Best 2 Retire

Continuing Care Retirement Communities: Contracts, Fees and Moving to a Higher Level of Care

By Abontu LLC · Last reviewed November 8, 2026 · Editorial policy

A continuing care retirement community (CCRC), now often called a Life Plan Community, puts several levels of living on one campus: usually independent living, assisted living and skilled nursing care, and often memory care. The idea is that if your needs change you can stay in the same community. Whether that is guaranteed, and what it costs, is set by the contract you sign, not by the label on the door. This guide explains the contract types, the money, and what to check. It is general information, not legal or financial advice.

The contract is the key

Three contract types are widely used. The U.S. Department of Health and Human Services described them in a report on CCRCs (1997; the numbers are old but the contract types are still used), and the accrediting group CARF explains them in its consumer guide:

  • Type A (extensive, often called "life care"). Housing, services and a promise of future care, with a monthly fee that is meant to stay about the same if you move to assisted living or nursing care. The upfront and monthly fees are generally the highest of the three because the community takes on the risk of your future care costs.
  • Type B (modified). Housing and services plus a set amount of care. After that allowance is used up, you generally pay a reduced or market rate for care.
  • Type C (fee-for-service). Housing and amenities, with care paid for as you use it at the community's rates. The upfront fee is often lower, and some communities charge none.
  • Rental. Some communities offer month-to-month rental with no entrance fee, with access to care at the community's rates.

Communities do not always use the letters. Some say "Life Care," "LifeCare" or "Life Plan" and describe the terms in their contract and disclosure statement. Read the actual wording.

Contract wording we found on community websites:

CommunityContract wording on its own site
Wake Robin, Shelburne, VermontOffers a Type A life care agreement
Cokesbury Village, Hockessin, Delaware (Acts Retirement-Life Communities)Acts names its contract as Type A life care
Broadmead, Cockeysville, MarylandNames Type A (LifeCare) and Type C (fee-for-service) contracts
Pilgrim Place, Claremont, CaliforniaNames its contract as Type B (modified)

This table is a sample of what we checked, not a list of every community or a recommendation. See examples in every state.

Can I move to a nursing home setting in the same community?

In a CCRC, usually yes, because skilled nursing is on the campus. What differs is the promise and the price. Ask:

  • Is a bed in assisted living or nursing care guaranteed to me, or only available when there is space? Some contracts promise "priority" access, which is not the same as a guarantee.
  • Who decides when I need a higher level of care, and can I appeal?
  • What does my monthly fee become when I move? Is the price the same, discounted, or the community's regular rate?
  • If my spouse needs care and I do not, what happens to each of our fees?
  • What happens if I run out of money through no fault of my own? Does the contract address it?
  • Is the nursing care Medicare-certified? Medicare covers skilled nursing only after a qualifying hospital stay of at least three days and only for a limited period, and it does not pay for long-term custodial care. See Medicare.gov for the current rules and amounts.

Entrance fees and refunds

Many CCRCs charge a one-time entrance fee plus a monthly fee. Refund terms vary a great deal and depend entirely on the contract. The HHS report describes several patterns: a fee that declines over time, a partially refundable fee, and a fully refundable fee (which that report called rare). Some communities now publish options on their own sites. For example:

  • Givens Estates in Asheville, North Carolina lists non-refundable, 50% refundable and 90% refundable entrance-fee options.
  • Piper Shores in Scarborough, Maine says its independent living entrance fee is 90% refundable.

Ask in writing: how much comes back, when, whether it is paid only after your apartment is resold or re-leased, and what happens to a refund if the community changes ownership.

We did not find a current government source for typical entrance or monthly fees, so we do not print averages. The community's fee schedule and, where your state requires one, its disclosure statement are the reliable sources.

States that regulate continuing care communities

There is no federal regulator for CCRCs. Some states regulate them, often through the insurance department, and require financial disclosure. The agencies below publish information about continuing care; this is not a complete list of states that regulate, and several states we could not confirm, so ask any community which agency oversees it.

Accreditation

CARF, a nonprofit accreditor, accredits CCRCs and describes its standards in the consumer guide linked above. Accreditation is voluntary, so a community without it is not necessarily worse, and one with it still needs a close look. CARF has a public provider search.

Before you sign

  • Get the contract and the disclosure statement well before you decide, and have an attorney who works with older adults review them.
  • Ask for the fee history for the past five years, including how often and by how much monthly fees rose.
  • Ask about the community's financial health and who owns and manages it. See large senior living companies.
  • Ask for the latest state inspection reports and see how to check a senior living community.
  • Visit more than once, eat a meal, and talk to residents and staff.

Sources