Questions to Ask a CCRC (Continuing Care Retirement Community)
A continuing care retirement community (many now call themselves life plan communities) takes a large entrance fee in return for a home now and care later, so these questions are for the person or couple weighing that trade, and for the son or daughter sitting in on the sales meeting. They are grouped the way the paperwork is: the contract, the entrance fee and its refund, the monthly fee, the community's finances, the move to assisted living or nursing care, and the terms for getting in and for leaving. The rules on these contracts change from one state or country to the next, so where a note mentions one, ask how it works at the community you are visiting.
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The questions
Each question, and why to ask it
Contract
Which contract types do you offer (life care, modified, fee-for-service), and which do most people moving in now choose?
Why ask it
These are often labeled Type A, B and C, but communities use the labels loosely, so ask what each one means here in dollars. The underlying trade is to pay more now for care at a predictable price later, or to pay less now and carry the cost of care when it comes. If only one type is sold, ask why, and whether it was always that way.
Under each contract, what would my monthly fee be in assisted living and in skilled nursing, next to what I pay in independent living?
Why ask it
Ask for this as a table at today's rates, for one person and for a couple, because it is the whole difference between the contracts. A life care contract usually keeps the fee near the independent living rate and fee-for-service usually moves it to the going daily rate, but the exceptions are in the wording. A sales office that cannot produce the table is not ready to sell you a contract.
If the contract includes a number of care days or a discount on care, how many days or what percentage, and what do I pay once that runs out?
Why ask it
This is the modified contract, and the limit is where one community differs most from the next. Find out whether the days are a lifetime allowance or renew each year, whether a couple shares one allowance, and whether the rate afterwards is the full market rate or a reduced one.
What do I actually hold when I sign: ownership of the home, a lease, or a contractual right to live here and receive care?
Why ask it
Most often it is a contractual right and not property, though some communities are organized as cooperatives or condominiums. The answer decides what can pass to your heirs and what you hold if the community changes hands, so write down the exact term the contract uses and ask a lawyer what it means where you live.
Which services are written into the contract, and which appear only in the brochure or the resident handbook?
Why ask it
Anything that lives only in marketing material, such as the number of meals, weekly housekeeping or the shuttle, can be trimmed or charged for later. Ask which document wins if the two disagree and whether the handbook can be rewritten without residents agreeing to it.
Given our ages, our health and the long-term care insurance we hold, which contract would you steer us toward, and why?
Why ask it
The answer shows whether the salesperson has listened or sells the most expensive option to everyone. A long-term care policy and a life care contract can cover the same risk twice, so ask how the policy's benefits would be used under each contract type. Then put the same question to an adviser who is not paid by the community.
Can the community change the terms of a contract after it is signed, and has it done so for residents who are already here?
Why ask it
Look for a clause that lets management amend fees, services or rules on notice. Then press for a real instance, such as a care benefit that was cut back or a refund schedule that was rewritten, and whether people who had already signed kept their old terms. Long-time residents can tell you whether the answer you were given is how it went.
May I take home a blank copy of every contract you offer, the fee schedule and the resident handbook before I put any money down?
Why ask it
A continuing care contract is long and can commit a large share of a household's savings, so nobody should sign one that was read only in a sales office. Take the papers to a lawyer who has reviewed these contracts before and to whoever does your taxes. Reluctance to hand over a blank copy deserves more attention than any answer on this list.
Entrance fee
What is the entrance fee for the apartment or cottage we are considering, and how much is added for a second person?
Why ask it
Get the figure for a specific home, not the 'from' price on the website, since the fee usually varies with size, view and refund plan. The second-person fee matters to a couple twice: at move-in, and again in what is refunded when the first of you dies or moves out.
What refund plans do you offer, and what does each one cost in a higher entrance fee or a higher monthly fee?
Why ask it
Common versions are a refund that shrinks month by month to nothing over a few years, and a fixed share, such as half or most of the fee, that is returned whenever you leave. Have the same apartment priced under each plan. The choice is really about whether the money is for you or for your heirs, so settle that at home before you compare.
When is a refund paid: within a set number of days, or only once the home has been taken by a new resident?
Why ask it
A refund tied to resale has no date on it, and in a slow market an estate can wait a long time. The clause to look for is an outside limit: payment after a fixed period whether or not the home is reoccupied. Some places set a legal deadline as well, so find out what applies here.
How many refunds are owed to former residents or their estates right now, and how long did the last few take to pay?
Why ask it
The contract tells you what is promised and this tells you what happens. A marketing director may not know offhand, so ask for the answer in writing from the finance office. A long line of unpaid refunds also says that apartments are slow to resell.
Is the refund a share of what I paid, or a share of what the next resident pays for the same home?
Why ask it
After fifteen years of price changes the two figures can be far apart, in either direction. If the refund follows the next resident's fee, ask what happens when the home is resold at a discount or stands empty for a year.
Can the refundable part be drawn on to pay for my care or for unpaid monthly fees, and is anything else deducted before it is returned?
Why ask it
Some contracts let the community set arrears, care charges or the cost of refurbishing the apartment against the refund. The list of permitted deductions, with a worked example in real figures, shows what would be left. Heirs who are expecting a set sum should hear about this clause from you, not find it later.
What happens to the entrance fee once you receive it: is any of it held in escrow or reserve, and what is the rest spent on?
Why ask it
Entrance fees commonly go toward debt, building work and paying out earlier residents' refunds, which is normal but means your own refund leans on future sales. Ask whether any rule here requires a portion to be held back, and for how long. The disclosure statement should say the same thing the salesperson does.
What do I pay at each step, from the waiting-list deposit to the balance, and what comes back if I change my mind before moving in or soon after?
Why ask it
Get the dates and amounts on one sheet. Many places have a cooling-off period after signing and some contracts add a trial period after move-in, but the length and the deductions vary, so get the figures for this community. The awkward follow-up is what happens if illness or death comes between signing and move-in day.
If we want a smaller or larger home on campus later, what happens to the entrance fee we already paid and to its refund terms?
Why ask it
People often downsize after a spouse dies, and a contract can treat that as a new purchase at current prices, as a simple transfer, or as something management settles case by case. Find out whether the difference comes back when you move to a cheaper home, and whether your original refund plan carries over or is swapped for whatever is being sold that year.
Is any part of the entrance fee or monthly fee treated as a prepaid medical expense, and do residents get a letter each year stating the amount?
Why ask it
Communities that sell life care contracts often calculate the share of fees that goes toward future health care. Whether that helps you depends on the tax rules where you live and on your own return, so take last year's percentage to a tax preparer and do not rely on the sales office's summary.
Monthly fee
What does the monthly fee cover in independent living, and what did a typical resident's statement come to last month once the extras were added?
Why ask it
The usual extras are additional meals, guest meals, a second parking space, television packages and any help in the apartment. A statement with the name removed shows the true monthly cost better than the fee sheet does. Ask for one from a single resident and one from a couple.
By how much has the monthly fee gone up in each of the past ten years?
Why ask it
A year-by-year list shows the one large jump that an average smooths away, so ask what happened in any year that stands out. Then raise today's fee by the same rate for twenty years and set the result beside the income you expect to have by then.
Is there any limit on fee increases in the contract, and who makes the decision each year?
Why ask it
Most contracts allow whatever increase the board or owner judges necessary, so a cap or a link to an index is unusual and worth having in writing. Find out how much notice residents get and whether the letter explains the reasons. 'We keep increases modest' describes a habit, and a habit is not a term of the contract.
Do residents see the budget before the increase is set, and does a resident sit on the board or on a finance committee?
Why ask it
When a residents' finance committee reads the budget, someone outside management is checking the numbers on your behalf. Ask how its members are chosen and whether you could speak to one. If the law where the community is gives residents a right to financial information, ask what it covers.
What happens to the monthly fee when one of us moves permanently to assisted living or nursing care, and when one of us dies?
Why ask it
For a couple this is the scenario to price. You may pay the apartment fee for one plus a care fee for the other, or a single combined fee, and the second-person fee may or may not drop away. Have both cases worked through with today's figures.
Have residents ever been billed a special assessment, or had a service taken out of the monthly fee and charged separately?
Why ask it
Fee increases are not the only way costs reach residents. A meal plan cut from thirty meals to twenty, or a new charge for something that used to be included, is an increase by another name. Ask what changed, in which year, and how residents were told.
Is any part of the monthly fee credited back when I am traveling or in the hospital for weeks at a time?
Why ask it
Where a credit exists it is often for missed meals only, and only after a set number of days away, on the reasoning that the apartment and the staff cost the same whether you are home or not. Anyone who winters elsewhere should get the rule in writing and price a year with three months gone.
Finances
What share of the homes is occupied today in independent living, assisted living and skilled nursing, and how has that moved over the past five years?
Why ask it
Independent living is the figure to watch, because new residents' entrance fees are a large part of the money most communities run on, refunds included. Ask for the numbers by year so that you can see the direction. Falling occupancy alongside rising fees is the combination to press on.
May I have the audited financial statements for the last three years and the current disclosure statement?
Why ask it
In many places a community must give a disclosure statement to anyone considering a contract, so ask whether that applies here and how recent the copy is. You do not have to read the accounts yourself. An accountant can tell you fairly quickly whether the community spends more than it takes in and whether the auditor raised any doubts.
Who owns the community, is it nonprofit or for-profit, and is it a single campus or part of a larger organization?
Why ask it
Neither form is safer in itself, so the follow-up is who stands behind the promises in your contract. With a group, ask whether the parent is legally obliged to support this campus or only shares its name. Ask too whether the owner or the management company has changed in recent years, and what was different for residents afterwards.
How much debt does the community carry, and has it ever missed a payment, broken a loan condition or had to restructure?
Why ask it
Most communities borrow to build, so debt alone is not a warning. A restructuring or a waiver from the lenders is one, and it should appear in the notes to the financial statements. If bonds were sold to the public, there may be a rating report or investor filings you can read at no cost.
How much cash and investments does the community hold in reserve, and has an actuary checked that the fees coming in will cover the care you have promised?
Why ask it
Reserves expressed as days of operating costs let you set one community beside another. An actuarial study matters most where life care contracts are sold, because the community is in effect insuring its residents against the cost of care. If there is a study, ask what it concluded and when it was last done.
Which agency oversees continuing care communities here, and what do you have to file with it?
Why ask it
Oversight differs a great deal from place to place: some regulators license these contracts and examine the finances, and others do very little. Write down the agency's name and look at what it publishes, including complaints and any enforcement action. The nursing wing is usually inspected by a different body from the one that looks at the contracts, so ask about both.
If the community were sold, or could not pay its debts, what would happen to my contract and my refund?
Why ask it
Nobody enjoys answering this, which is why it is useful. Ask where residents' refund claims would rank against the lenders, and whether any reserve, bond or guarantee fund protects them here. Of everything on the page, this is the answer most worth taking to a lawyer along with the contract.
What building work, expansion or major repairs are planned over the next ten years, and how will they be paid for?
Why ask it
A new wing can mean years of construction outside your window and new borrowing that fees have to service. An older campus with nothing planned is not better: ask to see the capital plan for roofs, elevators and plumbing. Either way the cost reaches residents in the end.
Is the community accredited or rated by any outside body, and has that status ever lapsed or been downgraded?
Why ask it
Accreditation is voluntary and a credit rating exists only where debt was issued, so the absence of either proves nothing. Where one exists, ask for the latest report and read what it criticizes. A change for the worse in the last few years needs an explanation.
Moving to care
Who decides when a resident has to move from independent living to assisted living or nursing care, and how much say do the resident, the family and their own doctor have?
Why ask it
Contracts often leave the final say with the community's medical director or a committee. The detail that matters is how a disagreement is handled: whether you can bring an outside opinion, and what happened the last time a resident objected. The way that story is told shows how it would feel to be on the other side of it.
Can I pay for home care or a private aide so that I can stay in my apartment longer, and are there limits or fees?
Why ask it
Some communities welcome private aides, some require you to use their own agency, and some set a point beyond which a move is required regardless. If you hold a life care contract, check whether paying for help in the apartment means paying a second time for care the entrance fee already funded.
Does the contract promise me a place in assisted living, memory care and skilled nursing on this campus, and what happens if all of them are full on the day I need one?
Why ask it
'Priority access' is not a guarantee. The numbers to get are how many contract holders were placed off campus in the past year, for how long, and who paid the difference between the outside facility's rate and the contract rate. Have the clause pointed out to you, since this promise is what the entrance fee is paying for.
How many care beds are there for the number of people in independent living, and how many of them are filled by people admitted from outside?
Why ask it
Outside admissions bring in revenue, and they also occupy beds that residents may need. Do a rough sum with the number of contract holders, their average age and the number of care beds. If the ratio looks thin, ask what the plan is as the people living here now grow older.
If I go to the health center for a few weeks of rehabilitation after surgery or a fall, what do I pay, and is my apartment held for me?
Why ask it
For many residents a short stay is the first time they use the health center, so it is worth pricing before the permanent move. Ask whether you pay the apartment fee, the care fee or both, how many days are covered under each contract type, and which insurance is expected to pay before the contract does.
Once a move to assisted living or nursing care is declared permanent, how soon must the apartment be given up, and what does that date set in motion?
Why ask it
The date matters for money and for dignity: it can start the refund clock, end the apartment fee, and leave a family clearing a home at short notice. Find out how many days are allowed, who pays for the empty apartment in the meantime, and whether a spouse still living there changes anything.
When one spouse moves to the health center and the other stays in the apartment, how far apart are they, and how easy is it to spend the day together?
Why ask it
Walk the route yourself at the pace of the slower of you, and picture it in bad weather if the buildings are not connected. Ask whether the well spouse can eat in the health center dining room and whether there is anywhere private to sit. Staying on one campus is the reason many couples choose a CCRC, so check that it means what you imagine.
Is memory care available on campus, and does the contract cover it on the same terms as assisted living and nursing care?
Why ask it
A contract written before a memory unit was built may not mention it, and some price it as an extra. Ask what the monthly fee would be there under your contract, and who decides that someone needs a secured unit and not ordinary assisted living.
What kinds of care can the campus not provide, so that a resident would have to go elsewhere, and who pays then?
Why ask it
Typical gaps are complex medical needs, some psychiatric conditions and behavior that puts other residents at risk, but each community draws its own line. Ask whether the contract's pricing follows you to an outside facility or stops at the gate.
Does the community staff the health center itself or contract it to an outside operator, and what happens to my care terms if that operator changes?
Why ask it
The price of care is fixed by your contract with the community, but the people who deliver it may work for a company that can be replaced. If the nursing wing is contracted out, ask how long the current operator has been in place and whether it has changed since the oldest residents moved in.
May we walk through assisted living and the nursing area today, and see their most recent inspection reports?
Why ask it
Sales tours favor the pool and the bistro, yet the health center is the part of the campus you are paying for in advance. Go at a mealtime if you can and notice whether residents are up, dressed and in company. If the tour cannot include it today, book a second visit that starts there.
Admission and exit
What are the health requirements for admission, and what does the assessment consist of?
Why ask it
Expect some mix of medical records, a physical and a memory screening, often with stricter standards for life care than for fee-for-service. Ask which conditions most often lead to a refusal and how recent the medical information has to be. This is why people are told to apply while they are still well, so ask how long an approval stays valid.
If one of us does not meet the health criteria, what are our options?
Why ask it
Possibilities include a different contract type for that person, direct admission to assisted living at market rates, or a refusal for both of you. Have the terms for each spouse written out separately, since the two of you may end up holding different contracts under one roof.
What income and assets do you require, and how is that calculated?
Why ask it
Communities usually want to see assets worth some multiple of the entrance fee and income comfortably above the monthly fee, tested against how long you are expected to live. Ask for the formula and whether the proceeds of a house not yet sold count. Passing their test shows the community thinks you can afford it; your own adviser should say whether you agree.
How does the waiting list work, what does a deposit hold, and what if my health changes while I wait?
Why ask it
A deposit normally buys a place in line, not a price or a promise of admission. Ask whether it is fully refundable, how many times you may turn down an offered home before losing your place, and whether the health assessment is done when you join the list or when you move in.
Could we stay a night or two in a guest apartment, eat in the dining room and sit in on a residents' council meeting before we commit?
Why ask it
A stay shows what a tour cannot: the noise at night, who comes down to dinner, how staff speak to residents when nobody from sales is present. A council meeting shows what residents are worried about this year, and it is the place to find someone who has been through a move to the health center. If both are refused, ask how else you can meet residents without a guide.
If I marry, or a partner moves in with me after I have signed, does that person have to qualify, and what do we pay?
Why ask it
A newcomer may have to pass the same health and financial screening and pay a second-person fee, and can end up on a different contract type from yours. Put the reverse case too: two residents with separate homes who marry and give one up, and which entrance fee refund survives.
Which insurance does the contract require me to keep, and which public programs or insurers is the health center approved to bill?
Why ask it
You may be required to hold certain health coverage for as long as you live there, and dropping it can put you in breach. In the United States, ask specifically whether the nursing beds are certified for Medicare and for Medicaid, since that affects who can pay after a hospital stay or once savings are spent. Elsewhere, ask what the public system covers on this campus.
If I outlive my money through no fault of my own, can I stay, and is that written in the contract or left to the community's discretion?
Why ask it
You may be told that nobody has ever been asked to leave for running out of funds, so ask to see the sentence in the contract that backs it up. Find out whether there is a benevolent or assistance fund, how large it is, and how many residents draw on it now. A promise that rests on a fund nobody can describe is only a hope.
What would count as running out of money through my own fault: are there limits on gifts, on moving assets into a trust, or on spending after I move in?
Why ask it
Contracts often require you to keep the assets you declared and not give them away, and may ask for a financial statement each year. If you plan to help children or grandchildren, raise it now and ask what is allowed. Ask too whether the refundable part of the entrance fee has to be used up before any assistance begins.
On what grounds can the community end my contract, and what would I get back if it did?
Why ask it
Nonpayment, misstating your health or finances on the application, and behavior that endangers others are the usual grounds. Ask how much notice is given, whether there is an appeal, and how the refund is worked out in that case. Then compare what you were told with the termination clause, word for word.
If I decide after a year or two that this is not the right place, how much notice must I give and what do I get back?
Why ask it
Leaving by choice is the case few people price before they sign. With a declining refund, a couple of years can use up a large part of the entrance fee. Ask for the dollar figure at twelve, twenty-four and thirty-six months for the home you are considering.
How to compare CCRCs before you pay an entrance fee
Practical guidance for the conversation itself
Before the sales appointment
Get the papers by email first
Ask for the fee schedule, a blank contract for each type and the disclosure statement before you book a tour. Reading them at home turns the appointment into a chance to question what you read, and a community that will only hand them over in person has told you how it sells.
Know your own figures
Write down what your home would sell for, your other savings and your yearly income. The entrance fee usually comes out of the house and the monthly fee out of income, so you need both numbers to know which communities and which refund plans are within reach.
Decide what the money is for
Talk at home about whether leaving an inheritance matters more than a lower fee, and how much you would pay to make future care costs predictable. Those two answers choose between refund plans and contract types more than anything a salesperson says.
Go while you are both well
Health screening means the choice of contracts narrows as conditions are diagnosed. Visiting a few years before you expect to move costs little, and a place on a waiting list can often be held with a refundable deposit, though you should confirm that it is.
At the community
Ask to meet the finance office
The marketing team can answer the Contract and Entrance fee questions. Occupancy by year, debt, reserves and unpaid refunds belong to the chief financial officer or the executive director, so ask for twenty minutes with one of them and bring the Finances group with you.
Start the tour at the health center
Assisted living and skilled nursing are what set a CCRC apart from an ordinary retirement community, and they are the last stop on most tours. Ask to see them first, while you still have the energy to look closely.
Talk to residents on their own
Sit down to lunch with residents and ask about the last fee letter, how a neighbor's move to care was handled and whether the place has changed since they came. They will tell you things no brochure does, though it is fair to remember that people who live there also want the empty apartments filled.
Have every figure written down
Fees, refund percentages, covered care days and the rate after them should be on paper with a date, for the specific home you looked at. Spoken figures are hard to compare a month later and impossible to hold anyone to.
Weighing one community against another
Run the same two stories through each
Price one case where you both stay in independent living for fifteen years, and one where one of you spends four years in nursing care while the other keeps the apartment. Add the entrance fee, the monthly fees and the care charges for each. Life care tends to look expensive in the first story and cheap in the second, and seeing both totals shows what you are paying to avoid.
Put the refund terms in one row
For each community note the percentage, how it declines, what triggers payment and whether there is an outside deadline. A larger refund with no payment date can be worth less to your family than a smaller one paid within a fixed time.
Compare trends, not single years
Line up occupancy and fee increases for each community over the same years. One that has held steady with moderate rises is easier to trust than one with a good current figure and a history that swings.
Pay for independent advice once
When you are down to one or two, have a lawyer read the contract and an accountant or fee-only adviser read the financial statements. Their fees are small next to the entrance fee, and neither of them earns anything if you sign.
What should make you wait
A refund with no date
If the only answer is that refunds are paid when the home is resold, and nobody will say how long recent ones took, treat the refundable part as money you may not see for years and plan around that.
Accounts you are not allowed to take away
Audited statements and the disclosure document are the evidence behind every promise in the contract. A community that lets you glance at them in the office and no more is asking for more trust than a decision of this size should need.
A price that expires this week
Incentives with a deadline are a sales tool, and they can also point to apartments that are not filling. Ask what occupancy is and why the offer exists before you let the date hurry you.
Assurances that stay spoken
If you hear that no one is ever asked to leave or that increases are always small, ask where the contract says so. When the answer is that it does not but that is how things are done, you have learned exactly what the promise is worth in a dispute.