Living/Nursing Care wings are connected to the Independent
Living facilities. One can go anywhere in the community under cover.
25
The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
FACILITIES AND SERVICES
Avail- Additional
able
Cost
Comments
I. FACILITIES
Bank
X
Beauty/Barber Shop
X
Billiard Room
X
Bowling Green
-
Card Room
X
Chapel/Non-Denominational
X
Coffee Shop
X
Dining Room – Guest policy
X
Dining Room – Seating
policy
X
Private Dining Room
X
Number of meals a day
Required
1
Alcohol in restaurant
X
Convenience store
-
Courses/lectures
X
Craft Rooms
X
Dry cleaner/laundry
X
Exercise Facility/Spa
X
Parking - Indoor
X
Parking - Outdoor
-
Golf Course Access
-
Internet Access
X
Library
X
Daily Newspapers
X
Independent Vendor
Presbyterian and open to other
denominations.
$10.50 for dinner; Sunday brunch $14
Maitre d’ in IL. Monthly assignments in
Assisted Living. NC has a separate dining
room.
Can be set up for private meal at an extra
cost.
If in IL, advise if traveling. Credit of $5.50
per person per day if away for ten days or
longer. In AL and NC, 3 meals per day are
provided.
Can bring own.
Wide range.
IL apartments have own W/D. In AL, use
community W/D (free)
No Spa
1 reserved parking space per unit in IL, at
no extra charge.
AL is by request, outdoors.
Well stocked. Two libraries, one in IL, one
in AL.
Ingleside provides daily papers to the
libraries. Own copy is through independent
arrangements with vendor.
26
The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
Pets allowed?
Avail- Additional
able
Cost
Only in IL.
X
Comments
Putting Green
-
Storage Bins
X
Swimming Pool - Indoor
X
Swimming Pool – Outdoor
-
Tennis Courts; how many
-
Workshop
X
Movies
X
Twice weekly, chosen by residents.
7/24 Emergency Response
X
Everywhere.
Medication Management
X
Only in AL and NC. Fee for service in IL.
Wellness Clinic
X
AL and NC. If in IL, one can use nursing
services but at variable cost in the
apartment.
Activities Program
X
Assistance w/taxes/bills
-
All Utilities except phone
X
Apartment maintenance
X
Basic Cable
X
Only in IL: 4’wide, 7’ deep, 8’ high
(chicken wire)
Large pool with striking outdoor views.
II. SERVICES
Housekeeping, times per
month
Linens provided
No – but a volunteer comes in
Basic cable inc. in IL
AL – pay a bill
Weekly service in IL. Includes light
cleaning.
4
-
Linens Laundered
X
Personal Nursing/home care
X
In IL, can be done at a cost. In AL, use own
or done for a charge. NC, included.
A price list shows range of charges.
Special Diets Available
X
Nursing Center.
Tipping policy
X
Transportation – personal
X
Transportation - scheduled
X
Facilities for overnight
guests
X
Telephone
X
Individual Gardens
X
$
No tipping. A voluntary collection is taken
up for the holidays.
To go to a doctor’s appointment, the van can
be booked in advance. $15 per trip (up to
15 miles).
No charge for vans doing regular runs
(which include 2 roundtrips to local
shopping centers per day, Mon-Sat.)
Guest House on grounds + two extra rooms
in AL.
Own responsibility
Plots available.
27
The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
Attachment: Tax Deductibility of Expenses at Ingleside at Rock Creek.
As an example of the tax deductions, which may be available to CCRC residents, the
following are the applicable deductions for LifeCare Contract Residents at Ingleside at
Rock Creek in February 2004. It must also be noted that the IRS has repeatedly stated
that the deductibility of medical expenses is a question of fact specific to each resident.
IRS Publication 502 refers.
Life Care Contract residents may elect to deduct from their 2004 income tax return
medical expenses computed by either the Blended or Non-blended Method. Under the
Blended Method, an annually updated percentage is applied to monthly fees and/or
entrance and admission fees paid without regard to the level of care received. Under the
Non-blended Method, the percentage of the fee included as a deduction is dependent on
the level of care. Residents elect one of their methods in their initial year of residency,
and must continue to use the same method as long as they reside at Ingleside regardless
of the level of care.
Blended Method: 39% of monthly fees and/or entrance and admission fees should be
include as an itemized medical deduction.
Non-blended Method:
Health Center monthly fees – 100% is an itemized medical deduction.
Assisted Living monthly fees – 81% is an itemized medical deduction.
Independent Living monthly fees– 23% is an itemized medical deduction.
28
The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
ANNEX 4
4. MAPLEWOOD
Point of Contact/Sales Representative: Michelle Michaels, Marketing Director
Address: 9707 Old Georgetown Road, Bethesda, Md. 20814
Phone: 301 571 7444
Fax: 301 493 9438
E-Mail: Maplewoodinfo@aol.com
Web site(by September):www.maplewood.com
Facility Operator/Parent Organization: Resident-owned Maplewood Cooperative
Setting: Located in Bethesda suburbs, just within the beltway the facility has an excellent
location for retirees from DC and the Maryland suburbs. Modern facility, opened in
1996 on 8.2 acres of land, surrounded by woods. Maplewood is an up-market facility
with good IL accommodations and amenities. Unit size ranges from 730 sq.ft for a 1bedroom to 1740 sq.ft. for a 2-bedroom/den. Maplewood has relatively fewer AL/NC
units than other facilities, but believes that they will be adequate as the resident
population ages since AL/NC facilities are available only to residents. AL units range in
size from 1-3 rooms; only the individual in need may move to an AL facility, so couples
wishing to remain together in IL facilities may prefer to arrange additional home help.
NC units are mostly semi-private. Community pets (colorful breeding birds, fish – and
soon a cat) add interest to the AL/NC units. Managed by Sunrise Senior Living.
CAPACITY
Total Number of
Units
Number of
Units
Available
207
0
Independent Living
Of which:
1-BDRM
Number of
Residents
Waiting list
(in months)*
300
1/3
3-12
Larger 1 & 2BDRM
1/3
12-24
Larger 2 & 3BDRM
1/3
18-36
Assisted Living
21
c.10%
Skilled Nursing
30
c.10%
Male/Female ratio: 1:2 * Low turnover – new facility
Type of Ownership:
Registered as:
Cooperative, owned by residents
CCRC
CCAC Accredited:
No
Form of Contract:
Life Care/Continuing Care: see below – financial arrangements quite complex, but
beneficial to residents and their estate. As a cooperative, residents own their units.
29
The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
Refund Provisions:
Cooperative ownership; meaning the actual sales price of the unit less 4.5% is returned.
The Entry Fee, which is slightly less than 10%, is also refunded on sale.
Range of Entrance fees: $270,000-610,000 including the above entry fee.
Range of Monthly fees: IL - $1854-3794; 2nd person $900; includes real estate taxes.
Lifecare contract provides for up to 90 days of AL/NC out of 150 days without additional
charge, except for meals4. This may happen up to two times in one year. After 90 days,
lifecare residents would pay $2025-3255 for AL and/or NC for the individual concerned.
If on joining Maplewood, an individual does not qualify for a lifecare contract on medical
grounds, s/he would pay current ‘market rates’ for AL of $4360-5460 and for NC of
$6250-7090.
Sign Up Policy $10,000 on joining wait list; when unit available, deposit another
$10,000 with closure in 40 days; resident may obtain bridge loan
Typical additional costs to monthly fee: Telephone, internet, food, insurance
Type of Health Care Benefits included: LTC not required
Medicare Certified:
Yes
Medicaid Certified:
No
Entry Requirements (Minimum Age): 62 for first, 60 for second
Average age on entry: 80-84
Average Time on Waiting List: Currently 3- 36 months depending on unit size
Average No. of years in facility: Opened in 1996, too early to gauge
Type of Facility:
Multi-story: 5 and 6 story building; indoor garages on 3 levels below
Religious Affiliation of Facility: Non-denominational
Miles to Shopping: 5 blocks to shopping; facility shuttle
Miles to Hospital: Suburban – 2 miles; Sibley – 5 miles
Access to Public Transportation: Yes: Buses outside and facility bus to metro
station; metro station is 1 mile.
Return Home Policy After Acute Leave: Try to keep couples together. AL is one
room, so home health care (at cost) is option for couples to remain in IL; NC mostly
semi-private. Do not take in from outside
Coordination/connection of Assisted Living with Independent Living facilities:
All in one building.
4
The additional charge for meals is currently $455/month.
30
The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
FACILITIES AND SERVICES ON-SITE
Avail- Additional
able
Cost
Comments
I. FACILITIES
Bank
X
Beauty/Barber Shop
X
Billiard Room
X
Bowling Green
-
Card Rooms
X
Chapel/Denomination
-
Coffee Shop
X
Dining Room – Guest policy
X
Dinner $12; Brunch $19
Dining Room–Seating Policy
X
Free seating
Private Dining Room
Number of meals a day
Required?
Alcohol in restaurant?
X
Convenience store
X
Courses/lectures
X
Craft Rooms
X
Dry cleaning/laundry
X
Exercise Facility/Spa
X
Parking - Indoor
X
Parking - Outdoor
X
Golf Course Access
Internet Access/Computer
Facilities
Library
X
Daily Newspapers
X
Pets
X
Putting Green
-
Storage Bins
X
Swimming Pool - Indoor
X
Swimming Pool – Outdoor
-
Tennis Courts; how many?
-
Workshop
X
Rooms available for services
27meals/month; refund for
extended absences
$3.75/glass of wine
1
X
$
Front desk handles
$
X
X
$
Approved
YMCA close by
31
The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
Avail- Additional
able
Cost
Comments
II. SERVICES
7/24 Emergency Response
X
Medication Management
X
Wellness Clinic
X
Activities Program
X
Assistance w/taxes/bills
X
All Utilities except phone
X
Apartment maintenance
X
Basic Cable
X
Housekeeping-times per month
4
Linens provided
-
Linens Laundered
X
Personal Nursing/home care
X
Special Diets Available
X
Tipping policy
X
Transportation - scheduled
X
Individual Gardens
$
$
Premium Cable included
Placed on beds
$
Residents manage an annual
collection
None
Transportation – personal
Facilities for overnight guests
RN on duty; schedule for visiting
doctors
$
-
X
Nominal fee of $20 p.a.
Hadler/RALC/Maplewoodsummary
32
The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
ANNEX 5
5. THE FOUNTAINS AT WASHINGTON HOUSE
Point of Contact/Sales Representative Andrew Morgan, Director of Marketing
Address: 5100 Filmore St., Alexandria, Va. 22311
Phone: 703 845 5100
Fax: 703 671 0468
E-Mail
amorgan@thefountains.com
Web site www.thefountains.com
Facility Operator/Parent Organization: The Fountains Corp., 800 635 9457
Setting in Alexandria suburbs, close to Goodwin House and the Hermitage CCRCs. 10 storey,
purpose built facility, opened in 1972. The facility is well-designed and contained within one
building. The Fountains is going through a major renovation of the entire facility ($7m); work
that is already completed shows very well and once the renovation is completed in March 2005,
the Fountains’ standards will be comparable to others visited. Currently offering significant
discounts on entry (15%) and monthly fees because of renovation. Apartments are good-sized,
attractive living units; and facility amenities are well-planned (1st class fitness center, ‘themed’
gathering spots with large windows on each floor). Some Assisted Living units have 2
bedrooms, so couples may remain together and no downsizing needed. Owned and managed by
the Fountains – a retirement corporation that owns 19 facilities nationwide; food service subcontracted. Roof terrace, facility walking paths and some gardens.
CAPACITY
Total Number of
Units
Number of
Units
Available
Number of
Residents*
Independent Living
(Studio – 3 BDRMs)
105
25%
69
Assisted Living
46
2
44
Skilled Nursing**
* Male/Female ratio 1:3
60
14
** All beds certified Medicare
46
Type of Ownership:
For Profit
Licensed as Retirement Living
CCAC Accredited:
No
Form of Contract:
Continuing Care (extensive & modified) and fee-for-service (rental)
Refund Provisions:
A 90% refund plan was introduced in August 2004.
Range of Entrance fees: $58,000-260,0000, with 90% refund - $90,000-395,000.
Contract for 2nd person: $20,000.
Range of Monthly fees: $1450-4913; 2nd person, $1200
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The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
AL and NC: if chose extensive contract form, no additional cost
If chose modified, get $500 reduction in monthly fees. This option designed for those w/ limited
LTC policies.
AL - $2995-4500/m
NC - $6500-7500/m
Both the entry fee and monthly fee are tax deductible. The deduction is averaging 23% and is
a function of the percentage of operating costs that is a medical expense. Both fees have been
increasing at about 4% p.a..
Sign Up Policy: For extensive & modified – 10% on identifying unit; refundable; will hold unit
for 60 days
Rental: $1000 deposit – holds for 30 days. Similarly, AL rental $1000 deposit olds for 15 days
Typical additional costs to monthly fee: Renters insurance, tel/cable, internet, additional food.
Types of Medical Insurance required: LTC not required.
Type of Health Care Benefits included: In-house health clinic w/RN
Medicare Certified:
Yes
Medicaid Certified:
No
Entry Requirements (Minimum Age): 65
Average age on entry: 82
Average Time on Waiting List: n/a
Average No. of years in facility: 6 years – is a function of the number of people
entering AL directly.
Religious Affiliation of Facility: none
Type of Facility:
10-story
Miles to Shopping: Bradley Shopping Center (2 1/2m) has regular shuttle
Miles to Hospital: Alexandria Hospital – 2 miles
Access to Public Transportation: Yes – and facility shuttle
Return Home Policy After Acute Leave: Keep couples together
Coordination/connection of Assisted Living with Independent Living facilities:
In same building; AL suites may have 2 bedrooms, so couples can remain together
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The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
FACILITIES AND SERVICES ON-SITE
Avail- Additional
able
Cost
Comments
I. FACILITIES
ATM
-
Beauty/Barber Shop
X
Billiard Room
X
Bowling Green
-
Card Rooms
X
Chapel/Denomination
X
Coffee Shop
X
Dining Room – Guest policy
X
Dining Room– Seating policy
X
Private Dining Room
Number of meals a day
Required?
Alcohol in restaurant?
X
Convenience store
$
Assigned seating; helps staff & residents
$
Continental Breakfast & Dinner; refunds
for extended absences
Have cocktail events
2
BYOB
X
Courses/lectures
X
Craft Rooms
**
Dry cleaner/laundry
X
Exercise Facility/Spa
X
Parking - Indoor
-
Parking - Outdoor
X
Golf Course Access
Internet Access/Computer
Facilities
Library
X
Daily Newspapers
X
Pets
X
Putting Green
X
Storage Bins
-
Swimming Pool - Indoor
-
Swimming Pool – Outdoor
-
Tennis Courts; how many?
-
Workshop
-
$7-9
Will be available after renovation
$
Front desk handles
First class facility; available to outsiders.
6 classes the day of visit; 2 full-time PTs
$
Can arrange
X
X
$
Approved
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The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
Avail- Additional
able
Cost
Comments
II. SERVICES
7/24 Emergency Response
X
Medication Management
X*
Wellness Clinic
X
Activities Program
X
Assistance w/taxes/bills
*
All Utilities except phone
X
Apartment maintenance
X
Basic Cable/Internet
Housekeeping, times per
month
Linens provided
X
*
$
Linens Laundered
*
$
Personal Nursing/home care
*
$
Special Diets Available
X
Tipping policy
2
End of year fund – can contribute
None
Transportation – personal
*
Transportation - scheduled
X
Facilities for overnight guests
X
Individual Gardens
-
$
$
$72
* The Fountains has an “At Home’ services program designed to help a person while still
in his/her own home. This assistance with living program is available at low cost to
residents in the community and to facility residents who need additional help. The
program also helps maintain residents in IL. Services include inter alia, running errands,
cutting grass, plumbing/maintenance and monitoring services.
Shadler/RALC/fountainssummmary
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The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
ANNEX 6
6. BLANK QUESTIONNAIRE FOR CCRC
Issues to Discuss
Organization Name …………………………………………………………………
Point of Contact/Sales Representative ………………………………………………
Address ………………………………………………………………………………
Phone ……………………………………..
Fax ………………………………..
E-Mail ……………………………………
Web site …………………………..
Facility Operator/Parent Organization……………………………………………….
Setting ……………………………………………………………………………….
CAPACITY
Total Number of
Units
Number of
Units
Available
Waiting list
(in years)
Number of
Residents
Independent Living
Apartment - Studio
Apartment - lBDRM
Apartment - 2BDRM
Cottage/house
Assisted Living
Skilled Nursing
Male/Female ratio
Type of Ownership:
Registered as:
Not for Profit
Insurance Co.
For Profit
Health provider
CCAC Accredited:
Yes
No
Form of Contract:
Life Care
Assign Assets
Fee for Service
Equity
Continuing Care
Entry Fee Rental
Other
Refund Provisions:
90%
75%
50%
Prorated
Other
Options…………………………………………………………………………
Conditions………………………………………………………………………
Range of Entrance fees:……………………………………………………………
Range of Monthly fees:…………………………………………………………….
Typical extra costs on a monthly bill………………………………………………
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The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
Signing Up Policy (Deposit required?)…………………………………………
Types of Medical Insurance required: ……………………………………………
Type of Health Care Benefits included: …………………………………………...
Medicare Certified:
Yes
No
Medicaid Certified:
Yes
No)
Entry Requirements (Minimum Age): ……………………………….
Average age on entry:…………………………………………………...
Average Time on Waiting List: ……………………………………….
Average No. of years in facility: …………………………………………..
Religious Affiliation of Facility: ……………………………………………………
Type of Facility:
Multi-story
Single Story
Both
Miles to Shopping: ……………………………………………………..
Miles to Hospital:
Access to Public Transportation: Yes
No
Distance?…………………………………………………………………
Return Home Policy After Acute Leave: ……………………………….
……………………………………………………………………………...
Coordination/connection of Assisted Living with Independent Living facilities:
………………………………………………………………………………………
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The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
FACILITIES AND SERVICES ON-SITE
Avail- Additional
able
Cost
Comments
I. FACILITIES
Bank
Beauty/Barber Shop
Billiard Room
Bowling Green
Card Rooms
Chapel/Denomination
Coffee Shop
Dining Room – Guest policy
Dining Room– Seating
policy
Private Dining Room
Number of meals a day
Required?
Alcohol in restaurant?
Convenience store
Courses/lectures
Craft Rooms
Dry cleaning/laundry
Exercise Facility/Spa
Parking - Indoor
Parking - Outdoor
Golf Course Access
Internet Access/Computer
Facilities
Library
Daily Newspapers
Pets
Putting Green
Storage Bins
Swimming Pool - Indoor
Swimming Pool – Outdoor
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The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
Avail- Additional
able
Cost
Comments
Tennis Courts; how many?
Workshop
II. SERVICES
7/24 Emergency Response
Medication Management
Wellness Clinic
Activities Program
Assistance w/taxes/bills
All Utilities except phone
Apartment maintenance
Basic Cable
Housekeeping, times per
month
Linens provided
Linens Laundered
Personal Nursing/home care
Special Diets Available
Tipping policy
Transportation – personal
Transportation - scheduled
Individual gardens
Short stays
Hadler/RALC/CCRCquest.
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The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
ANNEX 7
7. QUESTIONS TO SUPPLEMENT ANALYSIS OF CCRCs
Financial
 What medical expenses are covered in the various wings?
- Independent units
- Assisted living
- Nursing care
 What if stay in nursing care at any one time (while in AL or Independent facility) is longer
than prescribed annual number of days (e.g. 45 days)? Costs?
 Tax implications…% of fees that are tax deductible:
- initial entry fee
- monthly costs
 What have been average rate increases over past 3 years, 5 years?
 Financial position of facility…Small independents? Profit or non-profit?
 What are refund provisions
- if choose to leave after short period
- in event of early death
 Within facility, if one moves to a different size unit or to a different level of care, what is
the impact on
a) Initial entry fee
b) Monthly costs
 What are per diem costs if on entering one spouse is independent and one needs AL/NC?
 Is LTC insurance a pre-condition? What medical insurance required?
 What extra costs/living expenses can be anticipated: for instance besides clothing,
toiletries/personal care, entertainment, cable/telephone/internet, housekeeping.
 What is the policy if after signing up and before residence, one person falls ill?
 What is the length of time for which a new resident is required to remain healthy?
Other
 How many beds in advanced care and how many full on average? What if all full?
 What is the role of your personal physician in determining the next level of care?
 Are you required to shift to physicians at the facility?
 Are there specialists regularly at the facility, such as ophthalmologist, podiatrist?
 What is the role of Medicare, for US citizens?
 What types of medical insurance are required?
 Staff to resident ratio? Trained caregivers/residents as well as total staff.
 Quality of key staff. Ave length of employment of nursing staff; nationality?
 Short stays? Costs?
 Assistance w/bill paying/tax returns?
 Role of churches in running facilities w/which they are affiliated?
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The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
ANNEX 8
8. CONTACTS AND ADDITIONAL INFORMATION FOR CCRCs
1. CONTACTS


Retirement and Assisted Living Committee
Hazel Denton, Chair
Soonhoon Ahn
Sandra Hadler
Jean-Pierre Jacqmotte
Greg Votaw
CCRC Staff
Collington:
Kassie Foundos
Heron Point:
Sandra Johnston
Ingleside:
Angela Aloupis
Maplewood:
Michelle Michaels
The Fountains: Andrew Morgan
2. RETIREMENT COMMUNITY RATING SYSTEMS

Continuing Care Accreditation Commission (CCAC) is an independent
accreditation commission that formally gives a seal of approval to CCRCs that comply
with rigorous standards of excellence in the areas of governance, administration, resident
life, health and wellness and finance. CCAC standards exceed those of Government
financial and health regulations for CCRCs.
 The Senior Hospitality International
Since 1995, the Senior Hospitality International has been helping Seniors identify
outstanding communities for active retirement living, known as Retirement Resorts. It
does for the senior hospitality industry what other organizations do for hotels and
restaurants with 5-diamond and 5-star rating systems. To qualify as a Retirement Resort,
communities must have exceptional facilities and staff and offer a wide variety of
recreational, educational, cultural, spiritual and social opportunities. All Retirement
Resorts must also have on-site or nearby access to quality healthcare services. These
communities are designed for a new generation of seniors who want to enjoy an active
lifestyle in a resort setting. Each community is evaluated yearly through an on-site visit
and resident interviews.
3. USEFUL WEBSITES
 www.aahsa.org
American Association of Homes and Services for the Aging. This represents 5,600 nonprofit CCRCs, nursing homes, assisted living and senior housing facilities and
community service organizations across the country. Sponsors the CCAC.
 www.ccaconline.org
Provides an up-to-date list of accredited facilities as well as information about CCAC.
 www. Aarp.org
Provides a wealth of information on issues of concern to older adults. A search on
Senior Housing provides useful information.
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The 1818 Society: RALC-Committee – Continuing Care Retirement Communities, September 2004
 www.naic.org
The National Association of Insurance Commissioners provides useful, objective
information on Long-term Care insurance, as well as all other kinds of insurance.
 www. Essentialeldercare.org
In DC, provides information, advice and practical help for families facing difficult care
giving decisions; a department of IONA Senior Services.
 www. Elderweb.com
Research site for professionals and family members looking for information on eldercare
and long-term care. Includes links to information on legal, financial, medial and housing
issues. Click on Housing and Care.
 www.retirementliving.com
Established to assist seniors to find housing that matches their lifestyle and needs.
Provides information on special products and services for seniors; publications; state
agencies dealing with aging; tax situations; and, links to a range of websites. Publishers
of the Guide for Retirement Living (free upon request). Also puts out a monthly e-mail
providing lifestyle news and information about new retirement communities. Located in
Connecticut, the center does not provide phone or mailing service.
 www.retirementresorts.com
The Senior Hospitality Institute
630-665-8360
107 E. Front St., Wheaton, Ill. 60187
 www.virtual-retirement.com
Virtual Retirement Inc. (5311 Consentino Gardens, Mississauga, Ontario L4Z 3Z3,
Canada) is a U.S.-registered company with headquarters and marketing services in
Canada, listing U.S. and Canadian retirement properties that range from RV sites to
custom-built homes and long-term rental properties for those wishing to visit seasonally.
Also listed are communities serving special needs. The website also links to a golf-course
locator.
 www.seniorresource.com.
Seniorresource.com offers myriad links to sources for retirement-living communities;
other housing options and information for retirement; finance; insurance, and health care.
Information also is available for purchase or rental of homes in Arizona, California,
Colorado, Illinois, Minnesota, Nevada, New Mexico, Pennsylvania, South Carolina and
Texas. Continuing-care retirement communities are listed for California, Colorado,
Oregon, Pennsylvania, Texas and Virginia.
USEFUL REFERENCES

David Savageau - Retirement Places Rated (MacMillan; $21.95)
Useful source for retirement information. It is an objective wellspring of information,
such as which locations have the mildest winters and mildest summers.

AAHSA, The Continuing Care Retirement Community: A Guidebook for
Consumers, 2001

NAIC, A Shoppers Guide to Long-term Care Insurance, revised 2003.
43