Nursing Homes in West Virginia

With its beautiful location in the Appalachian Mountains, West Virginia appeals to people who love nature. It’s currently home to nearly 1.8 million residents, and 20.5% of the population is aged 65 and older. The state’s many senior services make it popular with retirees.

In addition to room and board, nursing homes provide around-the-clock supervision along with skilled nursing care. The Genworth Cost of Care Survey for 2020 indicates West Virginia has a higher-than-average cost for nursing home care. Seniors who want a semiprivate room pay an average of $11,276, and the cost increases to $12,136 for a private room.

This guide provides an overview of nursing home care options for West Virginia seniors, including what it may cost and what options to pay for coverage are available. It also offers resources that frail seniors and their families can use to help with independence at home or the transition to nursing home care.

The Cost of Nursing Home Care in West Virginia

The cost of skilled nursing home care in West Virginia is high compared to the rest of the nation. According to the 2020 Genworth Cost of Care Survey, West Virginia seniors pay an average of $11,376 per month for a semiprivate room in a nursing home. This is significantly higher than the national average of $7,756, and it’s also higher than the costs in several nearby states. For instance, in Kentucky, families can expect to pay around $7,330 per month, and in Virginia, the cost is just a little more at $7,665. Ohio has one of the lowest costs in the region at $7,148. In Pennsylvania, the average cost is $10,038 per month. While this is closer to the West Virginia rate, it’s still over $1,300 less expensive.

Across West Virginia, the cost of nursing home care varies quite a bit. In Weirton in the northern part of the state, seniors pay an average of $6,570. To the south in Beckley, the cost is nearly double at $12,106 per month, and nearby Charleston shares this high cost. In Huntington, located near the Kentucky border, the average cost is just $6,844 per month, while near the Ohio border in Parkersburg, the median cost is $9,384. In Wheeling, seniors pay an average of $7,528, while the cost in Morgantown is much higher at $11,482 per month.

Nursing home care is just one of several senior care options available in West Virginia. In comparison to the $11,376 average for nursing home care, the monthly identical costs of home care and home health care services are significantly lower at $3,527, based on an average of 44 hours of care per week. Residential care in an assisted living community costs $4,000, on average, while adult day care is the most affordable option at just $2,243 per month.

Does Medicaid Cover Nursing Home Care in West Virginia?

In West Virginia, Medicaid covers the cost of nursing home care for eligible individuals, including those with doctors’ orders and those who are unable to care for themselves. As of July 2021, more than 588,279 individuals were enrolled in Medicaid in the state. This program can cover the cost of personal care, including bathing, dressing, meals, housekeeping, mobility and medication monitoring. It also covers skilled nursing and other special services such as speech and occupational therapy.

Seniors who require around-the-clock monitoring and hospital-level care in West Virginia have access to 123 nursing homes throughout the state. Aside from Medicaid, the Medicaid Waiver (also referred to as the Home and Community-Based Services Waiver) and the Aged and Disabled Waiver can help provide assistance to those in long-term care.

Medicaid Eligibility in West Virginia

Medicaid for nursing homes is an entitlement program, meaning anyone who’s eligible can receive assistance. Income limits are calculated as a percentage of the federal poverty line. In West Virginia, individuals who are elderly, blind or disabled must have incomes that fall below 74% of the federal poverty line, which is $30,276 per year. If both spouses apply for Medicaid, the limit is $30,276 each or $60,552 per year for both people. Asset limits are $2,000 per person or $3,000 when both spouses apply.

2022 Medicaid Income Limits for Seniors in West Virginia

Other eligibility requirements apply. Applicants must be:

• American citizen or legal resident
• West Virginia resident
• Blind or disabled; or
  
• 65 years of age or older; or
  
• Responsible for a child who’s 18 years old or younger

How To Apply for Medicaid in West Virginia

There are several ways to apply for Medicaid, including online through the Health Insurance Marketplace at www.healthcare.gov or through the federal call center at (800) 318-2596. The West Virginia Department of Health and Human Resources (DHHR) also offers applications online at www.wvpath.org, or individuals may contact their local DHHR office. Local DHHR offices can provide paper documentation that may be submitted by mail, or individuals may contact the customer service call center at (877) 716-1212.

Information You Will Need:

• Copy of birth certificate
• Social Security card
• Bank statements for the past 5 years
• Proof of income for the past 5 years
• Verification of retirement income
• Proof of citizenship
• Legal documents, including powers of attorney, wills and legal trusts
• Home deeds
• Life insurance documentation

Additional Medicaid Support & Resources in West Virginia

The following is a list of resources that provide information on Medicaid, including how to apply. These free resources can be found online or contacted by phone.

Does Medicare Cover Nursing Home Care in West 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 and Resources in West Virginia

Families that are considering nursing home care for loved ones and require assistance in paying for services may check to see what services are covered under Medicare. Other types of insurance may also help with some services. Organizations on the following list may be able to provide information and assistance.

Other Financial Assistance Options for Nursing Home Care in West 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.

Free and Low-Cost Resources for Seniors in West Virginia

Seniors in West Virginia have access to multiple programs and services that help improve their quality of life. These programs are available at low cost or for free.

COVID-19 Rules for Nursing Homes in West Virginia

The following information is based on research done on several government websites, including dhhr.wv.gov/covid-19. 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

*Note: This information was not available for this state, contact your local area agency on aging or senior living facility for more information.

Outings & Social Activities

*Note: This information was not available for this state, contact your local area agency on aging or senior living facility for more information.

COVID-19 Safety Measures for Staff and Residents

Nursing Home Laws and Regulations in West Virginia