CCRCs ask for a large entrance fee up front in exchange for a promise about your future care. Here is how the three contract types differ, what Washington law entitles you to see before signing, and who these communities actually fit.
By Diane Whitfield, CSA · September 05, 2026
A continuing care retirement community — increasingly marketed as a “Life Plan Community” — is a single campus that offers independent living, assisted living, and often skilled nursing, with the expectation that a resident can move between levels as needs change without leaving the campus. Greater Seattle has a long-established cluster of them, from downtown high-rise campuses to suburban Eastside and South Sound settings, many operated by nonprofit and faith-based sponsors that have been in the region for decades.
What makes a CCRC structurally different from every other option this site covers is the money. Most assisted living and adult family homes are month-to-month: you pay for the month you receive. A CCRC typically asks for a substantial one-time entrance fee at move-in, plus a monthly service fee thereafter. You are buying two things at once — a residence today, and a contractual claim on care you may not need for another decade.
Contracts fall into three broad families, and sales materials rarely label them plainly. A Type A (life care / extensive) contract charges the highest entrance fee and monthly fee but largely holds your monthly rate steady when you move into assisted living or skilled nursing — the community absorbs the cost of higher care. A Type B (modified) contract includes a defined amount of higher-level care (a set number of days, or a discounted rate) and then converts to market pricing. A Type C (fee-for-service) contract has the lowest entrance fee, but when you need assisted living you pay the going rate for it — which in this market means roughly $6,000–$8,000 a month for assisted living and $7,500–$9,500 for memory care, on top of whatever you already committed.
This single distinction drives most of the disappointment families report. A household that believed it had bought “care for life” and actually signed a Type C contract can face a higher monthly bill in their eighties than a neighbor who never paid an entrance fee at all. Ask directly, in writing: is this Type A, B, or C, and what specifically changes on my invoice the month I move to assisted living?
Entrance fees are commonly offered in a declining-refund form (the refundable portion shrinks over the first several years to zero) or a partially refundable form — often quoted at 50%, 80%, or 90% — that is returned to you or your estate when the unit is re-occupied. The refundable options carry a meaningfully higher entrance fee, and the refund is frequently contingent on the apartment being resold, not on a fixed date.
Two questions cut through the brochure. First: what triggers the refund, a date or a resale? Second: how long have recent units actually taken to re-occupy? A family planning to use the refund to fund a surviving spouse's care needs to know whether that money arrives in ninety days or two years.
Washington regulates continuing care contracts under RCW 18.390, which requires a provider to give a prospective resident a written disclosure statement before a contract is signed. Ask for the current one and read the financial section rather than the amenity section — occupancy rates, reserves, and any recent history of monthly fee increases tell you more about the next fifteen years than the dining room does.
The care portions of the campus are licensed separately and are checkable for free. The assisted living building is licensed under RCW 18.20, a skilled nursing wing under RCW 18.51, and any adult family home under RCW 70.128 — all through DSHS Residential Care Services, with inspection and enforcement history available at the public lookup (fortress.wa.gov/dshs/adsaapps/lookup). A beautiful independent-living lobby tells you nothing about the survey history of the assisted living floor you may live on in ten years. Look it up before you sign, not after.
It is also worth having an elder-law attorney or a fee-only financial planner read the contract. The entrance fee is often one of the largest single checks a Puget Sound household will write in retirement, and a portion of it may be deductible as a prepaid medical expense — a question for your own tax professional, using the community's own annual allocation letter.
CCRCs work best for a couple or individual who is still genuinely independent, has liquid assets beyond the entrance fee, and is buying predictability and a social community rather than solving an immediate care crisis. Most require entry at the independent-living level with a health screen, which means the decision has to be made years before it feels urgent.
They fit poorly when care is needed now, when the entrance fee would consume most of the household's assets, or when Apple Health (Medicaid) is a realistic funding path within a few years — CCRC contracts are private-pay instruments and generally are not a Medicaid strategy. In those situations a licensed adult family home at roughly $4,500–$7,000 a month, or an assisted living community that accepts the COPES waiver through DSHS Home and Community Services, is usually the better structure. Aging and Disability Services in King County, Homage in Snohomish County, and Aging & Disability Resources of Pierce County can screen for those programs at no cost, and a local advisor can tell you which Puget Sound communities accept them.
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