I am fortunate to spend a lot of time talking with people all over the country who are considering a move to a continuing care retirement community (CCRC, also known as a life plan community). When I give presentations to those who are exploring their senior living options, I gain great insights into the thought process that goes into this major decision and the questions that commonly arise. One topic that I’m frequently asked about is what resources are available that provide continuing care retirement communities ratings or rankings.
Unfortunately, there really is not one central location that independently rates or ranks CCRCs. But there are different places where you can find useful information that can be referenced to inform your CCRC decision.
Commission on Accreditation of Rehabilitation Facilities (CARF)/Continuing Care Accreditation Commission (CCAC)
The CCAC was acquired by the CARF in 2003, and together, it is the only national accreditation provider for CCRCs. When a community is “CARF-accredited,” it means they have passed an in-depth review of their services and quality. Part of the accreditation process includes a review of the CCRC’s financials, though it’s not clear how much weight the financial analysis carries as part of ultimately achieving accreditation. Also, while CARF is independent and a non-profit organization, accreditation is voluntary, and providers pay for the accreditation review. Therefore, just because a CCRC is not accredited does not necessarily mean that it is not a high-quality organization. Many communities simply choose not to commit the resources necessary to apply for accreditation.
Centers for Medicare and Medicaid Services (CMS)
At medicare.gov/nursinghomecompare, you can see an easy-to-understand five-star scale rating provided by CMS based on its inspections and reporting. When considering CMS ratings, it’s important to understand that it only applies to skilled nursing facilities (and not to the entire community in the case of a CCRC), and it is only applied to providers that are Medicare and/or Medicaid-certified. Private pay facilities would not have a CMS rating.
Standard & Poor’s (S&P) and Fitch Ratings
Credit ratings are financial analysts’ assessments of a business or municipality’s credit risk, that is, an entity’s ability to meet its financial obligations in full and as scheduled. These two credit rating agencies rate some CCRCs that have publicly issued debt. While the assignment of a credit ratings is an inexact science, it is one way that is publicly available to examine a CCRC’s financial viability. The biggest issue from a consumer’s perspective is that these ratings only exist for about 20 percent of the communities in the CCRC industry, so this factor won’t offer any comparison for the 80 percent of non-rated CRCCs.
>> Related: 4 Key Factors of the CCRC Decision Process
I’d be remiss if I didn’t put this one on the list! MyLifeSite does not offer continuing care retirement communities ratings or rankings. However, from a financial perspective, we do collect communities’ audited financial statements and provide five key financial ratios on each of the hundreds of CCRCs we profile. We also provide an abundance of other information, including important contract details, that we extract directly from documents filed with the state in which they are located. Keep in mind that collecting this information in a timely manner isn’t always as easy as we would like, so some of our profiles may not reflect most recent fiscal year.
On myLifeSite, you can even sort your search results from best to worst based on communities’ debt service coverage and net operating margins. Debt service coverage reflects a provider’s ability to fund annual debt payments (where applicable) with cash flow; net operating margin measures a CCRC’s ability to generate operating revenue in excess of operating expenses, without relying on other revenue sources to fill the gaps. These two financial ratios in particular are closely looked at by bond rating agencies, equity investors, and bond issuers in the senior living vertical to determine a community’s financial stability.
It’s important to note that financial ratios don’t tell the entire story but can be a good place to start, and myLifeSite is the only place you’ll find this helpful research tool. We currently cover CCRCs in 11 states (though we plan to add additional states). To get started, check out our free online community search tool.
>> Related: How Do I Know If a CCRC is Financially Viable?
Other consumer feedback-based web resources
In addition to the resources above, you might also look at websites that have first-hand consumer reviews and ratings (for example, A Place for Mom), similar to how Yelp or TripAdvisor uses customer reviews to rate restaurants, hotels, and stores. On these types of sites, it is usually only communities that have a referral fee arrangement in place or that pay for placement on the website that will be featured. However, these sites do include all types of senior living providers, including many assisted living facilities. The reviews are often provided by adult children and are based more on the type of care provided, rather than focusing on independent living or the overall financial management of the community.
Making an informed CCRC decision
There are a lot of factors to consider when examining the CCRCs on your list of prospective new homes. That’s why I encourage people to do as much research as possible so they can make a fully informed choice about which one is right for them. Although there isn’t a single source for continuing care retirement communities ratings, these resources can give you a more objective, holistic picture of the communities you are looking at and may just be able to help you narrow down your list to “the one”!