The CCRC Conundrum: When Residents Resist Transitioning Through the Continuum

The nature of continuing care retirement communities (CCRCs) with their varying levels of care can create a variety of issues relating to discrimination and reasonable accommodation, reports Provider Magazine, and some communities have recently dealt with challenges regarding their ability to restrict access to certain parts of campuses to the most frail residents, or transition residents into higher levels of care.

“Every CCRC should be aware of the potential litigation hazards it faces when dealing with these questions and of the two federal statutes upon which a plaintiff will most likely base his or her potential discrimination case,” writes Andrew Bart for Provider.  “A CCRC is contractually obligated to provide a continuum of care to its residents and is authorized to assess its residents’ health along the continuum and transfer them accordingly. What happens, however, if a resident does not wish to move from his or her ILU to full-time care?”

He then goes on to examine a few cases. One deals with a CCRC resident who sued her community for discrimination because it didn’t accommodate her request to stay in her independent living unit with private caregivers, claiming that it was in violation of the Americans With Disabilities Act and the Fair Housing Amendments Act. 


However, the resident had signed a contract with the CCRC upon admission granting the provider rights to transfer residents to the “appropriate medical unit” when they become permanently ill, and the community’s staff physician had determined that it was in this particular resident’s best interest to transfer into a higher level of care. 

“The CCRC, in brief, claimed that it should not be required to seek an exception to its policy or to the California Department of Social Service’s regulations because it could not legally delegate its duty of care to private aides, and, even if an exception could be granted, it would fundamentally alter its continuing care program,” Bart explains. 

The Provider piece breaks down the court’s decision, which basically sided with the CCRC. It then goes on to mention some other cases regarding a community that restricted access to communal areas (such as dining rooms) for residents depending on acuity level, and other communities whose dining room policies brought them to court for alleged discrimination. 


“A CCRC should ensure that its policies comply with (along with the relevant state statutes and regulations) the dictates of the FHAA and the ADA,” writes Bart. “Any policy treating sicker residents differently from healthier residents in connection with access and/or rights to communal areas should be carefully scrutinized.”

Read more here

Written by Alyssa Gerace

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