Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-10T05:17:02.711Z Has data issue: false hasContentIssue false
  • English
  • Français

Continuing Care Retirement Communities — Attractive to Members, But What About Sponsors?

Published online by Cambridge University Press:  10 June 2011

R.A. Humble  and
D.G. Ryan
R.A. Humble
Affiliation:
Watson Wyatt Partners, Watson House, London Road, Reigate, Surrey, RH2 9PQ U.K. Tel: +44 (0)1737 241144; Fax: +44 (0)1737 241496
Get access Rights & Permissions [Opens in a new window]

Abstract

This paper is concerned with the development and operation of Continuing Care Retirement Communities (CCRCs). The paper examines the financial structure of a CCRC, being developed by the Joseph Rowntree Housing Trust, and describes a population model utilising transition probabilities to project care needs and financial performance.

The paper then explores the possibility of commercial organisations becoming involved in this market, and examines the risks that such a venture would entail and the strategies that may be adopted to reduce these risks.

Keywords

Continuing Care Retirement CommunitiesTransition ProbabilitiesActivities of Daily Living
Type
Sessional meetings: papers and abstracts of discussions
Information
British Actuarial Journal , Volume 4 , Issue 3 , 01 August 1998 , pp. 547 - 614
Copyright
Copyright © Institute and Faculty of Actuaries 1998

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

American Association of Homes for the Ageing (1985). Continuing care issues for non-profit providers.Google Scholar
American Hospital Association (1993). American Hospital Association, hospital statistics. 1994- 1995 edition. Data compiled from the American Hospital Association 1993 annual survey of hospitals.Google Scholar
Booth, T., Phillips, D., Barritt, A., Berry, S., Martin, D.N. & Melotte, C. (1983). Pattern of mortality in homes for the elderly. Age and Ageing, 12, 240–244.CrossRefGoogle ScholarPubMed
Brace, G.L. (1994). Continuing care retirement communities: a primer. Health Section News, February 1994, 4–6.Google Scholar
Branch, L.G. (1987). Continuing care retirement communities: self-insuring for long-term care. The Gerontologist, 27:1, 4–8.CrossRefGoogle ScholarPubMed
Brower, H.T. (1994). Policy implications for life care environments. Journal of Gerontological Nursing, May 1994, 17–22.CrossRefGoogle ScholarPubMed
Campbell, J., Diep, C., Reinken, J. & McCosh, L. (1985). Factors predicting mortality in a total population sample of the elderly. Journal of Epidemiology and Community Health, 39, 337–342.CrossRefGoogle Scholar
Cohen, M.A., Tell, E.J., Batten, H.L. & Larson, M.J. (1988a). Attitudes toward joining continuing care retirement communities. The Gerontologist, 28:5, 637–643.CrossRefGoogle ScholarPubMed
Cohen, M.A., Tell, H.J. & Wallack, S.S. (1988b). The risk factors of nursing home entry among residents of six continuing care retirement communities. Journal of Gerontology: Social Sciences, 43:1, S15–S21.CrossRefGoogle ScholarPubMed
Cohen, M.A., Tell, E.J., Bishop, C.E., Wallack, S.S. & Branch, L.G. (1989). Patterns of nursing home use in a prepaid managed care system: the continuing care retirement community. The Gerontologist, 29:1, 74–80.CrossRefGoogle Scholar
Cohen, M.A., Kumar, N., Mcguire, T. & Wallack, S.S. (1992). Financing long-term care: a practical mix of public and private. Journal of Health Politics, Policy and Law, 17:3, 403–423.Google ScholarPubMed
Cohen, M.A., Kumar, N. & Wallack, S.S. (1993). New perspectives in the affordability of long-term care insurance and potential market size. The Gerontologist, 33:1, 105–113.CrossRefGoogle ScholarPubMed
Committee on Continuing Care Retirement Communities (1994). Practices relating to continuing care retirement communities. Actuarial Standard of Practice, No. 3. American Academy of Actuaries.Google Scholar
Conover, C.J. & Sloan, F.A. (1995). Bankruptcy risk and state regulation of continuing care retirement communities. Inquiry, 32, 444–456.Google ScholarPubMed
Corder, L.S., Woodbury, M.A. & Manton, K.G. (1996). Proxy response patterns among the aged: effects on estimates of health status and medical care utilization from the 1982–1984 long-term care surveys. Journal of Clinical Epidemiology, 49:2, 173–182.CrossRefGoogle ScholarPubMed
Cumming, R.B. & Bluhm, W.F. (1992). CCRC population and financial model. The Actuary, March 1992.Google Scholar
Department of Health and Office of Population Censuses (1995). The Government's expenditure plans, 1995–96 and 1997–98. London: HMSO.Google Scholar
Donaldson, L.J., Clayton, D.G. & Clarke, M. (1980). The elderly in residential care: mortality in relation to functional capacity. Journal of Epidemiology and Community Health, 34, 96–101.CrossRefGoogle ScholarPubMed
Falconer, J., Naughton, B.J., Hughes, S.L., Chang, R.W., Singer, R.H. & Sinacore, J.M. (1992). Self-reported functional status predicts change in level of care in independent living residents of a continuing care retirement community. Journal of American Gerontological Society, 40, 255–258.CrossRefGoogle ScholarPubMed
Government Actuary (1996). National population projections ( 1994-bused). Prepared in consultation with the Registrars General. London: HMSO.Google Scholar
Government Statistical Service (1995). Hospital episode statistics, Volume I. Finished consultant episodes by diagnosis, operation and specialty. England: Financial year 1991–1994. London: HMSO.Google Scholar
Guralnik, J.M., Lacroix, A.Z., Branch, L.G., Kasl, S.V. & Wallace, R.B. (1991). Morbidity and disability in older persons in the years prior to death. American Journal of Public Health, 81:4, 443–447.CrossRefGoogle ScholarPubMed
Jones, B.L. (1995). Analysis of CCRC data. Department of' Statistics and Actuarial Science, University of Iowa.Google Scholar
Jones, B.L. (1997). Stochastic models for continuous care retirement communities. North American Actuarial Journal, 1:1, 50–73.CrossRefGoogle Scholar
Katz, S. & Akpom, C.A. (1976). A measure of primary sociobiological functions. International Journal of Health Services, 6:3, 493–508.CrossRefGoogle ScholarPubMed
Kumar, N., Cohen, M.A., Bishop, C.E. & Wallack, S.S. (1995). Understanding the factors behind the decision to purchase varying coverage amounts of long-term care insurance. HSR: Health Service Research, 29:6, 653–678.Google ScholarPubMed
Kunin, C.M., Douthitt, S., Dancing, J., Anderson, J. & Moeschberger, M. (1992). The association between the use of urinary catheters and morbidity and mortality. American Journal of Epidemiology, 135:3, 291–301.Google ScholarPubMed
Manton, K.G. (1988). A longitudinal study of functional change and mortality in the United States. Journal of Gerontology: Social Sciences, 43:5, S153–S161.CrossRefGoogle ScholarPubMed
Manton, K.G., Cornelius, E.S. & Woodbury, M.A. (1995a). Nursing home residents: a multivariate analysis of their medical, behavioural, psychosocial & service use characteristics. Journal of Gerontology: Medical Sciences, 50A:5, M242–M251.Google Scholar
Manton, K.G., Stallard, E. & Corder, L. (1995b). Changes in morbidity and chronic disability in the U.S. elderly population: evidence from the 1982, 1984 and 1989 national long term care surveys. Journal of Gerontology: Social Sciences, 50B:4, S194–S204.CrossRefGoogle Scholar
Manton, K.G. & Vaupel, J.W. (1995c). Survival after the age of 80 in the United States, Sweden, France, England and Japan. The New England Journal of Medicine, 333:18, 1232–1235.CrossRefGoogle ScholarPubMed
Manton, K.G., Woodbury, M.A. & Stallard, E. (1995d). Sex differences in human mortality and ageing at late ages: the effect of mortality selection and state dynamics. The Gerontologisl, 35:5, 597–608.CrossRefGoogle ScholarPubMed
Manton, K.G. & Stallard, E. (1996). Longevity in the United States: age and sex-specific evidence on life span limits from mortality patterns 1960–1990. Journal of Gerontology: Biological Sciences, 51A:5, B362-B375.Google Scholar
Manton, K.G., Corder, L. & Stallard, E. (1997a). Chronic disability trends in elderly United States populations: 1982–1984. Proc. Nati. Acad. Sci. U.S.A., 94, 2593–2598.CrossRefGoogle Scholar
Manton, K.G., Stallard, E. & Corder, L. (1997b). Changes in the age dependence of mortality and disability: cohort and other determinants. Demography, 34:1, 135–157.CrossRefGoogle ScholarPubMed
Nuttall, S.R., Blackwood, R.J.L., Bussell, B.M.H., Cliff, J.P., Cornall, M.J., Cowley, A., Gatenby, P.L. & Webber, J.M. (1994). Financing long-term care in Britain. J.I.A., 121, 1–53.Google Scholar
Office of Population Censuses & Surveys (1988). The prevalence of disability among adults. OPCS surveys of disability on Great Britain, Report I. London: HMSO.Google Scholar
Office of Population Censuses & Surveys (1993). 1991 Census of Great Britain, persons aged 60 and over. London: HMSO.Google Scholar
Powell, A.V. (1994). Report on actuarial study and cash flow projection for Kendal at Ithaca. Prepared as part of submission of a Certificate of Authority Application to the State of New York.Google Scholar
Rodermund, M. (1990). Letter from Medford: security in a CCRC. Contingencies, September/October 1990, 41–45.Google Scholar
Ruchlin, H.S. (1988). Continuing care retirement communities: an analysis of financial viability and health care coverage. The Geronwlogist. 28:2, 156–162.CrossRefGoogle ScholarPubMed
Sloan, F.A., Shayne, M.W. & Conover, C.J. (1995). Continuing care retirement communities: prospects for reducing institutional long-term care. Journal of Health Politics, Policy and Law, 20:1, 75–98.Google ScholarPubMed
Somers, A.R. (1993). ‘Life care’: a viable option for long-term care for the elderly. Journal of American Gerontological Society, 41, 188–191.CrossRefGoogle Scholar
Webber, J. (1989) Financing healthcare for the elderly. Paper published by the Staple Inn Actuarial SocietyGoogle Scholar
Winklevoss, H.E. & Powell, A.V. (1984). Continuing care retirement communities: an empirical, financial and legal analysis. Homewood: IllinoisGoogle Scholar