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.

$7665

Virginia

$7756

The United States

$11376

West Virginia

$10190

Maryland

$7300

North Carolina

$7072

Tennessee

$7330

Kentucky

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.

$9566

Winchester

$9125

Harrisonburg

$9064

Richmond

$7665

Virginia Beach

$7665

Blacksburg

$7513

Roanoke

$7452

Charlottesville

$6644

Lynchburg

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.

$1603

Adult day care

$4195

Home care

$4395

Home health care

$4850

Assisted living

$7665

Nursing home care

Does Medicaid Cover Nursing Home Care in Virginia?

In Virginia, there are over 1,739,600 residents enrolled in Medicaid. Once approved, seniors can receive coverage for nursing home placement and apply for other Medicaid programs. Coverage includes inpatient and outpatient hospital services as well as physician and laboratory services.

The state has over 280 nursing homes, and most accept Medicaid. Skilled nursing facilities can provide a higher level of care than what is available in assisted living or memory care communities. Alternatively, the Program of All-Inclusive Care for the Elderly (PACE) and the Commonwealth Coordinated Care Plus (CCC+) Waiver offer personalized care services in residential care facilities to prevent nursing home placement.

Medicaid Eligibility in Virginia

To be eligible for Medicaid in Virginia, the applicant’s income must be at or below $2,523, and assets cannot exceed $2,000. Couples cannot make more than $5,046 per month, and they must have no more than $4,000 in assets although some items can be excluded, such as a home and vehicle. If only one spouse is applying for benefits, the other spouse may be able to retain up to $137,400 in additional assets.

2022 Medicaid Income Limits for Seniors in Virginia

Monthly Income Limits

Asset Limits

Single Applicant

$30,276

$2,000

Two-Person Household
(Only One Person Applying)

$30,384

$2,000 for applicant
$137,400 for non applicant

Two-Person Household
(Both People Applying)

$60,552

$4,000

If the applicant’s income is higher than the limit, they may be able to spend down their income on medical services or by paying off debt if they meet specific requirements. Other qualifications include:

  • Citizenship status
  • Proof of residence
  • Military discharge status, if applicable

How to Apply for Medicaid in Virginia

Seniors and loved ones can apply for Medicaid in Virginia online or over the phone. Paper applications can be completed and submitted to a local Department of Social Services office. To apply online, Virginians can use CommonHelp. Before starting the application, seniors and loved ones should properly prepare by collecting appropriate documentation.

Information You Will Need:

  • Birth certificate or green card if born outside the United States
  • Social Security card
  • Medicare cards along with any other health insurance coverage
  • Bank statements from up to 60 months before the date on the application
  • Proof of earned and unearned income from the past 60 months, including 1099s
  • Proof of pensions, including a letter from the provider
  • Copy of life insurance policies
  • Proof of real property that has been sold or transferred within the past 60 months
  • Car registration and insurance
  • VA discharge papers (Form DD 214) for veteran applicants
  • Copies of documents pertaining to wills and trusts or powers of attorney
  • Any documents the applicants can use to support their claim

Additional Medicaid Support & Resources in Virginia

Seniors and loved ones who are applying for Medicaid can use any of the resources listed below to assist them during the application process or to get help with financial planning for long-term care. If they haven’t applied yet, Benefits.gov has an eligibility screening tool that can give applicants peace of mind as they wait for their application to be approved.

Resource

Contact

Service

(804) 662-7000

The Department for Aging and Rehabilitative Services offers Virginians a one-stop shop for over 27,000 programs and services throughout the state. With a network of over 500 providers, No Wrong Door Virginia can help families and seniors find the right nursing home or access personalized care services that can delay nursing home placement.

Online Only

The Medicaid Planning Assistance website offers a comprehensive guide to public and private Medicaid planners in addition to providing plenty of reading material for self-planners. Families and seniors can use the site to determine Medicaid eligibility and learn about Medicaid coverage. Users can also read about how to avoid application denials and apply for HCBS Waivers.

Online Only

VirginiaNavigator is a free website with a library of statewide and nationwide resources for seniors, veterans and disabled residents. Users can search for benefits by location and topic. The website also provides a list of books and articles that are relevant to the search query, such as guides for knowing when it's time for seniors to transition to long-term care facilities.

(855) 242-8282

As the federal government’s official website for benefits, Benefits.gov gives Americans the ability to browse by category and provides a series of video guides on how to find the right benefits to support their families. Seniors and loved ones can use the SSA Benefit Eligibility Screening Tool (BEST) to determine their eligibility for Medicare and other government benefits.

Does Medicare Cover Nursing Home Care in Virginia?

Medicare provides limited coverage for short-term stays in a skilled nursing facility following a hospital stay, but seniors must meet a number of specific requirements. This benefit is available to beneficiaries who have been hospitalized for at least three days, excluding the date of discharge, so it’s most valuable for those who are recovering from an injury, illness or surgery.

Once seniors meet the hospitalization requirement, Medicare will pay for up to 100 days of skilled nursing per benefit period. The first 20 days are covered in full. Starting on day 21, beneficiaries must pay a daily coinsurance rate. After day 100, seniors are responsible for the entire cost.

What Does Medicare Cover?

Medicare covers a number of specific services, including:

  • Meals
  • A semiprivate room
  • Medications
  • Skilled nursing
  • Physical therapy
  • Occupational therapy
  • Speech therapy
  • Audiologist care
  • Medical supplies
  • Medical social services
  • Nutritional counseling
  • Ambulance transportation

What Isn’t Covered by Medicare?

Medicare does not cover long-term custodial care that addresses seniors’ day-to-day needs. This includes help with daily activities, such as bathing, dressing and using medical equipment.

For more information about Medicare and when it covers Nursing Home Care, read our Guide to Nursing Homes.

Medicare Support & Resources in Virginia

While Medicare can’t cover all the costs of skilled nursing-level care, there are free programs designed to supplement Medicare coverage and help with out-of-pocket expenses. Whether families need help finding financial assistance or submitting an application, there are several websites providing detailed guides and free hotlines to address any questions or concerns.

Resource

Contact

Service

(800) 552-3402

The Virginia Insurance Counseling and Assistance Program (VICAP) provides unbiased and free Medicare counseling to beneficiaries and their families. In addition to explaining the basics of each Medicare component, experienced counselors can help seniors better understand their current policy and coverage. Counselors can assist with filing claims and appealing denials or determining if an individual qualifies for financial assistance to cover out-of-pocket costs.

(800) 794-6559

Provided by the National Council on Aging, BenefitsCheckUp offers a free library of statewide and nationwide benefits. Users can search by category or fill out a quick survey to determine their eligibility. Families can find financial assistance for medications and other health care needs in addition to family caregiver support and tax relief programs for the elderly and disabled. The website is available in English and Spanish.

(800) 633-4227

The official Medicare website offers a portal to apply for Medicare as well as lengthy articles about health care and drug plans. Users can explore the site's library of information on how to maintain benefits and what to do if they get fraudulent Medicare charges or lose their Medicare card. The website also provides a list of local medical and equipment providers.

Other Financial Assistance Options for Nursing Home Care in Virginia

While Medicaid and Medicare are two of the most common programs used to pay for Nursing Home Care, there are other financial assistance options available, depending on your unique situation.

How to Apply

How It Works

Aid and Attendance

Learn more and apply online at va.gov.

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

Learn more about your options and how to apply at ftc.gov

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. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.

Long-Term Care (LTC) Insurance

Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov.

Seniors who already have long-term care insurance may be able to use it to pay for skilled nursing care. Most policies cover at least a portion of the cost, but it depends on the specific policy terms. Note that older adults who are already in need of skilled nursing care will not typically be eligible to sign up for a LTC insurance policy.

Free and Low-Cost Resources for Seniors in Virginia

Listed below are free resources that can help Virginia families and seniors find local services and financial assistance for long-term care, many of which aim to delay seniors’ transition to skilled nursing facilities. A few of these, such as the Offices of Aging Services and PACE, offer a plethora of personal care services and partner with other organizations to ensure that seniors and caregivers find the services and programs they need.

Resource

Contact

Service

(804) 662-7000

The Offices of Aging Services provides a statewide network of services and programs for seniors and their caregivers. Working with long-term ombudsmen and other experienced professionals, the agency can help families assess their loved ones’ needs and plan for the future. Trained representatives can advise seniors and their families about how to identify and avoid Medicare scams as well as other financial exploits.

(804) 662-7000

The Adult Services Program provides personalized support for seniors whether they're homebound or residing in a long-term care facility. Designed to delay nursing home placement, seniors can receive assistance with acts of daily living and companion services, such as help with errands. Individuals who qualify for the Adult Services Program may also be eligible for screenings for Medicaid-funded services and Auxiliary Grants.

(804) 332-2111

Families and seniors may be eligible for tax relief if their medical expenses are more than a predetermined percentage of their adjusted gross income. Once the individual is certified as chronically ill, they can receive tax exemptions for personal and medical care services, including skilled nursing. To be considered chronically ill, seniors must need assistance with at least two activities of daily living and require supervision to ensure their well-being.

The goal of the Program of All-Inclusive Care for the Elderly (PACE) is to delay the need for institutional care provided in nursing homes and similar facilities. By providing a one-stop shop for health care services, seniors can find assistance for home- and community-based care whether they need acute or long-term care services. The program can also help families find ways to pay for care and predict future expenses.

(804) 662-7531

Provided by the Department for Aging and Rehabilitative Service, Auxiliary Grants can supplement the income of SSI recipients and individuals with certain disabilities, including blindness. The program can cover the cost of room and board as well as a select list of medical services. To determine eligibility, families should contact their local Department of Social Services. While not all assisted living facilities accept the grant, the website offers a list of participating facilities.

COVID-19 Rules for Nursing Homes in Virginia

The following information is based on research done on several government websites, including vdh.virginia.gov/coronavirus. These rules apply to Independent Living Communities and other types of senior living facilities. We’ve most recently updated this data on 2/15/2022, but since COVID-19 is a rapidly evolving pandemic, contact your local senior living facility or Area Agency on Aging for more specific and up-to-date information.

Visitation Policies

Rules for Virginia Communities

Are loved ones allowed to visit to provide emotional support?

Yes (Conditions Apply)

Are relatives allowed to visit for end-of-life care?

Yes

Are residents required to quarantine after visiting with a loved one?

No

Are visitors required to wear PPE (including masks) in order to visit residents?

Yes

Are non-medical contractors (such as hairdressers and entertainers) allowed in senior living facilities?

Yes

Does the state recommend or require that senior living facilities assist families with setting up virtual visit alternatives?

Yes

Are visitors checked for elevated temperatures?

Yes

Are visitors required to answer questions about health, travel, and potential virus contact?

Yes

Outings & Social Activities

Rules for Virginia Communities

Are residents allowed to leave (errands, visiting family, etc.) for non-medical reasons?

Yes

Are residents who leave required to quarantine when they return?

No (Conditions Apply)

Are senior living communities required to cancel all group outings?

No

Are residents allowed to eat meals together in a common area?

Yes (Conditions Apply)

Are residents allowed to gather in common areas for group activites?

Yes (Conditions Apply)

COVID-19 Safety Measures for Staff and Residents

Rules for Virginia Communities

Are staff members regularly required to do a temperature check?

Yes

Are staff members regularly tested for COVID-19?

Yes (Conditions Apply)

Are staff members members regularly required to do a health and safety screening, including questions about travel, contact with positive cases, etc?

Yes

Are residents regularly screened for COVID-19 symptoms?

Yes

Are residents regularly checked for elevated temperatures?

Yes

Are residents regularly tested for COVID-19?

Yes (Conditions Apply)

Nursing Home Laws and Regulations in Virginia

NURSING HOME LAWS AND REGULATIONS IN VIRGINIA
Licensing Requirements
All 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 Requirements
All 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 Requirements
Direct 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 Restrictions
Residents 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 Requirements
Individuals 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 Requirements
A 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 Services
SNFs 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 Services
Facilities 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 Requirements
SNFs 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 Requirements
Facilities 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 Coverage
Medicaid covers the cost of nursing home care in Virginia for those deemed financially and medically eligible.