Continuing Care Retirement Community (CCRC) Best Practices

As you hone your options, it’s important to understand CCRC best practices — or what CCRC ‘excellence’ looks like.


Operates legally: The nursing home and assisted living components of the CCRC are licensed and in compliance with all federal and state regulatory requirements. Voluntary accreditation through the Joint Commission on Accreditation of Health Care Organizations, JACHO, or the Continuing Care Accreditation Commission (CCAC-CARF) is a plus.


Demonstrates respect for residents: All residents are treated with respect by staff. This includes respect for each resident’s freedom, privacy and choice.


Supports resident and family councils: Resident and/or family councils are active and meet regularly.


Demonstrates financial transparency and viability: Financial disclosure statements are accessible, demonstrate a history of fiscal responsibility and show reserves necessary to meet future obligations.


Low staff/caregiver turnover rates: A low staff turnover rate is usually a measure of good management practices and employee satisfaction and typically, associated with higher quality care for residents.

Tips to Get Your CCRC Search Underway

  • Ask for recommendations from friends, clergy, your doctor and/or a local hospital.
  • Visit Nursing Home Compare to locate the Medicare-certified nursing facility affiliated with the CCRC you are considering to check out quality ratings and review survey results.
  • Know what ‘ratings’ mean. Be aware that Medicare quality ratings are based on self-reported data. Interpret all data with caution because the numbers do not tell everything. For example, a nursing home may report a higher number of falls or residents in pain because they accept very ill or frail patients, not because they are delivering poor care. There is no substitute for in-person investigation and research.
  • Go to your state website to check licensure and deficiency status if the nursing home affiliated with the CCRC is a non-Medicare certified nursing home.
  • Visit your state website to locate the assisted living facility affiliated with the CCRC to check licensure status, if state licensing is required.
  • Call to schedule an appointment to visit the continuing care facilities you think match your needs.
  • Review the checklist to prepare for your visit.
  • Tour the CCRC. Ask to see the residences, all public areas and the kitchen. Visit the nursing home and assisted living buildings as well. Look into resident rooms and talk to residents in those areas. Visit more than once, including during a mealtime, on a weekend or late in the day, if possible.
  • Once you narrow your search to one or two options, go back to revisit the assisted living and nursing home connected with the CCRC. Use the checklists for those facilities (assisted living facility and nursing home) to help you evaluate both.
  • Ask for financial statements and review these with your accountant and an attorney.
  • Carefully review the contract with an attorney prior to signing.
  • Remember that the person leading the tour is a salesperson who wants to show you the best side of the facility. Insist on seeing as much of the facility as you feel you need to in order to make a good decision.