CCRC Costs and Contracts: What to Know Before You Sign

A continuing care retirement community (CCRC) usually charges an entry fee, typically a large lump sum, plus ongoing monthly fees, and you pay them yourself.1 In exchange you get one promise: move in independent, and stay on one campus as your care needs grow. That promise is real, but it's a financial commitment, not just a housing choice.

This guide breaks down how CCRC costs work: what a CCRC is, how the entry fee and monthly fee work, the three contract types and what each one does to your costs, how refunds work, who regulates these communities, and the financial risks to weigh before signing.

What a CCRC Actually Is

A CCRC bundles three kinds of senior living on one campus: independent living, assisted living, and skilled nursing care.1 You move in while you can still live on your own. As you need more help, you move up the levels without leaving the community.

That's the selling point. Age in place, one address, no scramble to find a nursing home in a crisis. You'll also see these marketed as "Life Plan Communities," but it's the same thing.1

The trade-off is money. The entry fee and monthly fees are private charges, not a benefit any program administers, and GAO found that many residents pay them with the proceeds from selling their homes plus whatever retirement assets they have.1 Insurance isn't shut out on campus: GAO records one CCRC saying it bills Medicare Part A, Medicare Advantage plans, or any other available insurance for a qualified skilled nursing stay before billing the resident.1 But GAO also notes that Medicare and private health insurance typically don't cover long-term care, so you're funding the housing and the care promise yourself.

How CCRC Costs Work: The Entry Fee and Monthly Fee

Most CCRCs charge two things: an entry fee when you move in, and a monthly fee for as long as you live there.1 A rental agreement, which GAO calls Type D, generally skips the entry fee.

The entry fee is typically paid as a large lump sum, and industry participants told GAO it can represent a substantial portion, if not all, of a person's assets.1 Think of it as buying into the community and, under some contracts, pre-funding part of your future care.

The monthly fee covers your housing, services, and some level of care depending on your contract. It can rise over time. How much it rises when your health declines depends mostly on your contract type, but not only on that: GAO reports residents can face bigger-than-expected increases, and a CCRC in financial distress may raise monthly fees beyond the typical yearly increase written into the contract.1

Two numbers, then, decide affordability. The entry fee tests whether you have the assets to get in the door. The monthly fee, and how steeply it climbs as you need more care, tests whether you can stay. A community that looks affordable at move-in can become a strain a decade later if your health changes and your contract makes you pay for the extra care.

For scale on what care alone costs once you need it: the 2025 national median was about $6,200 a month for assisted living and about $315 a day, or about $114,975 a year, for a semi-private nursing home room, per the CareScout 2025 Cost of Care Survey.2 Those are the costs a CCRC contract is, in part, promising to manage for you. The contract type decides whether you pay those rates yourself later or pre-pay for them now.

The Three Contract Types That Set Your CCRC Costs

The contract you sign matters more than almost anything else about the community. CCRC contracts come in three main types, and a community may offer you a choice of them or only one.1 The difference is who absorbs the cost when your care needs grow.

Type A (extensive, or "life care"). Includes unlimited use of health services at little or no increase in your monthly fee as you move to higher levels of care.1 The community, not you, absorbs the risk of rising care costs, which makes it the most predictable of the three. It generally comes with a substantial entrance fee. You're essentially pre-paying for future care, including care you may never use.

Type B (modified). Includes only some health services in the base monthly fee.1 Once your needs go beyond what's bundled, your fees rise to market rates, so you carry the risk of high costs for the care you need.

Type C (fee-for-service). You pay market rates for all health-related services as you need them.1 Entrance and monthly fees may be lower while you're in independent living, but the risk of higher long-term care costs rests with you. If you stay healthy, you save. If you need years of skilled nursing, you pay full freight for it.

The pattern is a straight trade-off. Type A generally costs more up front and moves the care-cost risk to the community; Type C may cost less up front and leaves that risk with you. Neither fixes your costs for good, since fees can still rise more than expected under any contract.1

Those three aren't the only options. GAO also describes Type D rental agreements, which generally require no entrance fee at all, and AARP describes a Type E equity agreement, where you buy a share of your unit instead of paying an entry fee.1

There's no single "best" type. Type A suits someone who wants certainty and can afford the substantial entrance fee. Type C suits someone who's healthy, comfortable with risk, and wants to keep more cash up front.

How Refunds Work

People assume a big entry fee comes with a refund. Sometimes it does. Usually it's conditional, and the conditions matter.

Whether any of your entry fee is refundable depends on the contract: some include a refundable portion, and some may not.1 Ask exactly how your refund is calculated before you sign.

There's an important condition, though: CCRC officials told GAO that refunds were usually contingent on a new resident moving into the vacated unit.1 When occupancy drops, that wait stretches: the same officials said lower occupancy has meant former residents and their families waiting longer for refunds. So even an entry fee advertised as largely refundable may not come back until your unit is re-occupied. Read the refund clause closely, and ask exactly what triggers payment and when.

Who Regulates CCRCs

CCRCs are regulated mainly by states rather than the federal government, and among the states that regulate CCRCs specifically, the agency holding the file varies: some assign it to a department focused on insurance, financial services, or banking, and others to social services, aging or elder services, or community affairs.1 There's no single national agency setting CCRC standards, and no single kind of state agency either, so finding your regulator may take a call or two.

State oversight varies a lot. GAO reported in 2010 that, according to one industry study, 38 states had some level of regulation specifically addressing CCRCs, while 12 states and the District of Columbia did not.1 Because the rules differ by state, your protections as a resident differ by state too. Find out which department regulates CCRCs in your state rather than assuming it is any one agency, then check what that department requires before you commit.

The absence of a single federal regulator doesn't mean CCRCs are unregulated. It means the rulebook you live under is your state's, not Washington's. Ask the community which state agency oversees it, then ask that agency what financial information the community has to disclose to you.

The Financial Risk Behind the Promise

A CCRC is a long-term financial bet on the community's solvency, and if that bet goes bad, secured creditors are ahead of you in line.

If a CCRC is forced into bankruptcy, a resident's claim is subordinate to secured creditors such as bondholders and mortgage lenders.1 That means those creditors get paid before residents do. GAO reports that residents could lose the refundable portion of their entrance fees, which may amount to hundreds of thousands of dollars or more, if a community runs into financial difficulty.

How often that happens is unknown: GAO found no national data on it, and several state officials believed such losses are rare.1 But it does happen. Pennsylvania officials told GAO about an insolvent CCRC whose residents lost the refundable portion of their entrance fees in 2009, when the facility was sold to a new operator.1

So before you hand over a sizable entry fee, do two things. Review the contract line by line, especially the refund and fee-increase clauses. And review the provider's finances, including audited statements and reserve funding, ideally with help from a financial advisor or elder law attorney.

Cautions Before You Sign

A CCRC can be a sound choice. It can also lock up a large share of your savings in a community that may not be as stable as the brochure suggests. Keep these in mind.

• The entry fee is rarely "just" housing. It can take a substantial portion, if not all, of your assets, and many people sell their home to pay it.1
• Monthly fees rise. Your contract type sets most of how much they climb as your health declines, and Type C exposes you most. A CCRC in financial distress may also raise fees beyond the contract's typical yearly increase.1
• "Refundable" can mean "eventually, if your unit re-fills." Confirm the exact trigger and timeline.1
• In bankruptcy you rank behind secured creditors. Bondholders and mortgage lenders are paid before residents, so the community's solvency is your risk to vet.1

AARP likewise says most communities charge an entry fee.1 Go in with your eyes open, the contract in hand, and a professional reviewing the finances.

Learn More

Find personalized help weighing a continuing care retirement community against other senior care options at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.