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Continuing Care Retirement Communities (CCRCs) - Please Look Beyond the Luxury
Recently, The New York Times featured a story on CCRCs. The takeaway was, for those who can afford it, CCRCs are an attractive option to age comfortably and on your terms. The article hinted at the potential risks of CCRCs with a reference to the legal expertise needed to review CCRC’s contracts, but ultimately paints a picture of security and success, particularly for those who have selected Fountaingrove Lodge in Santa Rosa.
CARR has recently experienced an uptick in inquiries from residents of CCRCs about how to square a CCRCs' original promises with their actual provisions. Here are a few examples --
“Aren’t staff suppose to be available at night to help me when I need them? The facility only has 2-night staff onsite for 175 residents. I did not pay a $500,000 signing fee, plus $7,000 per month, to wait an hour for assistance.” (The facility is meeting the letter of the law by the way with this staffing, See Title 22 Regulation Section 87415)
“My parents bought this unit year’s ago with the promise of aging-in-place together. Now, the CCRC management wants to separate my parents since my father’s diagnosis of early-stage dementia and wants them to pay double the rent. Monthly rent for my father’s new space in the dementia wing and monthly rent for my mother to remain in their original unit.”
“What recourse do I have if the CCRC burns down and my unit is no longer available? Can I back out of my contract if I am not happy with my new unit or am concerned about the facility’s proximity to fire-prone areas? How much control do I have over my temporary relocation space?”
The intent of this article is not to demonize CCRCs, but was written to convey the dire need for consumers to do their homework before signing a lifetime contract with any CCRC and to tell consumers the straight truth--when you sign up for care within a CCRC, you are electing to age within the confines of organizational policies and practices, which may translate into a loss of control for you (and a significant loss of money if you chose to move out).
For consistency, we will follow The New York Times lead and use Oakmont’s Santa Rosa CCRCs. Taking a peek at the public records on Fountaingrove Lodge, Varenna at Fountaingrove and Villa Capri offer a good example of how much CCRCs might not be directly disclosing to potential residents. Using these facilities is also helpful since their promise and provisions were recently tested during the Tubbs Fire of October 2017 and they have since had to do damage control to preserve their image.
All of the information below is based on the public records available on California’s Department of Social Services website. We recommend first reading The New York Times article and viewing the facilities’ websites for a more meaningful comparison.
Capacity Claims - The NYT article reports Oakmont’s claim of maximum occupancies and waitlists. Consumers would be wise to verify this information as fact or a marketing tactic. As of May 2018, Fountaingrove Lodge had a census of 126 residents out of a maximum licensed capacity of 173. As of September, Varenna at Fountaingrove had a census of 230 out of a maximum capacity of 322.
Compliance Records - As of December 18, 2018, Fountaingrove Lodge has earned 15 citations within 5-years (12 Type As and 3 Type Bs). Incidents include personal rights violations, a medication error, two dementia residents going AWOL, and failing to report numerous resident falls which included head injuries. Varena at Fountaingrove has earned 11 citations and Villa Capri has earned 12 citations. You can review their compliance records using the hyperlinks above.
Customer Service - On December 11, 2018, at Varenna at Fountaingrove, the state substantiated an allegation of “staff failing to meet resident needs”. After assisting a resident with their evening shower, the staff’s shift was over in the middle of dressing the resident. The staff member left the resident undressed sitting on their bed since it was the end of their shift. The next caregiver did not arrive until 10 minutes later to finish assisting.
Emergency Preparedness - The Tubbs Fire in October 2017 caused upheaval for the whole Santa Rosa area. This is directly acknowledged on Oakmont’s website. However, what Oakmont has not necessarily disclosed to potential residents is the specifics about how their team mismanaged resident evacuations during the fire at all three facility locations. In fact, Oakmont takes the liberty of suggesting to consumers that the mishandling was disputable, with the State of California and Oakmont reaching “a settlement”.
The “settlement”, however, is a Stipulation and Waiver and Order (CDSS#7218241101-F) that “stays” the license revocation of Varenna at Fountaingrove and Villa Capri. Both of these CCRCS are now operating under a probationary license due to the findings of the state’s administrative proceedings. Here are some excerpts from the proceedings -
- Two caregiving staff and two maintenance staff were on the night shift to evacuate 230 residents when the fires started;
- No documentation of fire safety or emergency response training for four staff on shift during the evacuation;
- At no time did staff have a master key to resident units during the evacuation, nor keys to vehicles and no management was present;
- Insufficient staff to evacuate 40 residents who needed assistance to evacuate due to dementia or non-ambulatory status;
- 3 residents were left overnight at the facility.
On December 8, 2016, a year prior to the Tubbs Fire, a complaint was filed against the Varenna facility alleging the facility had insufficient staff to safely evacuate residents. Regrettably, the state analyst determined the complaint to be “unfounded” during the visit.
So what does all this mean to consumers?
Executive chefs, Swedish massages and chandeliers are nice touches at any resort experience. But CCRCs should only be able to leverage this aspect of their business model so far.
Consumers must continue to be wowed by the quality of care delivered and the personalized assistance provided. With a lifetime contract, consumers need to be asking about that phase of residency when they may need a modified diet or can no longer lounge poolside unattended. Does that million-dollar service promise still apply? The public records of CCRCs can help prepare consumers to ask those tougher questions and to distinguish facilities that can deliver on their promises.
Additional Resources for California consumers of CCRC services:
- California Department of Social Services Website link: Laws & Regulations for CCRCs – Continuing Care Contract Statues Continuing
- Care Contract Statue link: Health & Safety Code, Section 1770 et seq.
 You can verify this information provided here by using the CA’s Department of Social Services’ Facility Search option & searching for the Oakmont facilities using their license numbers – Fountaingrove Lodge #496803440, Varenna At Fountaingrove #496803049, Villa Capri #496802026.