LeadingAge: CCRC-Without-Walls Model Not a Bailout for Troubled Communities

Continuing care at home (CCAH) programs aren’t new to the senior living industry, but the concept garners a lot of attention and consideration and LeadingAge had published white paper reminding its members that creating and launching this kind of program isn’t for everyone. 

The concept has been around for just south of 30 years, but there are currently only 12 CCRCs in the United States that are known to be offering a “without walls” style of contract to people still living in their homes, says the white paper.

About 3,000 seniors are currently enrolled in CCAH programs, says an article by actuarial AV Powell in an August 2012 issue of Ziegler’s Z-News newsletter. While the figure is relatively low, it has been growing, as the number of at-home programs offered by the largest 100 nonprofit senior living organizations in the U.S. grew by 32% between 2010 and 2011, according to the 2012 LeadingAge Ziegler 100 Fact Sheet cited in a CliftonLarsonAllen white paper on the topic.


That white paper, along with the LeadingAge one, both emphasize the need for careful consideration and actuarial soundness before pursuing this kind of program. 

“CCAH is not intended to bail out financially troubled CCRCs,” says the LeadingAge white paper. “Rather, it is a product that financially sound CCRCs may want to consider to expand their mission and market and position themselves for future generations of elder consumers that do not have the income or the desire to leave their homes.”

While CCAH programs are believed to eventually boost occupancy in senior living communities, the CliftonLarsonAllen white paper didn’t find the model to increase occupancy in independent living units, and LeadingAge further states that it’s not an “immediate revenue producer.” 


For one provider who introduced a CCAH program, it took about three years to reach a “break-even point,” and growth in membership enrollment should be slow by design, as the maximum number of CCAH contracts must be “carefully determined based on actuarial, financial feasibility and marketing projections.”

Additionally, the continuing care at home model is complementary to a traditional CCRC rather than competing with it, says LeadingAge.

The white paper also addresses the risks associated with the model, along with its history and some specific examples of providers who have successfully established programs.

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Written by Alyssa Gerace