The Continuing Care Retirement Community or “CCRC” was a concept developed in the 1970’s to provide a community living environment for aging people that would enable them to ‘age in place” as their health care needs increased. Ordinarily, new residents start out in independent housing, then may migrate up to Assisted Living, and eventually, if necessary, into the nursing home that is on the same campus. The resident signs a contract whereby for a set advance fee, they purchase the right to occupy a specific unit. The payment is invested by the CCRC. There will be ongoing monthly maintenance fees as well. Frequently, the individual sells their home and uses the proceeds for the contract. The contract must specify the terms and conditions for refunds upon death or departure of the resident.
There can come a time that the resident starts to require hands-on care or is evidencing dementia or behaviors that are noticeable to staff and affecting the resident’s ability to perform his or her Activities of Daily Living (ADL’s). Perhaps these changes are becoming problematic for other residents. Question: Who decides when the individual must move into assisted living (which carries a higher monthly fee), or into the nursing (even higher)? Answer: the CCRC.
The Bill of Rights for Continuing Care Retirement Community Residents in Independent Living Act ( N.J.S.A. 52:27D-360.1 et al.) became effective on May 1, 2014. Under the CCRC regulations issued by the NJ Department of Community Affairs (NJAC 5:19-6.4), the contract must disclose the following, among many other things: a description of the health and financial conditions on which the CCRC can base its decision that the resident must vacate his unit in a designated facility. A resident cannot be dismissed or involuntarily discharged from their unit without “just cause for the removal” under NJAC 5:19-6.5(c). The CCRC must issue a written notice specifying that the decision was made in good faith, that the resident is a danger to himself or others, and that there is no less restrictive alternative in order to reduce the dangerousness of the resident. The notice must also specify the precise reasons for each of these conclusions.
Is there an appeal mechanism? The first line of appeal is to the Director of the CCRC. The CCRC’s decision can then be appealed to the Director of the Division of Community Affairs, and the dissatisfied party can then file a request for administrative Fair hearing at the Office of Administrative Law. Eventually, appeal through the court system is available. The legal issues will include (but not be limited to) proof of the medical condition and needs of the resident as well as proofs concerning whether the CCRC followed the law in its decision-making and Notice processes.
A threatened discharge or a suggested relocation within a CCRC can create panic. Legal advice is available.
Call us for elder care advice concerning CCRCs and related matters … 732-382-6070