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Aged, Blind and Disabled Manual Policy Manual Number: 110.050 Section: Financial Eligibility Requirements Chapter: ABD Countable and Excluded Resources
September 1, 2026 Division of TennCare 15 Continuing Care Retirement Community Entrance Fee or Deposit Resource Type 1. Description of Continuing Care Retirement Communities
Continuing Care Retirement Communities (CCRC), or life communities, provide living arrangements for individuals as they get older and who may require different levels of assistance. Many of these communities include independent living arrangements, memory support living arrangements and skilled nursing care.
CCRCs provide various options to individuals who wish to live in their community. Most contracts require significant entrance and monthly fees, which are used to cover all aspects of their needs within the community. Potential residents must provide extensive information about their finances, prior to being accepted for admission, and sign detailed contracts regarding current and future needs and payments.
2. CCRC Entrance Fee and Spousal Impoverishment
The Deficit Reduction Act of 2005 (DRA) amended the Social Security Act to require that CCRC contracts are subject to the Medicaid spousal impoverishment rules. CCRC contract provisions requiring the expenditure of resident entrance deposits must take into account the required allocation of resources and of the entrance or income to the community spouse before determining the amount of resources that a resident must spend on her own care.
3. CCRC Entrance Fees as a Countable Resource
Entrance fees paid to a CCRC may be a countable resource. The following three conditions must all be met in order for the entrance fee to be an available, countable resource:
• The entrance fee can be used to pay for care under the terms of the entrance contract should other resources of the individual be insufficient;
• The entrance fee (or remaining portion) is refundable when the individual dies or terminates the contract and leaves the CCRC; and