McKnight’s Senior Living Writer/Editor Poses the Hot Question: “Can We Trust the Promises Being Made by Senior Living Operators?”
This semester, retired New York Judge Karen Miller, who served as part of the team of stakeholders who spoke to my fall seminar on Health Law, Policy and Ethics at Penn State Dickinson Law, sent me another great article for my students and me to read. Tip of my hat to Karen, once again!
John O’Connor is terrific at capturing the moment in his editorial columns for McKnight’s Senior Living News. On December 3, with the headline “It’s Show Time,” John points to North Carolina as the progenitor of a detailed, carefully revised Continuing Care Retirement Communities Act, that focuses on new financial reporting and transparency requirements for the Continuing Care and Life Plan models of senior living. The new law (Session Law 2025-58/House Bill 357) was signed by the Governor on June 25, 2025 and became effective on December 1.
John O’Connor describes the North Carolina law as promoting “sensible stuff,” such as requiring:
- Quarterly financial statements
- Clearer disclosures
- Straightforward bylaws
- Prompt notice when entrance-fee refunds might be delayed
- A new “advisory committee that brings residents, providers and professionals together to flag issues before they metastasize”
The law also bites a tough bullet for some CCRC providers, mandating at Section 58-64A-210 that providers “shall provide at least once every three years, an actuarial study prepared in accordance with accepted actuarial standards of practice for each CCRC operated by the provider in this state and any continuing care at hoe program…..”
Perhaps more importantly, John O’Connor makes it clear that in the wake of high profile insolvencies of CCRCs, “Residents and families are making it clear: they want more visibility, more clarity, and more reassurances that what’s promised is what’s delivered.”
In Pennsylvania, the Chapter 11 petition filed on November 21, 2025 by SpiriTrust Lutheran a long-standing company with 6 CCRC sites in the south-central part of the Commonwealth, provides the latest “source material” for identifying problems sometimes hiding in the shadows. Pennsylvania’s statewide Continuing Care resident organization, PARCR, is underway with its comprehensive plan for rethinking Pennsylvania oversight rules.
In April 2011, I wrote an article asking “Will Continuing Care Retirement Communities Continue?” where I worried that providers and regulators were failing to take seriously ongoing questions raised by residents concerned they were receiving inaccurate information from and about providers. I questioned the fact that Pennsylvania had actually reduced the frequency of required audits in 2010. The reduction may have been driven by state budget concerns or beliefs the audits were so superficial as to be meaningless, but that move sent the wrong message to residents.
There are plenty of new lessons lurking in the records of recent bankruptcies. Perhaps North Carolina’s “collaborative” approach to crafting better CCRC safeguards, that John O’Connor praised this month, will take root with legislators who care about older adults in Pennsylvania.