When a loved one becomes disabled or chronically ill and requires around-the-clock care, helping them transition to a nursing home may be the best choice. Nearly 16% of Virginia’s population is aged 65 and above, with 19,550 of those living in nursing homes across the state. In this type of setting, seniors receive personal care and skilled nursing services, such as medication administration and management of long-term conditions. Room and board, meals and recreational activities are typically included in the cost of nursing home care. In Virginia, a shared semiprivate room at a nursing home costs about $7,665 per month; seniors who’d prefer a private room can expect to pay $8,821.

In this guide, we explore the cost of nursing home care in Virginia and describe a number of resources, programs and waivers that can help families pay for the care seniors need.

The Cost of Nursing Home Care in Virginia

Nursing home care in Virginia is slightly cheaper than the national average of $7,756 according to the 2020 Genworth Cost of Care Survey, This makes it one of the most affordable options in the Mid-Atlantic. In Maryland, for example, prices skyrocket to $10,190 for a semiprivate room. Rates in West Virginia are even higher at $11,376. North Carolina and Tennessee are more affordable than Virginia, however, with prices around $7,300 and $7,072 respectively.




The United States


West Virginia




North Carolina





Rates for nursing home care vary considerably across Virginia. In the Winchester area, prices are the highest in the state at $9,566. Seniors in Harrisonburg pay slightly less at $9,125; to the south in Charlottesville, costs fall to $7,452. The lowest rates in Virginia can be found in the Lynchburg area. Seniors there pay just $6,644 for a semiprivate room. In the capital city of Richmond, costs rise to $9,064. Seniors in the Virginia Beach and Norfolk area pay the state average of $7,665.








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Aside from nursing home care, seniors in Virginia have other options, including assisted living communities, adult day care, in-home care and home health care. Adult day care provides meals, activities and supervision in a community-based setting; it’s the least-expensive option at $1,603 per month. At $4,195, in-home caregivers can offer companionship, personal care and assistance with daily activities of living. Home health care costs about $190 more and includes basic medical services in addition to regular home care. Assisted living, which costs $4,850, provides care in a residential setting. This type of care is suitable for seniors who don’t require constant supervision and are able to maintain a level of independence.


Adult day care


Home care


Home health care


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Nursing home care

Financial Assistance for Nursing Home Care in Virginia

Most people do not pay for skilled nursing care entirely out-of-pocket. Rather, they utilize financial assistance programs to help cover the cost of nursing care. Of public financial assistance programs, Medicaid provides the most comprehensive coverage of nursing home care. But, not all seniors qualify. And because each state operates its own Medicaid program within federal guidelines, eligibility and benefits vary from state to state. Below, we provide more information on Medicaid in Virginia.

Virginia’s Medicaid Program

As of July 2020, 1,519,888 Virginia residents are enrolled in the state’s programs for Medicaid and CHIP, and 26,063 receive Long-Term Services and Supports. LTSS includes a variety of long-term care services, such as assisted living, home health care and nursing home care.

In Virginia, Medicaid covers the cost of nursing home services for those who can’t afford the price of care. Recipients must meet a countable income limit of $2,205 per month to qualify. Individuals must also undergo a preadmission screening to determine whether nursing home care is medically necessary. Care is determined medically necessary when an individual requires around-the-clock skilled nursing services and assistance with a number of activities of daily living, including eating, bathing, dressing and toileting. Several waiver programs are available to help pay for the cost of care. There are currently 287 registered nursing homes in Virginia that serve more than 19,500 people per year.

Medicaid Eligibility in Virginia

To receive Medicaid benefits in Virginia, an individual must be a resident of the state and a U.S. citizen, national or legal alien who meets income eligibility requirements. Income must be within 138% of the Federal Poverty Level, which is approximately $16,971 per year for a one-person household. Countable assets cannot exceed $2,000 per individual. Those whose income exceeds the limit may be eligible for the Medically Needy Program, which allows recipients to use medical bills to reduce or spend down their income to allowable levels. 

Virginia residents can apply for Medicaid online via the state’s CommonHelp portal. Paper applications may be dropped off or mailed to a senior’s local Department of Social Services.

Alternative Financial Assistance Options

  • Medicare: Medicare will cover the cost of one’s care in a skilled nursing facility for the first 20 days of their stay, and a portion of the costs up until day 100. After 100 days, the individual is responsible for all costs. Seniors must also have a “qualifying hospital stay” of at least 3 days prior to their admission to a nursing home in order to qualify for Medicare coverage.
  • Aid and Attendance: Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for skilled nursing care.
  • Reverse Mortgages: If you own a home, you may be able to use a reverse mortgage to help pay for nursing care. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home’s equity into cash. This type of funding can be especially useful for married couples when only one partner needs nursing care, as the other residents of the home may continue living there. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.
  • Long-Term Care Insurance: Seniors who already have long-term care insurance may be covered for skilled nursing care. Most policies cover at least a portion of the cost of nursing home care, but it depends on the specific policy terms. Note that older adults who are already in need of skilled nursing care will not be eligible to sign up for a LTC insurance policy.

Free and Low-Cost Resources for Seniors in Virginia

Seniors in Virginia have access to a number of programs and services that may help them cover the cost of nursing home care or access services that can help them remain in their own home for as long as possible.

Adult Services Program(804) 662-7000The Adult Services Program connects seniors with resources, support and options for free or low-cost home care. Services may include assistance with daily living activities, adult foster care and long-term support screenings.
CCC Plus Waiver(804) 649-8481Seniors 65 and up with a medical or nursing need may be eligible for this waiver, which provides agency- and consumer-directed services, such as personal care, home health care, therapy and social services. The waiver includes up to $5,000 per year for environmental safety modifications to an individual’s home.
Auxiliary Grants(804) 662-7531Seniors who live in a licensed assisted living community, nursing home or other approved supportive housing setting may be able to receive an Auxiliary Grant income supplement. The grant covers room and board, personal care, supervision and some basic medical services. Recipients also receive a personal allowance for clothing, eyeglasses and over-the-counter medications. Seniors must be 65 or older, disabled or blind to qualify.
Program for All-Inclusive Care of the Elderlyinfo@vapacealliance.comPACE is an alternative to nursing home care and provides a comprehensive spectrum of services, including skilled nursing, personal care and help with activities of daily living in a senior’s own home and in long-term care facilities. Prescription drugs and medical specialties are also covered. PACE can help seniors with the transition to a nursing home setting when necessary. Individuals must be 55 or older, certified by the state as requiring nursing home care and live in one of PACE’s 11 service areas to qualify.
VA Aid and Attendance/Housebound Allowance(800) 698-2411Seniors who receive a VA pension may also be eligible for additional monthly payments that can help pay for home care or skilled nursing. Seniors must reside in a nursing home or need significant assistance with living activities to qualify for Aid & Attendance benefits. Those who are permanently disabled and seldom able to leave home can receive the Housebound Allowance.
Tax Relief and Exemptions(804) 332-2111Several tax rebates and exemptions available to Virginia seniors who are living in their own home or a nursing home can make it easier for residents to afford the care they need. Certified chronically ill individuals can deduct the cost of meals, medical expenses and lodging in a long-term care facility. The state offers an $800 exemption for seniors 65 or older with an additional exemption offered to blind individuals.
Office of Aging Services(804) 662-7000In conjunction with Virginia’s 25 Area Agencies on Aging, the Office of Aging Services connects seniors and their families with assistance that may help them pay for nursing home care. Volunteers can direct seniors who live at home to a variety of local resources, including meal delivery, transportation services and free or low-cost home care for residents with limited income.

Nursing Home Laws and Regulations in Virginia

Licensing RequirementsAll SNFs must be licensed by the state of Virginia. Licenses may be valid for one to three years depending on annual inspection results. A six-month provisional license is provided to facilities with significant issues that need to be addressed immediately.
Staffing RequirementsAll nursing facilities must employ a full-time administrator who is responsible for day-to-day management. Current Virginia law does not mandate any staff-to-resident ratio although there’s a minimum number of staff who must be on night duty and in special needs units.
Staff Training RequirementsDirect care staff must be at least 18 years old unless certified as a nurse aide in Virginia. Staff must complete a Virginia Board of Nursing-approved educational program to become a nurse aid, registered nurse or practical nurse licensure, or they must currently be enrolled in a program that includes at least 40 hours of direct care clinical experience.
Admission RestrictionsResidents may not be admitted if the facility cannot provide an appropriate level of care or if the individual requires a type or level of care that the facility isn’t licensed to provide.
Care Planning RequirementsIndividuals must be provided with a preliminary plan of care within seven days of admission to a SNF and a comprehensive care plan within 30 days of admission. Plans should be reviewed and updated every 12 months or as the resident’s condition changes.
Dietary and Nutritional Services RequirementsA minimum of three meals must be provided per day with snacks available to residents at all times. Residents on a special diet must have their dietary plan reviewed by a dietitian or nutritionist every six months.
Specialized Rehabilitative ServicesSNFs must ensure that residents’ rehabilitative needs are met by coordinating with appropriate professional service providers. Staff should make every effort to keep residents active and encourage compliance with physical therapy exercises between appointments.
Medication and Pharmaceutical ServicesFacilities must have a current, up-to-date written plan for medication management that has been approved by the resident’s physician. Staff administering medication must be licensed to do so or certified as a medication aide by the state.
Activities RequirementsSNFs must provide a variety of individual and group activities that accommodate all levels of ability. Facilities licensed for residential and assisted living care must offer at least 14 hours of scheduled activities per week for no less than one hour per day.
Infection Control RequirementsFacilities must have a written infection control program that’s consistent with guidelines provided by the Centers for Disease Control and Prevention. The plan must be reviewed annually by administrators and approved by a licensed health care professional.
Medicaid CoverageMedicaid covers the cost of nursing home care in Virginia for those deemed financially and medically eligible.