Continuing care retirement communities (CCRCs) combine residential accommodations with health services for older adults. As a senior’s health status changes, CCRCs provide a continuum of care, from independent living to assisted living to skilled nursing care.

This means individuals don’t need to move out of the retirement community as their needs increase. Couples can remain near each other if one becomes ill and requires more care than the other, and residents can create meaningful bonds over time.

CCRCs offer various rooms and apartments in a campus-like or urban high-rise setting for independent or assisted living and a separate wing for short-term or long-term skilled nursing care. Applicants must meet admission criteria. This guide explores continuing care retirement communities in depth, including how they work, how much they cost and how to find a local community.

Retirement communities have admission criteria that normally specify a minimum age and level of health for incoming residents. To comply with legal provisions in the Housing for Older Persons Act of 1995, the youngest age at which someone can move into a CCRC stands at 62, although communities may also set older minimum ages.

Although people sometimes refer to continuing care retirement communities as life care communities, they differ. Life care is a subset of continuing care available through one of three types of continuing care contracts offered at a continuing care retirement community.

In general, CCRCs offer three types of contracts:

• Type A contracts provide extensive or full life care service.
• Type B contracts provide modified or continuing care service.
• Type C contracts are fee-for-service arrangements that provide continuing care service.

Type A contracts provide the most comprehensive support, including residential services, amenities and long-term nursing care without an increase in monthly fees. Type B and C contracts cover residential services and amenities but limit nursing care, often requiring extra fees.

Life care communities are CCRCs operating under Type A contracts but with one distinct difference. Like standard CCRCs, a life care community offers a continuum of care to a resident for life. However, if residents become financially unable to pay their monthly care fees, the community subsidizes their costs. Residents continue to receive the same access to services with no interruption in care or change in priority status, regardless of their personal financial situation.

Whether a continuing care retirement community is strictly a life care community or offers all three contract types, most communities have independent living housing, assisted living housing and a skilled nursing facility to provide three distinct levels of care.

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Most CCRCs provide 24/7 security service and an emergency call system to all residents. Many also offer diverse amenities and services. Monthly fees cover most services for contract types A and B. However, those with type C contracts may have additional fees for certain services.

Under typical type A or B continuing care contracts, basic services generally include:

• Three meals daily
• Weekly housekeeping
• Laundered linens and towels
• Banking and postal services
• On-site social, recreational and educational activities
• Scheduled transportation and outings

Contracts may also include health care services, such as:

• Access to an on-site doctor by appointment
• House calls during an illness
• Meal delivery during an illness
• Daily van service to an off-site hospital
• The option to retain services under a separate medical plan, with certain provisions

Many CCRCs have diverse amenities, such as:

• Fitness center
• Salon
• Arts and crafts room
• Convenience store
• Movie theater
• Library
• Dog park
• Garden
• Golf course
• Tennis court
• Swimming pool

CCRCs may suit older adults who value security. No matter how your loved one’s health changes, their needs will be met and they’ll never have to move. Residents also benefit from social connections and recreational activities.

On the other hand, joining a continuing care retirement community requires residents to hand over a large chunk of their assets to secure a spot. Furthermore, CCRC administrators play a significant role in deciding when your loved one needs to move from one level of care to the next, which can remove independent decision-making.  

For further information, see our article, Who Should Consider a CCRC?

Even if your loved one isn’t ready to move out of their home, finding what’s available locally will still help them prepare for a future move. Because most seniors relocate to a continuing care retirement community while still relatively independent, planning is essential. While helping your loved one with their continuing care decision, consider the following signs that it may be time to start looking for a CCRC:    

• Increasing Difficulties with Chores: If you or a loved one find daily chores and maintenance more of a struggle, settling into a continuing care retirement community early allows you or your loved one to enjoy the independent living aspects before requiring greater day-to-day support.  
• Loneliness: Social isolation and loneliness impact long-term health. CCRC residents have a private living space alongside communal amenities, leisure activities and opportunities to meet new people.
• Desire for Stability: Choosing a CCRC makes it less likely that you or your loved one will need to move following a change in care needs. This offers stability and familiarity.  
• Safety Concerns: CCRCs provide regular safety checks, and residents can call for help 24/7 with an easily accessible emergency call system. On-site support staff enhance reassurance for seniors and their loved ones.

Remember: Many CCRCs have long waitlists. Individuals should expect to wait between six months and two years for sought-after CCRCs. However, this gives plenty of time to prepare for a move, including downsizing.

These tips can help you identify the most appropriate continuing care retirement community for you or your loved one:

• Enter your zip code into our Continuing Care Retirement Directory on this page or search by state or popular city.
• Compare ratings and read reviews.
• Schedule community tours.
• Apply for waiting lists.

Although continuing care retirement communities often cost more than other care settings, they provide a stable environment and continuity of care as seniors’ needs change. This brings peace of mind to many older adults planning their future long-term care needs. Individuals should carefully consider contract types, inclusive services and funding options when deciding whether a CCRC offers the best fit for their future.