Tourist card or tourist visa?? That is my question?

It's very hard for me to actually ask this question as my health, background, transportation issues, Disability status, and other factors all play into why I want to "Mostly Retire" in either Punta Cana where I am beginning my 6 month trial stay as suggested in a condo that is perfectly suited for me (unit is ocean view with steps to the beach, huge pool, gated community.

I will go home to the US once during my 6 month stay as a trial to see how this will work as when one has MS (which comes with some other issues that I am going to work hard to avoid), I want to visit my specialist doctors and must keep my health insurance anyway.  Of note, I have checked and because it is a Blue Shield related plan, it comes with international coverage and I have checked to confirm that the preferred provider is a local private hospital (later for those questions).

Oddly, I have found different web sites (some older) that list up to 3 different "tourist card" lengths of stay so I am going to refer to the Embassy of the Dominican Republic in the US (Consular Section) which lists options for tourist cards and tourist visas.. However; as usual, those of you living there, I feel, can help me the most..
As of today, the Consular site states that the tourist card only requires me to have the Passport and valid Driver's license or ID and I can pick it up at the airport... only place they even state that the 'Card" allows only a 30 day stay is under their FAQ section. 

I feel like if I am staying (or renting) for 6 months initially with the intent of signing a monthly payment, yearly lease (even have a few leads already), I should perhaps get a Tourist Visa however the language on the Consular site is so unclear.  I have no problem getting the documents for the Tourist Visa but the lagnuage states that it allows you "ONE entry within 60 days of the application for the Visa.. So if I apply in March 2014, Arrive May 1st, 2014... I read this as if my trial return home for doctor visits will be fine but I can't get back in?  I would love to better understand that.

There is a non-official page that seemingly encourages one that all they have to do is have a "Tourist Card" to stay longer up to 90 days and pay a $22 fee ... But as you, the expat experts have informed, they are cracking down on people overstaying the 30 days. 

I'm curious as to why no website that rents long-term mentions anything about this complexity or has suggestions on what one should do.  I am renting from a couple who has several condos and comes down each winter for 3 months.. I assume they just overstay the "Tourist Card".

The last category I could find is the "Residential Visa"..which would seem to be the way to go long term as long as I get to travel back and forth to the US every 3 months.  I can show that I will be no burden medically, have the funds, etc.  But I wonder what being a resident will effect as far as my US citizenship which I must keep. 

To add one last point of contention...the US State Dept.gov site for the Dominican republic lists clearly that a "Tourist Card" is good for 60 full days?

In summary, based on my need to travel back to the US every 3 or so months, with my trial of doing that starting in May, 2014, what is the best thing for me to do?