Choosing a Continuing Care Retirement Community (CCRC) in Massachusetts is a major decision — both financially and emotionally. CCRCs offer the promise of housing, healthcare, and a vibrant community under one roof, but the contract you sign will dictate the fine print of what you actually receive. These contracts are legally binding, financially complex, and filled with details that can have lasting implications for you and your family.
That’s why it’s so important to carefully review a CCRC contract before signing. Doing so ensures you understand not only the terms of the agreement but also how the community’s financial health supports those promises. Massachusetts has many reputable CCRCs, some with waitlists so long they’ve begun building sister communities to meet demand. But even in a well-regarded market, there are risks, and a thoughtful review is essential.
How to Review a CCRC Contract: Key Terms, Upgrades, and Care
At first glance, a CCRC contract may seem straightforward: you pay an entrance fee and monthly charges in exchange for housing, services, and sometimes a future refund. But within those broad strokes lie many details worth a second look.
One area where families often miss important implications is apartment improvements. Sales teams typically showcase a variety of style options — carpet versus wood flooring, paint colors, countertop materials — and if you select from their pre-approved packages, upgrade fees tend to be modest. For example, a community may replace carpet at no cost, but charge an upgrade fee for a pre-selected hardwood floor. The fee is often reasonable because it offsets the cost of the carpet that would otherwise have been installed.
The complication arises if you decide to bypass their options and bring in your own contractor for custom work — say, a unique tile pattern in the bathroom or high-end countertops not offered by the community. While the new look may suit your tastes, you could also be responsible for removing those improvements later. If the next resident prefers the standard carpet or kitchen design, the cost of deinstallation will likely come out of your refundable deposit. By sticking with the community’s options, your liability is typically limited to the original upgrade fee.
Another critical detail involves refund terms. Many families assume refunds are triggered when a resident passes away or becomes seriously ill causing an extended stay in the hospital, but contracts usually start the clock only when the family formally gives notice and/or clears the unit. In Massachusetts, it’s common to see a 30 – 90 day notice requirement. During that period, utilities and amenities may be shut off, even though monthly fees continue. It can feel frustrating to keep paying after your loved one has moved out, but this system helps the community prepare the apartment for resale quickly and reduces the chance of long vacancies. From the operator’s perspective, this consistency improves solvency, which ultimately supports their ability to repay deposits.
Most importantly, you’ll also want to look at how healthcare is addressed. Some contracts guarantee on-site long-term care at a predictable cost, while others leave room for significant price increases or even relocation to an outside facility. In Massachusetts, it’s very important to understand if they have the ability to provide long-term skilled care. Assisted living, memory care, and rehab are typically insufficient options for someone requiring long-term skilled care. The only workaround in this situation is a move to another community or hiring your own home health aide to administer care at the community on top of paying monthly rent.
Learn more about the differences between assisted living, CCRCs, and skilled care here.
The termination provisions matter as well: what happens if you decide a few months in that the community is not the right fit, or if your health needs change faster than expected? Is steady pricing for care dependent on medical eligibility and years spent at the community? Or is it simply market pricing – available when you need it? These are all questions that the contract should answer clearly.
How to Review a Massachusetts CCRC’s Financial Statements and Stability
Even the most carefully worded contract won’t protect you if the CCRC itself isn’t financially sound. That’s why it’s essential to review a CCRC contract alongside the community’s financial statements. Unfortunately, there have been cases in Massachusetts and elsewhere where communities went bankrupt, leaving residents and heirs without the refunds they expected.
Start by requesting the community’s audited financial statements, which they are required to provide. Look for signs of strong occupancy — high vacancy rates can signal trouble, while robust waitlists are usually a good sign of demand. Many of the most successful CCRCs in Massachusetts maintain waitlists so long they are actively building new “sister communities.” While this can demonstrate strength, it also raises questions about how funds are used. Is each community financially independent, or can revenue from one be siphoned off to fund construction in another? A well-managed organization will have clear accounting that prevents a profitable location from being dragged down by cost overruns elsewhere.
Debt levels also matter. Expansion projects and renovations are common, but heavy borrowing increases risk, especially if interest rates rise or new units don’t fill quickly. Look for a balance between growth and stability. Another key area is how the community accounts for future refund obligations. If they promise that 90 percent of an entrance fee is refundable, are reserves set aside to cover that promise, or is repayment dependent on finding new buyers? The latter can feel precarious, relying on constant new cash flow to pay off old commitments.
Finally, ask whether the community is regulated or registered with the Massachusetts Executive Office of Elder Affairs, which oversees continuing care providers. Registration and disclosure requirements provide some level of accountability, but they don’t replace your own due diligence. An experienced financial advisor can help you interpret statements and flag risks that may not be obvious.
Bringing It All Together
A move to a Massachusetts CCRC can provide peace of mind and a supportive lifestyle, but only if you understand the obligations and risks upfront. Pay close attention to the fine print around improvements, refunds, and notice periods, and take the time to dig into the community’s financial practices. Healthy occupancy, transparent accounting, and careful management of expansion projects all signal that the community is better positioned to deliver on its promises.
By approaching the process with care and asking the right questions, you can make a confident decision that secures both comfort today and financial protection for the future.
Ready to take the plunge into a CCRC? Read our blog on whether you may benefit from any tax savings.
CCRCs & Bankruptcy: What’s Happened Nationwide
In general, CCRC bankruptcies are extremely rare—about 0.3% per year—though the industry is not risk-free. PubMed
Nationally, at least 16 CCRCs have filed for Chapter 11 bankruptcy since March 2020, affecting over 1,000 families and leading to the loss of approximately $190 million in entrance fees. cozen.com
A prominent example is Harborside in Port Washington, NY—while not in Massachusetts—that filed for bankruptcy multiple times, ultimately wiping out much of residents’ refundable entrance fees.
In the 1970s–1980s, there were other financial failures in the CCRC industry. One notable case involved Erickson Retirement Communities, which filed for Chapter 11 in 2009. However, Erickson reorganized successfully and continues to operate—including in Massachusetts. Massachusetts Real Estate Law Blog
Despite occasional financial challenges, no rent confiscations or evictions due to bankruptcy have occurred in CCRCs, and most resident contracts have been honored—even through reorganizations. nextavenue.org
Key Questions to Ask Before Signing a Massachusetts CCRC Contract
What is the community’s current occupancy rate and length of its waitlist?
What is the deposit refund policy? What are my responsibilities for rent after moving out?
What happens if the unit is vacant for several months after notice is given?
How are upgrade costs and potential deinstallation fees handled?
What happens if this isn’t a good fit and I want to move out within a year?
Are entrance fee refunds backed by reserves or dependent on new residents moving in?
How are sister communities financed — does each stand alone, or can one subsidize another?
What happens if I run out of funds to cover ongoing rent?
