CCRC (Continuing Care Retirement Community) selection

A Continuing Care Retirement Community (CCRC), also known as a Life Plan Community, is a senior living option that provides a full continuum of care — from independent living through assisted living, memory care, and skilled nursing — all on one campus. Residents move in while still independent and have guaranteed access to higher levels of care as needs change, without having to relocate.

54 steps across 9 sections

1. Assess Your Readiness

  • Are you willing to sell your current home and relocate?
  • Do you have the financial resources for the entrance fee and monthly costs?
  • Are you attracted to maintenance-free living with built-in social activities?
  • Do you value having guaranteed access to higher levels of care on the same campus?
  • Is your current home becoming difficult to maintain or isolating?
  • Are you ready to make this commitment while still healthy (most CCRCs require health screening)?

2. Understand Contract Types

  • Type A (Life Care/Extensive) Highest entrance fee; predictable monthly costs regardless of care level; includes unlimited nursing care at little or no additional cost
  • Type B (Modified) Moderate entrance fee; includes a set amount of health care services; additional care at discounted rates beyond the included amount
  • Type C (Fee-for-Service) Lower entrance fee; you pay market rates for healthcare services as needed; most financial risk on the resident
  • Rental/Type D No entrance fee; monthly rent with services available at market rates; most flexible but no care guarantee

3. Research Communities in Your Area

  • Use the Eldercare Locator (1-800-677-1116) or eldercare.acl.gov
  • Contact the Commission on Accreditation of Rehabilitation Facilities (CARF) for accredited communities
  • Visit LeadingAge.org for member communities
  • Ask friends, family, and financial advisors for recommendations
  • Attend virtual or in-person information sessions offered by communities

4. Evaluate Financial Stability of the Community

  • Request audited financial statements (communities should willingly share these)
  • Check for CARF accreditation (indicates quality standards and financial health)
  • Review the community's occupancy rate (healthy communities maintain 90%+ occupancy)
  • Ask about reserve funds and how they handle unexpected expenses
  • Inquire about the history of monthly fee increases (typical: 3-5%/year)
  • Check for any outstanding lawsuits, regulatory actions, or financial difficulties

5. Visit and Experience the Community

  • Take a detailed tour of ALL care levels: independent living, assisted living, memory care, and nursing
  • Stay for a meal in the dining room to evaluate food quality and social atmosphere
  • Attend an activity or event to experience the community culture
  • Stay overnight if the community offers trial stays
  • Talk to current residents — ask about their experience, complaints, and what they love
  • Visit at different times of day and days of the week

6. Evaluate Services and Amenities

  • Healthcare On-site clinic, physician visits, pharmacy, rehabilitation services
  • Dining Number of venues, menu variety, special diet accommodations, included meals
  • Activities Fitness centers, pools, classes, clubs, educational programs, arts
  • Personal services Housekeeping, laundry, maintenance, transportation
  • Outdoor spaces Walking paths, gardens, grounds maintenance
  • Location Proximity to hospitals, shopping, family, cultural activities, and public transit
  • Technology Wi-Fi, emergency call systems, telehealth capabilities

7. Review the Contract Thoroughly

  • Have an elder law attorney review the contract before signing
  • Understand the entrance fee structure:
  • Is any portion refundable? Under what conditions? (0%, 50%, 90% refundable options)
  • What happens if you leave or pass away within 1, 5, or 10 years?
  • Is the entrance fee amortized over time?
  • Clarify monthly fee details: what is included, what costs extra, how increases are determined
  • Understand the healthcare guarantee: how is the transition to higher care levels handled?
  • Review the discharge/transfer policy: under what circumstances can the community ask you to leave?
  • Check for arbitration clauses and resident rights protections

8. Plan the Financial Strategy

  • Determine how to fund the entrance fee (home sale, savings, bridge loan)
  • Calculate ongoing monthly costs against income and assets
  • Understand tax implications: a portion of CCRC fees may be deductible as medical expenses
  • Evaluate long-term care insurance coverage and how it applies to CCRC costs
  • Project total costs over 10, 15, and 20+ years under each contract type
  • Consider the opportunity cost of the entrance fee versus investing that money

9. Make Your Decision

  • Compare at least 3 communities using a standardized evaluation checklist
  • Weight financial stability and care quality above amenities
  • Consider the culture and social fit — you will be part of this community for years
  • Get on waiting lists early if interested (popular communities have 1-3 year waits)
  • Make the decision with your spouse/family and advisors

Common Mistakes

  • Choosing based on amenities over financial stability
  • Not having an attorney review the contract
  • Ignoring refund policies
  • Not talking to current residents
  • Waiting too long to apply

Pro Tips

  • CARF-accredited communities must meet rigorous financial and quality standard...
  • Ask for the community's "benevolent care" or "financial assistance" policy — ...
  • Request the community's most recent actuarial study or financial audit
  • Type A (Life Care) contracts offer the most predictable costs but highest ent...
  • The tax deduction for medical expenses at a CCRC can be substantial — ask the...

Sources

Related Checklists