Revision 10-1; Effective March 1, 2010

A continuing care retirement community (CCRC) offers life care to a person in one setting. For example, the facility may accommodate independent living, assisted living and nursing care as a person's needs change. A person may be required to pay a substantial entrance fee as a prerequisite to admission to a CCRC.

For purposes of determining a person's eligibility for, or amount of, benefits under the State Plan, this policy applies to persons residing in CCRCs or life care communities that collect an entrance fee on admission from such persons.

A person's entrance fee in a CCRC or life care community is considered a resource available to the person to the extent that:

• the person has the ability to use the entrance fee, or the contract provides that the entrance fee may be used, to pay for care should other resources or income of the person be insufficient to pay for such care;
• the person is eligible for a refund of any remaining entrance fee when the person dies or terminates the CCRC or life care community contract and leaves the community; and
• the entrance fee does not confer an ownership interest in the CCRC or life care community.

Treat an entrance fee to a CCRC as a countable resource of a person applying for Medicaid in an institutional setting on or after Oct. 1, 2006, if the entrance fee meets all of the following requirements:

• Person can use the fee to pay for care.
• Person is eligible for a refund of any remaining fee upon death or leaving the CCRC.
• Entrance fee does not confer an ownership interest in the CCRC.

The countable amount of the resource is the entrance fee value, minus the amount of the entrance fee spent on care.

If there is a community spouse, consider the countable entrance fee amount in the computation of the spousal share.

If an applicant for Medicaid in an institutional setting has a CCRC contract, obtain a copy for the case record and document the following elements in case comments:

• CCRC contract date;
• CCRC facility name;
• CCRC entry date;
• resource accessible (yes/no);
• contract specifies fee be used to pay for care (yes/no);
• eligible for refund on termination of contract or departure from the CCRC (yes/no);
• CCRC entrance fee value;
• amount of entrance fee spent on care; and
• refundable amount.

See Section E-3331, Interest and Dividends.