CareCheck
What Is a CCRC (Continuing Care Retirement Community)?
Key takeaways
- A CCRC (or Life Plan Community) lets a resident move between independent living, assisted living, and skilled nursing on one campus, under one contract.
- Most CCRCs require a one-time entrance fee — commonly $100,000 to $500,000 or more — plus an ongoing monthly fee.
- The contract type (Type A, B, or C) determines how much future care that entrance fee actually covers — read it as closely as the price.
- Entrance-fee refund terms vary enormously by contract, from 0% to 90% refundable, and often depend on the unit being re-occupied.
A Continuing Care Retirement Community (CCRC) — also called a Life Plan Community — is built around a promise most other senior living options can't make: a resident can move from independent living to assisted living to skilled nursing as their needs change, without leaving the campus. That promise comes with the largest, most complex contract in senior living, often called a life care contract (most precisely describing a Type A agreement, though the term gets used loosely for CCRC contracts generally).
How the three levels work
A resident typically starts in an independent living apartment or cottage, with access to assisted living and a skilled nursing unit on the same campus if their needs increase. The transition is usually triggered by a care assessment, similar to how care levels work in a standalone assisted living community — the difference is the resident doesn't have to find and qualify for a new community under time pressure.
The entrance fee
Most CCRCs require a one-time entrance fee before move-in — commonly $100,000 to $500,000 or more, depending on the community, the unit size, and the contract type — on top of an ongoing monthly fee. The entrance fee is effectively pre-paying for a share of future care and campus access; it is one of the largest single payments most families make in senior living, and its refund terms deserve as much attention as its size.
Type A, B, and C contracts
| Contract type | What it covers | Entrance fee vs. monthly fee |
|---|---|---|
| Type A — "life care" | Bundles future assisted living and nursing care into one predictable fee | Highest entrance fee; monthly fee changes little even if care needs rise |
| Type B — "modified" | Includes a limited amount of future care at a discount; more billed separately beyond that | Mid-range entrance fee; some future cost risk remains |
| Type C — "fee-for-service" | No bundled future care — pays market rate if and when care is needed | Lower entrance fee; most future cost risk stays with the resident |
None of the three is simply "better" — Type A trades a higher upfront cost for predictability; Type C trades a lower upfront cost for exposure to future care costs. The right choice depends on the family's finances and risk tolerance as much as the numbers on the page.
What to check before signing
- Refund percentage and trigger. Is the entrance fee 0%, partially, or up to 90% refundable — to the resident or their estate — and does the refund depend on the unit being re-occupied first?
- What the contract type actually promises. Confirm in writing what happens to the monthly fee if the resident moves to assisted living or skilled nursing under this specific contract.
- The community's financial health. A CCRC's ability to deliver decades of promised future care depends on its own solvency — ask for recent financial statements or an independent rating, not just a sales presentation.
- Monthly fee increases. Same questions as any residency agreement — see rate increases — plus how a level-of-care change affects the monthly fee under this specific contract type.
Questions worth asking in writing
- What percentage of the entrance fee is refundable, to whom, and on what timeline?
- Under this contract type, exactly what happens to our monthly fee if care needs increase?
- Can you share recent financial statements or an independent financial-strength rating for the community?
- What is the actual wait time historically for an entrance-fee refund after a unit is vacated?
Have the actual documents?
CareCheck reads the residency agreement, fee schedule, care assessment, and any written offer as one set — pulling out every fee, linking each to the page it came from, and flagging where the documents disagree.
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