Life Plan Communities vs. Standalone Assisted Living

What is a Life Plan community and how is it different?

A Life Plan community, also called a continuing care retirement community, combines independent living, assisted living and nursing care on one campus under a long-term contract. A standalone assisted living facility offers only assisted living, usually with a month-to-month agreement and no promise of other care levels.

The pitch is simple: move in while you are healthy, and the campus manages your future care. In Hampton Roads, with a large retiree and Navy-connected population, many people consider this around the time they sell a house. Whether it suits you depends on the contract, not the brochure.

How do entry fees and monthly fees work?

Most Life Plan communities charge a one-time entry fee, often large, plus a monthly fee. The entry fee may be partly refundable, declining over time or non-refundable depending on the contract. Standalone assisted living typically charges a monthly rate and a move-in fee, with no large entry payment.

We do not print entry fee figures because they vary by community and contract and none is in the facts we trust. Ask for the full fee schedule in writing, including how the monthly fee changes when you move up a level of care and whether the entry fee shrinks over time. A fee that looks like an investment can behave like a prepaid service.

Ask what happens to the entry fee if you leave in the first year, and what happens to it when you die. Heirs are sometimes surprised to learn how little comes back, and a surviving spouse may be asked to pay a different monthly fee.

What kinds of contracts do Life Plan communities offer?

Contracts differ mainly in how they price future care. Some include a set amount of nursing or assisted living care at roughly the independent living monthly fee, some discount it, and some charge market rates when you move to higher care. The more care that is prepaid, the higher the entry fee tends to be.

Read what happens if your funds run out. Some communities keep a resident who becomes unable to pay; others do not. Have a lawyer who handles elder law read the contract before you sign. Ask whether the community is financially audited and how reserves are held.

Is access to assisted living or nursing care actually guaranteed?

Guaranteed access depends on the contract, not on the campus. Some contracts guarantee a bed in assisted living or nursing care when needed; others only give residents priority, and a bed may not be available the day you need it. Ask for the exact wording and how often residents have waited.

Assisted living on the campus must still follow Virginia rules. A Virginia Department of Social Services (VDSS) licensed assisted living facility cannot keep a resident who needs a ventilator or continuous licensed nursing care, so a resident may move to the nursing wing, which is licensed by the Virginia Department of Health. See admission limits for what triggers a move.

Who is better off with a standalone assisted living facility?

Standalone assisted living suits people who need help now, do not want to commit a large entry fee, or want a smaller, more flexible setting. It is also easier to leave: you give notice and move. Families who are paying from monthly income or a home sale often prefer that flexibility.

It also fits couples where one spouse has high needs today. A Life Plan campus may require both partners to qualify medically for entry. The tradeoff is risk: if care needs grow past the assisted living license, you may have to move to a nursing home somewhere else, so ask the community which nearby nursing homes it works with and how it handles transfers. See assisted living vs. nursing home.

How should you compare two campuses before you commit?

Compare the contract first, then the care. Ask for the fee schedule, refund terms, what happens when money runs out, and a list of services that are prepaid. Then compare the Virginia inspection record for the assisted living and nursing wings, which appears in the VDSS search and on federal Care Compare.

Also read the emergency plan; low-lying Hampton Roads campuses have to deal with tidal flooding and storm evacuation for residents at every level. Visit twice, once at a meal. We are paid by communities when a referred family moves in, so press us on any recommendation and check our answers against the state record. Start with the assisted living directory.