Choosing a continuing care retirement community is one of the largest decisions a family makes for an aging parent or for themselves. The contract is long, the entrance fee is significant, and the consequences of a poor choice are felt daily for years. The five operators below are among the largest and most established national senior living networks in 2026, each with multiple CCRC and continuum-of-care campuses across the United States. They are starting points for research, not endorsements; every campus and contract must be evaluated independently before signing.
This guide does not constitute medical or financial advice. Always consult with a licensed financial advisor, elder law attorney, and the resident's physician before making any senior living decision.
Quick comparison
| Operator | Footprint | Care levels | Typical contract type |
|---|---|---|---|
| Brookdale Senior Living | National (650+ communities) | Independent, assisted, memory care, skilled | Rental and entrance fee options |
| Sunrise Senior Living | National (270+ communities) | Assisted, memory care, skilled | Mostly rental |
| Atria Senior Living | National (180+ communities) | Independent, assisted, memory care | Mostly rental |
| Holiday Retirement | National (200+ communities) | Independent living focus | Rental |
| Belmont Village Senior Living | Multi-state (35+ communities) | Independent, assisted, memory care | Rental |
Brookdale Senior Living - Largest National Network
Brookdale is the largest senior living operator in the United States by community count, with more than 650 communities across nearly every state. The breadth of the network means most families can find a Brookdale community within driving distance of where they want to live, and the operator runs a centralized resident transfer program that allows residents to relocate between Brookdale campuses if family circumstances change. The continuum-of-care campuses offer independent living through skilled nursing on one site.
The scale brings tradeoffs. Quality varies between campuses because each operates with a different administrator and local staff. A Brookdale community in one city may earn high marks for dining and activities while one in another city draws complaints about staffing. Visit the specific campus, review the state inspection reports, and ask about staff turnover before making any commitment.
Best for: families who want a large national network with the option to transfer between campuses.
Sunrise Senior Living - Strong on Assisted Living and Memory Care
Sunrise operates more than 270 communities across the United States, Canada, and the United Kingdom, with a focus on assisted living and memory care rather than full continuum-of-care campuses. The Sunrise model uses smaller, residential-scale buildings with mansion-style architecture and a stated emphasis on dignity-first care for residents with cognitive decline. The Reminiscence neighborhoods are purpose-built memory care wings that reflect a researched approach to dementia caregiving.
Sunrise does not operate as many true CCRC campuses as Brookdale, so families needing on-site skilled nursing on day one should confirm availability at the specific community. The rental-only model means no large entrance fee, which can be a strength for residents who prefer predictability over a long-term contract.
Best for: families prioritizing assisted living and memory care in a smaller, residential-scale setting.
Atria Senior Living - Active Lifestyle Focus
Atria operates more than 180 communities across the United States and Canada, with a stated focus on active lifestyle programming for independent living and assisted living residents. The Atria Engage Life curriculum emphasizes social, cultural, and physical activities, which appeals to residents who are moving to senior living while still active and want a calendar of programming rather than only care services.
The Atria Park and Atria Senior Living communities offer different price points and amenity levels. Memory care is offered at many but not all communities and skilled nursing is typically not on-site, so families with anticipated long-term care needs should confirm continuum availability or be prepared to relocate if higher-level care becomes necessary.
Best for: active seniors moving into independent or assisted living who want a strong programming calendar.
Holiday Retirement - Independent Living Specialist
Holiday Retirement operates approximately 200 communities focused almost entirely on independent living for active seniors aged 55 and older. The model is rental-only with month-to-month or annual leases, no large entrance fee, and a single all-inclusive monthly rate that covers an apartment, three daily meals, housekeeping, transportation, and activities. The simplicity is the appeal; residents pay a predictable monthly rate and can leave on short notice.
Holiday does not offer on-site assisted living, memory care, or skilled nursing at most communities, so the model works best for active seniors who want a supportive community but do not anticipate needing higher levels of care soon. Residents who develop care needs typically need to relocate to a different community type, which is the major tradeoff of the Holiday model.
Best for: active independent seniors who want rental flexibility and a simple all-inclusive monthly rate.
Belmont Village Senior Living - Premium Multi State Operator
Visit Belmont Village Senior Living
Belmont Village operates approximately 35 communities across California, Texas, Illinois, Florida, and a handful of other states, with a positioning as a premium senior living operator. The communities offer independent living, assisted living, and memory care on the same campus at many locations, which gives residents the option to move between care levels without leaving the community. The Whole Brain Fitness Living program is a researched cognitive wellness curriculum developed with academic medical center partners.
The smaller footprint means Belmont communities are not available in every market. Pricing tends to be at the higher end of the senior living market in each city where Belmont operates. Quality control is consistent across the smaller footprint compared to larger national operators.
Best for: families seeking premium senior living in markets where Belmont operates, with anticipated transition to memory care.
How to choose the right CCRC
Visit multiple times. Tour during weekdays and weekends, at meal times, and during programming. Eat in the dining room. Sit in the lobby and watch the staff-resident interactions.
Talk to current residents. Ask residents away from staff what they wish they had known before moving in. Ask about staff turnover, dining quality, and how the community handles care transitions.
Review the disclosure statement. Every CCRC must provide a financial disclosure under state law. Review occupancy rate, debt service coverage, days cash on hand, and the operating ratio. A financial advisor familiar with senior living finance can flag warning signs.
Confirm accreditation. CARF International and the Continuing Care Accreditation Commission accredit CCRCs that meet quality and financial standards. Accreditation is voluntary, but its presence is a positive signal.
Read the contract carefully. Type A, B, and C contracts have very different financial implications. Have an elder law attorney review the contract before signing.
Questions to ask on a tour
Staffing. What is the staff-to-resident ratio at each care level, and what is the annual turnover rate for nursing aides and licensed nurses?
Care transitions. Who decides when a resident moves to a higher level of care, and what is the appeal process?
Refunds. Under what conditions is the entrance fee refundable, and over what timeline?
Skilled nursing quality. What is the most recent CMS five-star rating for the skilled nursing wing, and what citations did the most recent state inspection produce?
Dining. Who runs food service (in-house or contracted), and how are special dietary needs accommodated?
For more on senior care planning, see our long-term care insurance guide and our aging in place modifications walkthrough. Our full evaluation approach is documented in our methodology.
This is not medical or financial advice. The senior living decision is highly personal and depends on health status, financial resources, family support, and local availability. Use this guide as a starting list of national operators to investigate, then evaluate each specific community on its own merits with the help of a financial advisor and an elder law attorney.
Frequently asked questions
What is a continuing care retirement community and how is it different from assisted living?+
A continuing care retirement community offers a range of housing and care options on one campus, including independent living for active seniors, assisted living for residents who need help with daily activities, and skilled nursing for those who need full medical care. Residents move between these levels of care as their needs change without leaving the community. Stand-alone assisted living facilities offer one level only and require relocation if care needs increase. CCRCs typically charge an entrance fee plus monthly fees in exchange for guaranteed access to higher levels of care.
How much does a CCRC cost?+
CCRC costs vary widely by location and contract type. Entrance fees range from approximately $40,000 at modest communities to over $1 million at luxury communities in high-cost regions. Monthly fees typically range from $3,000 to $8,000 and may increase as a resident transitions to higher levels of care. Some CCRCs offer rental-only options without an entrance fee, and some offer refundable entrance fee contracts that return a portion to the estate. Always request a detailed disclosure statement and review with a financial advisor before signing.
What contract types do CCRCs offer?+
CCRCs typically offer three contract types. Type A (life care) charges a higher entrance fee and includes unlimited higher-level care at little or no additional monthly cost. Type B (modified) charges a moderate entrance fee and includes a limited number of days of higher-level care, after which residents pay market rates. Type C (fee for service) charges the lowest entrance fee but residents pay full market rate for assisted living or skilled nursing when needed. Each type has tradeoffs in upfront cost, monthly cost predictability, and lifetime risk.
How do I evaluate a CCRC before moving in?+
Visit the campus multiple times at different days and times. Eat in the dining room. Talk to current residents away from staff. Request the most recent state inspection report for the skilled nursing wing. Review the disclosure statement for financial health metrics including occupancy rate, operating ratio, and debt service coverage. Confirm the CCRC is accredited by CARF International or a state equivalent. Ask about staff turnover rates at every care level. Verify the contract type and what happens if you outlive your assets.
Is a CCRC covered by Medicare or Medicaid?+
Medicare does not pay for long-term residency at a CCRC. Medicare may pay for short-term skilled nursing care (up to 100 days) following a qualifying hospital stay if the skilled nursing wing is Medicare-certified. Medicaid coverage of CCRC skilled nursing depends on the state and the specific community; some CCRCs accept Medicaid for residents who have spent down assets, but many do not. Long-term care insurance and personal assets are the typical funding sources. Confirm Medicare and Medicaid policies in writing before signing.
Priya Sharma
Priya Sharma writes for The Tested Hub.