Continuing Care Retirement Community (CCRC) Guide
CCRCs — now often called LifePlan Communities — offer a full care continuum on one campus. Entrance fees range from $50,000 to $800,000+. This guide explains the three contract types, what financial vetting to do, and the questions that protect your family.
What Is a CCRC / LifePlan Community?
The CCRC Promise
A CCRC is a campus with multiple buildings or sections offering independent living, assisted living, memory care, and skilled nursing — all under one contract. Residents enter at the independent living level and are contractually guaranteed access to higher levels of care on the same campus as they age.
Key Numbers
- ~2,000 CCRCs in the US (LeadingAge 2024)
- Average entrance fee: $200,000–$500,000
- Average monthly fee: $3,500–$6,000
- Typical resident age at entry: 74–78
- 90%+ of residents report they'd make the same decision
- Regulated by state insurance or health departments
The Three CCRC Contract Types
The contract type determines what happens when you need a higher level of care — and is the most important financial variable in a CCRC decision.
Type A — Life Care / Extensive
The most comprehensive contract. Residents pay a large entrance fee and predictable monthly fee; in exchange, they can move to assisted living, memory care, or skilled nursing with little or no increase in monthly cost. The CCRC absorbs the actuarial risk of higher-level care.
Entrance fee range
$200,000–$800,000+
Monthly fee range
$3,500–$8,000/mo
Best for
Seniors with substantial assets who want financial certainty for life
Pros
- Predictable lifetime costs
- No surprise rate increases when care level rises
- Best protection against long-term care cost inflation
Cons
- Highest entrance fee
- Entry fee is not fully refundable in many cases
- Requires careful actuarial vetting of the community's financial health
Type B — Modified
Middle ground. The entrance fee is lower, and monthly costs are lower — but if the resident moves to a higher level of care (AL or nursing), the monthly fee increases to market rate. Often includes a set number of days of higher-level care at no extra cost.
Entrance fee range
$100,000–$500,000+
Monthly fee range
$3,000–$6,500/mo
Best for
Seniors who want some financial protection but not at the highest entrance fee
Pros
- Lower entrance fee than Type A
- Some protection against care costs
- Refundable options more common
Cons
- Monthly cost increases at higher care levels
- Less predictable long-term than Type A
Type C — Fee-for-Service
The most flexible and lowest entry cost. Residents pay market rate for each level of care as needed. No pre-paid care guarantee — costs rise substantially if the resident needs assisted living or nursing care.
Entrance fee range
$50,000–$300,000+
Monthly fee range
$2,500–$5,500/mo
Best for
Seniors in good health who want access to the campus but plan to use LTC insurance or Medicaid if needed
Pros
- Lowest entry fee
- Most common — widest availability
- Refundable deposits more standard
Cons
- No cost protection — care costs are market rate
- Long-term costs can be highest if extensive care is needed
Financial Vetting Checklist
CCRC financial failures happen. Over 30 CCRCs have filed for bankruptcy or closed in the past decade, leaving residents without entrance fee refunds and disrupted care. Entrance fees are not FDIC insured. This checklist is non-negotiable before signing.
Request audited financial statements for the last 3 years
Look for operating margins, occupancy trends, and debt levels
Verify Days Cash on Hand (DCOH) is at least 200 days
Under 100 days is a warning sign; over 300 days is financially strong
Check occupancy rate — target 90%+ in independent living
Low occupancy strains the financial model and often precedes fee increases
Ask for the 5-year fee increase history
Increases over 5%/year suggest financial stress or mismanagement
Review the state disclosure document (required in most states)
Includes financial projections, governance, and fee history
Check for bond ratings (Moody's, Fitch) if applicable
Investment-grade ratings (Baa3 / BBB- or higher) indicate lower financial risk
Ask what happens if you outlive your assets — is there a benevolent fund?
Get the policy in writing, including the conditions and history of benevolent fund use
Have an elder law attorney or CCRC specialist review the contract
Contract is often 50–100 pages; hidden clauses affect refundability and care guarantees
CCRC Frequently Asked Questions
What is a CCRC (Continuing Care Retirement Community)?▾
A Continuing Care Retirement Community (CCRC), now often called a LifePlan Community, is a senior living campus that provides multiple levels of care — independent living, assisted living, memory care, and skilled nursing — on a single campus under one contract. Residents typically pay an upfront entrance fee ($50,000–$800,000+) plus a monthly fee, and the contract guarantees access to higher levels of care as needs change. CCRCs are regulated by states and are the most 'all-in-one' senior housing model in the US.
What is the difference between a CCRC and regular assisted living?▾
Standard assisted living serves one level of care — residents who need daily support but don't require skilled nursing. If a resident's needs exceed what the community can provide, they must move. A CCRC eliminates this: residents enter in independent living and have guaranteed access to assisted living, memory care, and skilled nursing on the same campus without moving to a new community. This 'aging in place' model is the CCRC's primary value proposition.
Are CCRC entrance fees refundable?▾
It depends on the contract. Many CCRCs offer declining balance refunds — for example, the entrance fee declines 2% per month over 50 months, after which no refund is due. Some offer 50–90% refundable plans at a higher upfront cost. A few offer 100% refundable options at the highest fee. The refundability of the entrance fee is one of the most important contractual terms — negotiate it and have an elder law attorney review the disclosure documents before signing.
Does Medicare or Medicaid cover CCRC costs?▾
Medicare covers skilled nursing or rehabilitation in a CCRC's skilled nursing wing (up to 100 days after a qualifying hospital stay), just as it would in any SNF. Medicare does not cover independent living, assisted living, or memory care room and board in a CCRC. Medicaid coverage depends on the contract type and state: some CCRCs accept Medicaid for the skilled nursing component once residents have spent down assets; many Type A contracts specifically address what happens to Medicaid-eligible residents. Verify the community's Medicaid policy in writing before signing.
What financial information should I ask for before joining a CCRC?▾
Request and review: (1) Audited financial statements for the past 3 years; (2) Days Cash on Hand (indicator of financial stability — 200+ days is strong); (3) Occupancy rates (85%+ is healthy); (4) Moody's or Fitch bond ratings if the community has issued bonds; (5) The Disclosure Document (required by most states), which includes financial projections, fee history, and board governance; (6) Rate increase history for the past 5 years. Consider hiring a geriatric care manager or CCRC specialist to evaluate the community's financial health — entrance fees are too large to trust brochure language.
What questions should I ask when touring a CCRC?▾
Key questions: (1) What is the policy if I run out of money — is there a benevolent fund and under what terms? (2) How much have monthly fees increased on average per year for the past 5 years? (3) What is the current occupancy rate and waitlist status? (4) How long has the current management company been in place? (5) What percentage of residents who entered independent living have eventually moved to higher levels of care? (6) What happens to the entrance fee if I die in the first year? (7) Can I bring my own physicians and can they continue treating me on campus?
Compare CCRCs and traditional assisted living
Browse assisted living, memory care, and skilled nursing facilities with AllyKin Safety Scores and CMS inspection data — as you weigh CCRC alternatives.
Browse communities directory → →Sources: LeadingAge (2024) · AARP Public Policy Institute · NIC (National Investment Center) · American Seniors Housing Association. Entrance fee and monthly cost ranges are national estimates; actual figures vary significantly by community and contract. This is educational content, not financial or legal advice.