Life Plan Communities & CCRCs

Type A (Life Care) contracts provide access to all levels of care — independent living, assisted living, and skilled nursing — at little to no additional cost beyond the standard monthly fee. These contracts typically have the highest entrance fees. Type B (Modified) contracts provide some care at discounted rates, with additional costs for higher care levels. Type C (Fee-for-Service) contracts provide housing and basic services at a lower entrance fee, with care billed at the full market rate when needed. Type A offers the most financial predictability; Type C carries the most exposure to care cost escalation.

It depends entirely on the contract. Some contracts offer 0% refundability — the entrance fee is fully earned upon occupancy. Others offer declining refund schedules (e.g., 2% per month for 50 months until fully earned). Some offer 50%, 90%, or even 100% refundability to heirs or upon departure. The refundability terms are one of the most important financial variables in a CCRC contract and should be reviewed carefully by an attorney and financial advisor before signing.

Request the community's most recent audited financial statements and have them reviewed by an independent financial advisor — not one affiliated with the community. Look at occupancy trends across all care levels, long-term debt levels, reserve fund adequacy, and any history of financial distress or ownership changes. Ask whether the community is accredited by CARF (Commission on Accreditation of Rehabilitation Facilities) or another body. CCRCs have failed financially, and families who paid large entrance fees have lost them — financial due diligence is not optional.

This depends on the contract and the specific community. Some nonprofit CCRCs have benevolence funds for residents who outlive their financial resources; others do not. Some CCRCs accept Medicaid for skilled nursing care once a resident's private funds are depleted; many do not. This is one of the most critical questions to ask — and to get in writing — before signing a CCRC contract. An elder law attorney can help you understand the implications for your specific financial situation.

Have an elder law attorney review the contract in full. Have an independent financial advisor review the community's audited financials. Confirm the contract type (A, B, or C) and exactly what triggers additional charges. Understand the entrance fee refund terms. Ask about the financial distress and ownership history. Verify accreditation status. Talk to current residents and family members of residents in the care center — not just the marketing team. This is likely the largest financial commitment of your life after a home purchase.