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The CCRC Decision Process - Four Key Aspects

Posted on 
October 27, 2021

Continuing care retirement communities (CCRCs) are a popular retirement living choice among older adults who live independently today but desire to live in a setting whereby long-term care services are available on-site if eventually needed. Choosing the right community is an important, often complex, decision process. If you, a loved one, or possibly a client of yours is considering a CCRC here are four key aspects of the decision process:

Contract Details

Among the approximately 2,000 CCRCs across the United States there are a number of different types of residency contracts available. The vast majority of CCRCs require an entry fee and monthly fees. These fees are impacted by factors such as the size of the home or apartment, location, available services and other amenities. Yet the fees are also based, in part, on what you will pay for assisted living and healthcare services when needed.

Some residency contracts state that your monthly fees will remain relatively level over the course of your lifetime, except for inflationary increases, regardless of whether you are living independently or require care services. Other residency contracts may require a smaller entry fee and possibly even lower monthly fees, but if you ever require care services your monthly fees will increase to reflect the market cost of care at that time. Still yet, there are other contracts that are essentially a blend of these two.

In addition to the types of residency contracts available, many providers also offer refundable entry fee contracts. These contracts essentially pay back some portion of the entry fee if the resident moves out or at death. The tradeoff: entry fees are almost always higher for a refundable entry fee contract.

Financial Stability of CCRC

The financial stability of a CCRC will determine in large part if it can fulfill its long-term commitment to provide housing and health care to residents for life. Do your research to learn about the community’s occupancy ratios and evidence of demand, history of operations, financial ratios, and the experience and expertise of its management. Consult with a financial or tax professional for additional guidance.


To ensure that a CCRC is the last residency decision you make, consider the community’s setting and culture, services and amenities, and mission to ensure these align with your personal preferences. Inquire about staying in the community for a night or two to get a sense of what living there might be like. Try the food and talk to current residents about what they enjoy about living in the community.

Health Care

Although most people are attracted to CCRCs by the independent living features, the ultimate reason for considering this type of retirement community and paying an entry fee is gaining guaranteed access to health care. Here are some key questions to ask:

  • Does the community appear to take pride in the care that makes available to residents?
  • What sets the community’s care facility apart from other providers?
  • If there is a record of complaints against the CCRC, can you review it? If skilled nursing care is offered in a Medicare-certified facility (versus private pay only), consult the CMS star rating on Medicare.gov.
  • Has the healthcare facility received any special awards or special recognition for quality of care?
  • Ask about staff turnover in the health care facility. A high turnover rate may indicate an unhappy staff, which could translate into poor care delivery.
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