Continuing Care Retirement Communities in the Greater Puget Sound Area

What Is a Continuing Care Retirement Community (CCRC)?

Long-term planning, predictable care access, and a campus-style lifestyle

Continuing Care Retirement Communities, often called CCRCs or Life Plan Communities, are designed for older adults who want to plan ahead for future care needs while remaining in one community.

Residents typically move in while living independently and gain access to higher levels of care over time, including assisted living, memory care, and skilled nursing, without needing to change organizations.

For the right individual or couple, a CCRC can offer stability, continuity, and peace of mind. It is also one of the most complex senior living models to evaluate.

Why Choose a CCRC?

Who CCRCs Are Best Suited For

CCRCs appeal to older adults who value long-term planning and want to reduce uncertainty around future care transitions.

Residents are often drawn to CCRCs because they offer:

• Independent living with robust amenities

• Priority access to higher levels of care

• A single community designed to support aging in place

• A strong sense of continuity and shared lifestyle

Unlike traditional assisted living or retirement communities, CCRCs operate under long-term contracts rather than month-to-month agreements.

How Care Works in CCRCs

A Tiered Care Model, and How It Works in Practice

CCRCs are built around a tiered care model within one organization. Most communities include:

• Independent living

• Assisted living

• Memory care

• Skilled nursing

Residents usually enter while living independently, with the expectation that they can transition to higher levels of care over time without leaving the community.

The core promise of a CCRC is long-term predictability. After paying an entrance fee and ongoing monthly fee, residents expect access to higher levels of care as needs change, without significant increases in cost.

In a traditional Life Care or extensive contract, care is included rather than billed separately.

Much of this information comes from direct conversations with leadership at local Washington State CCRCs and reflects how care transitions are being handled today.

How This Works in Reality

Families should understand how CCRCs operate in real situations, not just how they are designed to work on paper.

One of the primary benefits of a Life Care contract is that residents generally do not pay additional fees for personal care as they move between levels. In most cases, assisted living or nursing care does not trigger new care charges.

That said, there are a few practical realities families should be aware of.

Service details can change by setting.

At some Washington State CCRCs, independent living fees do not include a meal plan. When a resident transitions to assisted living, a required meal plan may be added to the monthly cost. This is not a care charge, and personal care itself is still included under many Life Care contracts.

Care availability can affect timing.

As residents live longer and care needs increase, assisted living or nursing units may occasionally reach capacity. When this happens, CCRCs typically manage transitions based on medical need rather than request order.

Depending on the situation, a resident may:

• Remain in independent living with private caregivers temporarily, or

• Transition to skilled nursing for a short period if appropriate, with the community coordinating care based on contract terms

Most CCRCs use a transition or care coordination team to monitor residents’ health and anticipate when higher levels of support may be needed. This allows communities to plan ahead and prioritize placements based on clinical need.

Some residents also choose to remain in their independent living apartment long term and continue using private caregivers, even when assisted living is available. While this can preserve familiarity and comfort, it may involve additional out-of-pocket costs that are not always obvious at move-in.

Understanding CCRC Contracts

Not All CCRCs Work the Same Way

CCRCs operate under different contract structures, each with tradeoffs related to cost, predictability, and long-term risk.

Common contract types include:

• Life Care or extensive contracts

• Modified contracts with limited included care

• Fee-for-service contracts

Each structure affects how much care is included, how future care is priced, and how financial risk is shared between the resident and the community.

Contract language matters, and disclosure documents should always be reviewed carefully before making a decision.

When a CCRC May Not Be the Right Fit

Important Considerations and Limitations

While CCRCs can be an excellent option for some, they are not right for everyone.

A different care setting may be more appropriate if:

• Upfront entrance fees create financial strain

• Medicaid may be needed in the future

• Flexibility to move freely is important

• Care needs are already high at move-in

• A smaller or more home-like environment is preferred

CCRCS require confidence in the organization’s long-term financial stability and management practices.

Memory Care in CCRCs

Dementia and Cognitive Care Within CCRCs

Some CCRCs offer dedicated memory care neighborhoods with secure environments and dementia-trained staff. Others provide more limited cognitive support.

The quality, staffing model, and philosophy of memory care vary significantly and should be evaluated independently, even within well-known communities.

How Silver Age Can Help

Objective Guidance for a Complex Decision

CCRCS are often marketed as a simple solution for aging in place, but the reality is more nuanced.

Silver Age advisors help families:

• Compare CCRC contracts and care guarantees

• Understand long-term financial implications

• Evaluate care quality beyond marketing materials

• Decide whether a CCRC or another care model is the best fit

We provide unbiased guidance based on real-world experience with Washington State communities.