Continuing Care Retirement Communities (CCRCs) and Lifecare



Continuing Care Retirement Communities (CCRCs) are designed to offer active seniors an independent lifestyle from the privacy of their own home. The community offers them access to coordinated social activities, dining services and health care when and if the course of aging raises the need. It is sometimes referred to as Lifecare because of the opportunity for a continuum of care provided by or within one community.

Continuing Care Retirement Communities (CCRCs)

Residents should expect a CCRC to offer a contract stating that the community will offer a home, social activities, a list of services and amenities, and access to on-site levels of health care. Most CCRCs require a one-time entrance fee which may be called "a purchase price" or "annuity". There will also be a monthly service fees. The continuing care contract should provide residents with long-term security and a life long assurance for care.

A few CCRCs offer continuing care contracts that do not require an entrance fee and offer care assurances only on a month-to-month basis.

One's physical and mental health is often subject to review before a CCRC will approve you for a contract.

There are different types of entrance fee contracts:

  • Extensive Agreement: provides residents with lifetime access to health care without an increase in the monthly service when care is provided. It requires residents to pay a higher fee initially with the assumption that they will utilize an increased level of health care in the future.
  • Modified Agreement: offers the same access to health care, however residents only pay for care as it is needed. The monthly service fee increases as levels of care increase, although residents may receive a discounted rate for the care and a specified number of days of long term nursing care at no additional cost.
  • Fee For Service Agreement: residents may initially pay a lower monthly service fee than with other types of contracts, however residents are responsible for all costs of additional health care if they are needed, without the benefit of resident discounts or any free long term care days.


    Some CCRCs may require residents to purchase long term care insurance as a criteria for acceptance.

    Monthly fees may cover provision of the following:

  • Meals - number per month may very by community
  • Scheduled transportation
  • Housekeeping services
  • Unit maintenance
  • Linen and personal laundry
  • Health monitoring services
  • Some utilities
  • Coordinated social activities
  • Emergency call monitoring
  • Round the clock security
  • Additional services that may be provided in the community
  • Indexing of increases in monthly fees for services and care may be spelled out in the contract.

    Entry fees may be refundable on a sliding scale within a short time after move in. Generally the refund declines to zero after some period of residency.


    You may want to compare fees for services and health care at a CCRC, to fees at Congregate, Assisted Living and Skilled Nursing homes, to see how the the costs match up on fee services. Keep in mind the guarantee of a life-long place to live provided by contract at a CCRC. Congregate, Assisted Living and Skilled Nursing Facilities, make no such guarantees, and may ask you to leave when they are unable to provide the care they deem appropriate for your medical condition.

    CCRCs are highly regulated in some states but no federal agency oversees retirement communities. The Commission on Accreditation of Rehabilitation Facilities, CARF, a private nonprofit organizaiton, accredits these communities. CRAF works with the community, reviewing its finances, governance and administration; resident health and wellness, and resident life. For more information contact the Commission on Accreditation of Rehabilitation Facilities, CARF HERE.