CCRC marketing: life care claims, entrance fee refunds, disclosure statements and Medicaid wording

A continuing care retirement community sells something unusual: a home now and a promise about care later, paid for with an entrance fee due up front. The prospect is deciding about the next twenty years, and adult children are reading over their shoulder. That makes CCRC marketing less about amenities and more about explaining a contract honestly, in words a family can check against the documents they will sign.

Two related topics have their own guides and are not repeated here. Fair housing rules for senior housing ads, Google Ads targeting limits, resident photos and reviews are in our assisted living marketing guide. Resident rights at admission, Care Compare star ratings and Medicare coverage for skilled nursing are in our nursing home marketing guide. This guide covers what is specific to a community that sells continuing care contracts.

Describe the contract you actually sell

The GAO’s 2010 report on CCRCs describes communities that let older adults move among independent living, assisted living and skilled nursing care in one community, and notes that they offer a range of contract types and fees designed to transfer different degrees of the risk of future cost increases from the resident to the community. That range is the first thing your marketing has to get right. A contract that includes future care at little or no change in the monthly fee is a different product from one that discounts care, or one that charges market rates for care when it is needed.

The FTC Act makes unfair or deceptive acts or practices in commerce unlawful (15 U.S.C. 45) and bars false advertisements likely to induce the purchase of services (15 U.S.C. 52). The FTC Policy Statement on Deception looks at representations, omissions and practices likely to mislead a reasonable consumer, and it judges the net impression of the whole ad, not each sentence alone. A brochure that says “lifetime care” in large type while the contract charges full rates for assisted living and nursing care leaves a net impression the contract does not support, even if the fine print is accurate.

Name the contract types you offer, in the words your contract uses, and put a short plain explanation next to each: what the entrance fee covers, what the monthly fee covers, and what happens to the monthly fee if the resident moves to a higher level of care. If you offer more than one type, a side by side table on the website does more for trust than any lifestyle photo.

Illustration: a pricing page lists two contract options. Under each it says what changes, in dollars or in words, when a resident moves from independent living to assisted living or nursing care, and it links to the full contract and the disclosure statement for the details.

Care for life and financial security claims

“Care for life,” “never move again,” “your future is secure” and “protect your savings” are the phrases CCRC ads reach for, and each is an objective claim a reader will rely on. The FTC Policy Statement Regarding Advertising Substantiation says objective claims need a reasonable basis before they are made. For a CCRC, the basis is the contract, the community’s financial condition and its policies, and the claim cannot promise more than all three deliver.

The GAO report explains why the gap matters. It found that CCRC financial difficulties can lead to unexpected increases in residents’ monthly fees, that a CCRC failure could cause residents to lose all or part of their entrance fee, and that residents can become dissatisfied when operations fall short of expectations or arrangements they believed were fixed by contract change, such as charges for services that were previously free. Each of those outcomes turns a confident ad into a complaint.

Replace outcome promises with descriptions of terms. “Your contract includes access to assisted living and nursing care on our campus, with the monthly fee changes described in section 4” is a claim you can support. “Monthly fees are reviewed each year and changes are announced in advance; our fee history for the last five years is on this page” tells a family something useful. Financial strength claims belong next to the audited financial statements or the disclosure the state requires, not in place of them.

Entrance fee and refund wording

Refund language is where loose wording does real damage. “Refundable entrance fee” means different things in different contracts: a refund may be due only after the unit is reoccupied, may decline over time, or may be a fixed percentage. Say exactly what your contract says, including when the refund is paid and what it depends on, and use the same numbers in the ad, the website and the sales script.

Refund terms also have a federal Medicaid consequence that families ask about. Under 42 U.S.C. 1396p(g), for Medicaid eligibility, an entrance fee in a continuing care retirement community or life care community counts as a resource available to the individual to the extent that the individual can use it, or the contract provides that it may be used, to pay for care when other resources or income fall short, the individual is eligible for a refund of any remaining entrance fee on death or on ending the contract and leaving, and the fee does not confer an ownership interest. Do not tell a prospect how their fee will be treated; tell them the rule exists and that their state Medicaid agency and their own advisor decide how it applies.

Tax lines need the same restraint. IRS Publication 502 says a person can include in medical expenses a part of a life care fee or founder’s fee paid under an agreement with a retirement home, the part properly allocable to medical care, where the agreement requires the fee as a condition for the home’s promise to provide lifetime care that includes medical care. It adds that a statement from the retirement home can be used to prove that amount, based on the home’s prior experience or on information from a comparable home. If you provide that statement, say so. Do not advertise a deduction or a percentage as if it applies to every buyer.

The disclosure statement comes first

CCRC disclosure rules are set state by state. The GAO report cited an industry study finding that not every state had CCRC-specific regulations, and it described steps taken by states it reviewed, such as requiring escrow of entrance fees and mandating certain disclosures, that a number required contracts to be readable, and that not all of them required disclosure of policies likely to affect residents’ satisfaction, such as policies for moving between levels of care. Your marketing should work with whatever your state requires, not around it.

In practice, that means the disclosure statement and the contract are linked from the pricing page, offered at the first meeting, and never described as a formality. If your state sets a waiting period, a rescission period or a deposit escrow rule, say so in the sales materials in the same words the law and your contract use. A prospect who reads the disclosure statement before the tour asks better questions and is less likely to feel misled later.

Moving between levels of care

The promise of continuing care rests on the move from independent living to assisted living or nursing care, and the GAO report singles out these transfer policies as a disclosure not every state requires. Publish yours anyway. Say who decides when a resident needs a higher level of care, whether the resident and family are part of that decision, what happens if the on-site assisted living or nursing beds are full, and whether a couple can live apart at different levels without paying two full monthly fees.

Do not describe your nursing care as included, priority or reserved access unless the contract says so in those terms. If the nursing level is certified for Medicare or Medicaid, the resident rights and admission rules in our nursing home guide apply to that part of the campus, and your marketing for it should follow them.

Medicare and Medicaid wording

Coverage wording is where CCRC copy can mislead without meaning to. Medicare.gov says long-term care, also called custodial care, includes medical and non-medical care for people with a chronic illness or disability, that long-term care is different from skilled nursing facility care, and that Medicare and Medicare Supplement Insurance do not pay for long-term care services, including care in a nursing home or in the community. It adds that a person may be eligible for long-term care through Medicaid if they meet the eligibility requirements in their state, or may buy private long-term care insurance. Our guide to marketing to Medicare patients covers the broader rules.

So avoid “Medicare covers your care here” and similar lines. Where Medicare pays for a covered skilled nursing stay in your certified nursing unit, say that narrowly, and say plainly that custodial care is paid by the resident, by the contract terms or by other coverage. For Medicaid, the federal nursing facility statute lets a contract for admission to a state licensed, registered, certified or equivalent CCRC or life care community, including services in a nursing facility that is part of it, require residents to spend on their care the resources declared for admission before applying for medical assistance (42 U.S.C. 1396r(c)(5)(B)(v)). If your contract has that term, the sales materials should not imply that Medicaid will step in early.

Sales calls, events and follow-up

A CCRC decision takes time, and follow-up calls are part of the sale. The FCC’s telemarketing rule bars telephone solicitations to residential numbers on the national do-not-call registry and calls before 8 a.m. or after 9 p.m. local time at the called party’s location (47 CFR 64.1200(c)). A call to someone who gave prior express invitation or permission, or with whom you have an established business relationship, is not a telephone solicitation under the rule’s definition, and a relationship based on an inquiry lasts three months after the inquiry, while one based on a purchase or transaction lasts eighteen months (64.1200(f)(5) and (f)(15)). A request to stop calling ends the relationship for that purpose.

Autodialed or prerecorded marketing calls to cell phones need the called party’s prior express written consent under 64.1200(a)(2). Build your inquiry forms so consent is separate, specific and recorded, and keep a do-not-call list your whole sales team uses.

Lunch seminars and tours are a fair way to meet prospects. Describe them as sales events for the community, say a sales counselor will be present, and do not present them as independent financial or retirement planning advice.

Illustration: two ways to describe the same contract

Illustration: the first ad reads “Lifetime care. Never pay more. Your entrance fee is fully refundable and tax deductible, and Medicare covers your nursing care here.” It promises a fixed fee the contract does not provide, states a refund without its conditions, makes a tax claim that depends on each buyer, and misstates Medicare coverage for custodial care.

Illustration: the second reads “Our continuing care contract includes access to assisted living and nursing care on campus, with monthly fee changes set out in the contract. Under our refundable plan, the refund percentage is set out in the contract and is paid after your residence is reoccupied. Ask for our disclosure statement, and for the medical care statement you can share with your tax advisor. Medicare does not pay for long-term custodial care; see our page on how care is paid for.” It describes the terms and points the family to the documents.

Checklist

• Name each contract type in the contract’s own words and say what happens to the monthly fee at each level of care.
• Replace care for life and security slogans with terms you can show in the contract and financial statements.
• State refund conditions, timing and percentages exactly as the contract does, in every channel.
• Do not tell prospects how Medicaid or the IRS will treat their entrance fee; point to the rule and their advisor.
• Link the disclosure statement and contract from the pricing page and offer them at the first meeting.
• Publish the policy for moving between levels of care, including who decides and what happens when beds are full.
• Keep Medicare lines narrow: skilled nursing coverage only where it applies, and no coverage for custodial care.
• Run sales calls through the do-not-call registry, honor stop requests and keep consent records for automated calls.

How we help

We build websites, local search, Google Ads and AI front desk tools for independent practices and health businesses. For a CCRC, that means a website with clear contract, pricing and care-level pages linked to your disclosure documents, local search that reaches families comparing communities, and inquiry flows that record calling consent separately and collect only what the sales team needs. Our tools are built with HIPAA in mind. We confirm in writing what a BAA covers before any patient information flows through a tool, and if it is not covered, we do not route patient information through it. We are not a healthcare provider and we do not give legal, tax or financial advice. We do not sell lead lists and we do not pay for referrals. For the wider rules, see our healthcare marketing rules hub.

Sources

• GAO-10-611: Older Americans: Continuing Care Retirement Communities Can Provide Benefits, but Not Without Some Risk (June 2010)
• GAO-10-611 Highlights (PDF)
• 15 U.S.C. 45: Unfair methods of competition and unfair or deceptive acts or practices
• 15 U.S.C. 52: Dissemination of false advertisements
• FTC Policy Statement on Deception
• FTC Policy Statement Regarding Advertising Substantiation
• Medicare.gov: Long-term care
• 42 U.S.C. 1396p: Liens, adjustments and recoveries, and transfers of assets, subsection (g)
• 42 U.S.C. 1396r: Requirements for nursing facilities, subsection (c)(5)(B)(v)
• IRS Publication 502: Medical and Dental Expenses
• 47 CFR 64.1200: Delivery restrictions

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