The Second Edition of my Book is Available on Kindle!!

Senior Housing Cover3

Click here to purchase!

Here’s the overview:

Continuing care retirement communities (called “CCRCs” by industry insiders) are retirement communities that offer multiple living options (independent living, assisted living, and nursing). In exchange for an entrance fee and ongoing monthly fees, CCRC’s agree to care for residents for the rest of their lives.

Written by a former senior housing consultant, Continuing Care Retirement Communities: An Insider Tells All is a sweeping overview of the popular senior housing product. The book shows you:

  • What services are offered for seniors
  • How to find communities in your area
  • What to look for during your visit
  • How to read the contracts and disclosure statements
  • Why some communities go bankrupt
  • Some warning signs for potential residents of CCRC’s

The second edition has been updated and includes three new chapters: the financial analysis of CCRCs, how to learn about quality of care at a CCRCs nursing home, and the state of the senior housing industry since the recession.

You deserve the best coach when searching for the community of your dreams! Continuing Care Retirement Communities: An Insider Tells All shows you the good and the bad in the industry and offers advice on how to make the most of your move into senior housing.

 

Here’s the preface:

[Note: I have decided not to publish a paper copy of this book for a few reasons (mainly that it’s expensive and time-consuming). If you would like a paper copy, shoot me an email, and I’ll figure out a way to send you a file that you can print from the comfort of your home.]

You’re reading a second edition of my book. Why did I feel the need to put together a second edition? Well, some things have changed over the past few years:

  1. I’ve found a new (and better) source for nursing home information.
  2. Improvements in the economy have flowed over into the retirement industry, and consequently, senior housing is doing well.
  3. Hedge funds and other institutional investors have gotten more involved in senior housing.
  4. Readers have written to ask me questions that I feel should be covered in a new edition.

As a result, I’ve added three new chapters and updated the entire book with information pertinent to today’s economic market.

I am also going through some personal changes that make 2015 a good year to rerelease my book.  I’ve been writing about the senior housing since 2011. I initially scheduled one article a week, but, frankly, senior housing doesn’t move that fast. After a while, I got a bit tired of writing the same stuff over and over.

Plus, I’ve always liked digging deeper into intellectual topics and have been doing so in my spare time. In 2014, I started taking higher-level math courses on the side, and as of August 2015, I’ll be starting a PhD program. It will demand a great deal of my attention. Thus, in preparation for that transition, I want to give my readers a fresh look at senior housing before crawling into the cave that is my new PhD office.

In this updated edition, you’ll find all of the same information that was in the original: information about how to find retirement communities, how CCRCs fees and contracts work, how to negotiate for upgrades, and what happened during some of the industry’s biggest bankruptcies.

I’ve also added more information to help readers who have questions about their move to senior housing: a financial perspective on the costs of moving to senior housing versus staying at home, some good advice on learning about nursing homes in your area, and an update on the aftermath of the 2007 housing crash and how it impacted CCRCs.

While I probably won’t be writing for SeniorHousingMove.com or releasing books after 2015, I’ll still have my email, Virginia@SeniorHousingMove.com, and I’ll keep the site up and available. If I see anything that’s incredibly interesting or that seniors need to know, I’ll add a post.  But, frankly, most of what you need is either in this book or on my website.  I don’t anticipate that the industry makes a huge shift any time in the near future.

If you have questions, please email me.  I like helping people, and I don’t mind fielding a few questions now and then about how to find a good community.

I have enjoyed my years at SeniorHousingMove.com, and I appreciate all of the comments that I’ve gotten from my readers over the years.  I hope that I have helped you find the best place to spend your retirement years.

Virginia Traweek

May 1, 2015

Dear Readers

This spring, I’m taking a brief break from blogging. While I have loved writing for you, I have an interesting opportunity that I just can’t turn down. However, I am still researching, speaking and writing about senior housing.

Although I’m not actively blogging, you can still find plenty of good stuff on the site about senior housing. In order to make it even easier, you can read my best, most informative articles by clicking on the links below. I’ve roughly grouped them by topic, but there is a great deal of overlap:

General:

Continuing Care Retirement Communities:

Independent Living:

Assisted Living & Memory Care:

Nursing Homes

Hospice/Home Health/Living at Home:

And, of course, you can always buy one of my books on Amazon:

Also, just because I’m not blogging right now doesn’t mean that I’m not here to help answer your questions. If you have anything that you don’t see answered on my site, feel free to email me: Virginia@SeniorHousingMove.com.

Additionally, I’m still happy to come speak to your group about senior housing issues. You can email me for more information.

Have a safe and prosperous 2015, and thank you for visiting Senior Housing Move.com.

Virginia

Walk more = live longer, doctors & end of life, liquid meal replacements, and top-rated senior housing communities

shoes

Seniors who walk more live longer.

Most doctors wouldn’t want heroic measures at the end of life.

Liquid meal replacements can’t replace the real thing.

SeniorAdvisor.com has released its list of top-rated senior housing communities.

Seniors bust dishonest business, assisted living staff member buries patient behind facility, abuse & neglect in nursing homes, and checkered pasts

CSI logo

Next on “CSI: Adult daycare,” a senior busts adult daycare operators who falsify documents!

Creepiest thing I’ve heard in a long time: An assisted living staff member was arresting for burying a resident behind the facility.

85% of nursing homes reported abuse or neglect in 2012.

Assisted living operators sometimes have a checkered past.  That’s why it’s always good to check with your local nursing home ombudsman or check your state’s assisted living complaints database.

Caregivers’ lost income, nursing home scam, suicide amongst seniors, and a giant nursing home company

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How do caregivers cope with lost income due to caring for a loved one?

This makes me sick: A broker in California used nursing home residents’ identities to scam investors.

Seniors contemplate suicide for a number of reasons.

Two big senior housing companies are merging to create a giant retirement community provider.

Warning to my Readers: Nursing Home Compare isn’t Reliable

medicare nursing home compare

For a long time now, I’ve written about how consumers can use Medicare.gov’s tool, Nursing Home Compare, to get ratings for skilled nursing facilities in their area.  However, today I have decided that I can no longer endorse the use of Nursing Home Compare use as a tool for deciding between facilities.

There have been complaints about the accuracy of Nursing Home Compare’s ratings for a long time, but last week, several articles came out that make it impossible to ignore the problems.  According to the New York Times:

Only one of the three criteria used to determine the star ratings — the results of annual health inspections — relies on assessments from independent reviewers. The other measures — staff levels and quality statistics — are reported by the nursing homes and accepted by Medicare, with limited exceptions, at face value.

The ratings also do not take into account entire sets of potentially negative information, including fines and other enforcement actions by state, rather than federal, authorities, as well as complaints filed by consumers with state agencies.

The remainder of the article goes into greater depth about how ratings are calculated and instances in which highly-rated nursing homes did not provide adequate patient care.  (It’s a good article, and well worth the read if you have family members who need skilled nursing care.)

What should consumers do with this information?  Well, a few things:

You can still use the site to find nursing homes in your area.  It’s pretty straight-forward to type in your city, state, and ZIP code and narrow your search to a specific area.  This is super helpful if you’re just getting started and need a quick, all-in-one place to find rating information.

You can still use the site to find basic information about a community.  Nursing Home Compare still has a wealth of information: ownership, inspection reports, type of payments accepted, and location.  So, feel free to use the site to help you learn more about potential skilled nursing facilities.

You can’t trust the site to provide accurate ratings. Unfortunately, you just can’t trust what you see on Nursing Home Compare.  It’s too easy for nursing homes to game the system right now, and that means that the ratings just aren’t indicative of quality of care.  Even using it to weed out seemingly poor-performing providers isn’t a good recipe for finding the best nursing home.

However, here are a few other ways of checking the quality of care at a senior housing community:

  • Call your local ombudsman. Nursing home ombudsman are awesome resources that you can use free of charge.  You can find your ombudsman by searching the National Consumer Voice website and clicking “Locate an Ombudsman.”
  • Make multiple (sometimes unannounced) visits to the facility.  I’ve heard of unscrupulous marketing agents who spray deodorizing spray in the skilled nursing wing of a retirement community prior to a scheduled tour.  Of course, they do this because the nursing staff isn’t doing a good job of removing odor-causing soiled clothing, diapers, or wound dressings.  But, because you only arrived for the “official tour,” then you won’t see (or, rather, smell) the truth. Another reason to make multiple visits is that, especially when you’re not accompanied by marketing agent, you have a higher chance of observing staff members revert to their “natural behavior.”
  • Talk to other families in the parking lot or hallways.  Now is not the time to be a wallflower.  If you want to learn more about a skilled nursing facility, the best folks to ask are those who have been through the process with a loved one.  To that end, feel free to strike up a conversation with other families that you see in the facility.  They’re highly motivated to share “the gossip” with you and they don’t have any competing interests (unlike the marketing agent whose job is tied to filling beds). Note: Make sure you approach families in a respectful, discrete manner.  It’s one thing to do your own due diligence.  It’s another to infringe on a family who is going through a difficult time.  Please do the right thing, and don’t be obnoxious or ask them overly personal questions.

I’m continually reminded of the fact that skilled nursing, assisted living, and dementia care are not easy jobs.  The senior housing industry has a difficult problem: How can it make money, offer the highest possible level of care, and provide an affordable product?  So far, no one has been able to provide a good solution to that equation, and it’s only served to harm seniors during a very vulnerable time in their lives.

Unfortunately, the odds are not in a consumer’s favor, and it’s very difficult to find a good, one-stop source for senior housing information.  Especially after this week’s article, I can no longer recommend Nursing Home Compare as a viable option.

Want to learn more? Here are a few other links that you might find helpful:

Who to call when things go wrong

Signs of trouble in any community.

Five questions to asking during your senior housing visit.

Finding communities that share your beliefs.

Crisis management 101.

Whom to Call when things go Wrong

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I hope that no one ever has to use the information in this post.  However, senior caregivers are in a unique position to either help people in their most vulnerable hour or inflict serious injury on them.   While the industry has been working (somewhat unsuccessfully) to improve its safety record, there are a few things that you can do if you notice a facility isn’t properly caring for its residents:

First of all, if it’s an emergency, call 911. I sometimes forget to mention this because it seems really obvious, but not everyone thinks about it.  If you see someone who is in serious danger, you can (and should) call the police.  It may turn out to be something that is best handled by another agency, but, frankly, why not let the management sort that out? Your job is to keep your loved one safe.

Also, don’t hesitate to remove your loved one from the situation.  There are probably other nursing homes in your area that meet your criteria and can provide good-quality care.  If something “just doesn’t seem right,” then feel free to take your business (and your loved one) elsewhere.

If it’s not an emergency, but you suspect that there are problems or if you feel that your loved one is being unfairly treated, then you have a few things that you can do to help the situation:

1) Document everything.  Whatever the situation, you will have a much stronger case if you keep a detailed record of your findings. Take pictures.  Write down notes if you notice unusual behavior, bruising, marks, treatment, or other problems with dates, times, and other pertinent details.  In some cases, police have even used hidden cameras to catch nursing home abuse.  (Note: Check with authorities before placing hidden cameras or wires, since recording without someone’s consent can be a crime in some areas.)

2) Call the nursing home ombudsman in your area. You may not know it, but there is an individual (called an “ombudsman”) who is designated as a consumer advocate in your area.  The nursing home ombudsman program is completely free for you to use, and the ombudsman in your area will be able to help you get your grievances resolved.  Click here for information about locating an ombudsman in your area.

3) Call the state health department, aging, or human services. States regulate nursing home and assisted living facilities.  Often, the state will handle certification and bed licensure, which means that a ding on the state’s database can prevent bad communities from having their licenses renewed.  Formally submitting a claim can help open investigations into nursing home abuse and cement the case against operators.  You should note two things about state oversight: 1) The department that regulates nursing homes differs from state to state, so you’ll have to do some research online to find the right person. 2) State regulatory oversight can be a slow and steady process, so you cannot count on the state to fix problems in a short time period.  If your loved one is in danger, remove them from the facility immediately.

4) Call the county health department.  Often times, the county will have some oversight in local nursing homes, especially when it comes to how the kitchen is handled.  If you encounter a problem with sanitation, county health department employees may be able to help intervene to fix the problem.

Again, I hope that you never have to use the information in this post.  Unfortunately, some residents of assisted living and nursing facilities experience abuse or neglect.  It’s up to family members, friends, and concerned staff members to do something to prevent this type of treatment from continuing.

Want to learn more about senior housing?  Check out some of these articles:

The naked truth about CCRC entrance fee refunds.

Understanding a CCRCs permanent transfer policy.

Who owns CCRCs?

Should a retirement community be run like a McDonald’s?

 

Sex in senior housing, long term care insurance, nursing home lawsuit, and doing brain exercises

teen with condom

Sex in senior housing isn’t always handled well by staff.

Missing one payment can put your long-term-care insurance in jeopardy.

A jury awards over $3 million in nursing home lawsuit.

Doing brain exercises can help delay your move into senior housing.

The Naked Truth about CCRC Entrance Fee Refunds

Continuing care retirement communities market the entrance fee refund as a big selling point.  They try to make it sound like an easy transaction: You give them $100,000 to $1,000,000 up front, and they’ll return a portion of that fee to your estate when you die.  Since you’ll be selling your home to pay for the entrance fee, it’s not like it’s money you’ll miss, right?

Like most things in life, the truth isn’t that simple.  Entrance fee refunds are not the straight-forward transactions that CCRCs would have you believe.  In this post, I’ll share some of the hidden downsides of the entrance fee model, specifically as it relates to the entrance fee refund.

Be warned: This is kind of a dark subject, since it deals with what will happen after you die (or move out of the community).  But, for those who want to know, here are the facts.

Virtually all communities will have some waiting period after you pass. Obviously the manager of the CCRC won’t be standing over your bedside with a check waiting for your family the moment you pass away. But, you would except a check be presented to the estate within 30 days, right? Nope.  The truth is that your family may have to wait for a long time (in some cases over a year) for the refund to be processed.

Some communities require that your apartment be “resold.” In other words, your independent living apartment must be reoccupied by a new tenant.  How long does that take?  Could be months.  Could be years if the community has trouble filling the apartment.  And guess what?  Even after it gets reoccupied, the community usually has 45 days or more to cut your estate a check.

Some communities require that ALL of your apartments be “resold.” Spent a few months in assisted living and/or nursing? Those apartments must also be reoccupied by a new tenant before you get your check.

Refund policies vary if the apartment doesn’t sell. Some contracts stipulate a one-year maximum waiting period.  Others don’t say anything about when you’ll be getting a refund if apartments don’t sell.

No matter what’s in the contract, the community still has to have enough cash to pay it back. This seems like common sense, but most people don’t really think about it.  Your entrance fee refund is 100% dependent upon the community being in the financial situation that would allow them to pay you back.  While most states have laws requiring that CCRCs keep a certain amount of cash on hand for refunds, this can be put in danger if the community is in financial difficulty. Thankfully, this has been a rare occurrence historically.

Want to protect yourself? There’s two main things that you can do:

  • Check your contract. The resident agreement will contain a detailed description of how the community plans on paying you the balance of the fee.  If it’s important to you that your estate get the refund in a timely manner, then pay particular attention to this section of the agreement.
  • Don’t move in if the terms aren’t favorable. For too long, CCRCs have made all of the rules when it comes to resident agreements.  It’s worked out for the most part, but some seniors have gotten seriously burned when communities went bankrupt. While the CCRC lifestyle makes it tempting to overlook things like the entrance fee refund policy, I believe that seniors have the power to express their displeasure and be a force of change in the industry.

Want to learn more about CCRCs? Check out some other posts:

Who owns CCRCS?

What is adult daycare?

What is memory care?

Why pushing for a move to senior housing isn’t a good idea.