A Continuing Care Retirement Community — also called a Life Plan Community — is a senior living campus that offers multiple levels of care in one place: typically independent living, assisted living, memory care, and skilled nursing. Residents can move through levels of care as their needs change without ever leaving their community.
For many seniors and their families, this is the ultimate peace-of-mind solution: you choose once, you stay. No future moves to unfamiliar places when health declines. No separation from friends you’ve made. No scrambling to find placement during a health crisis.
The Levels of Care in a CCRC
| Level | For Whom | What’s Included |
|---|---|---|
| Independent Living | Active, healthy seniors 62+ | Private apartment/cottage; meals, housekeeping, social activities, transportation |
| Assisted Living | Seniors needing help with daily activities | All IL services plus personal care assistance, medication management |
| Memory Care | Residents with dementia or Alzheimer’s | Secured unit; specialized dementia programming; higher staffing ratio |
| Skilled Nursing | Residents needing 24-hour medical care or rehabilitation | Full nursing care, therapies, medical oversight |
The Three Contract Types
CCRCs offer different financial structures, and the contract type dramatically affects both upfront cost and long-term financial protection:
Type A — Life Care (Extensive) Contract
The most comprehensive — and most expensive — option. A large entry fee (often $150,000–$600,000+) buys lifetime access to all levels of care at little to no increase in monthly fees, regardless of how much care you eventually need. Essentially, you’re pre-paying for all future care costs. Best for those who want maximum financial predictability and can afford the upfront cost.
Type B — Modified Contract
Lower entry fee than Type A. Includes some health care services, but care above a set amount is charged at market rates. A middle-ground option between full life care and fee-for-service.
Type C — Fee-for-Service Contract
The lowest entry fee. You pay market rates for care services as you use them. Most affordable entry point, but least financial protection — if significant care is needed, costs can escalate substantially.
Type D — Rental Contract
No large entry fee — you pay monthly rental costs and care fees as needed. Maximum flexibility, no large capital commitment, but no equity or discounted future care.
Financial Due Diligence Before Choosing a CCRC
Because CCRCs involve large financial commitments, financial stability of the community itself matters. Before committing:
- Request the community’s audited financial statements for the past 3 years
- Ask about occupancy rates (below 85% is a concern)
- Check for any regulatory actions or financial difficulties in their history
- Ask whether the community is accredited by CARF (Commission on Accreditation of Rehabilitation Facilities) — a meaningful quality benchmark
- Have an independent financial advisor review the contract, actuarial assumptions, and fee escalation history
Who CCRCs Are Right For
CCRCs are best suited for:
- Seniors who are currently healthy and active but want to plan for the full continuum of care
- Couples with different anticipated care needs who want to stay together
- Seniors who value community, social connection, and amenities alongside care security
- Those with sufficient assets to fund an entry fee and ongoing monthly costs
- People who want to make one housing decision and not face future moves
What CCRCs Are Not Right For
- Seniors who already need significant care — most CCRCs require residents to be relatively healthy at entry
- Those without substantial assets or home equity to fund the entry fee
- Seniors who want to stay in a specific neighborhood or near specific family and the local CCRCs don’t match their preferences
- Those who prefer a smaller, more residential care setting
Is the entry fee for a CCRC refundable?
Refund policies vary by contract and community. Some offer 90–100% refund if you leave within a short window, decreasing to 0% over several years. Others offer a declining balance refund over the life of residency. Still others are entirely non-refundable. Understanding the refund policy is critical — it affects both your estate planning and your family’s financial security if circumstances change.
Does Medicare or Medicaid cover CCRC costs?
Medicare may cover specific services within a CCRC’s skilled nursing facility (under the same rules as any SNF stay — up to 100 days after a qualifying hospital admission). Medicare does not cover independent or assisted living within a CCRC. Medicaid may cover skilled nursing care in a CCRC if the community is Medicaid-certified and the resident meets eligibility requirements — but this varies widely and not all CCRCs accept Medicaid.
What’s the difference between a CCRC and a “Life Plan Community”?
They’re the same thing. The senior living industry has increasingly adopted the term “Life Plan Community” because it focuses on the positive — planning for a full and engaged life — rather than the clinical connotation of “continuing care.” Both terms refer to communities offering the full continuum of care under one roof or campus.
