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.

$11376

West Virginia

$7756

The United States

$7148

Ohio

$7330

Kentucky

$7665

Virginia

$10038

Pennsylvania

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.

$12106

Beckley

$12106

Charleston

$11482

Morgantown

$9384

Parkersburg

$7528

Wheeling

$6844

Huntington

$6570

Weirton

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.

$3527

In-Home Care

$3527

Home Health Care

$2243

Adult Day Care

$4000

Assisted Living Facility

$11376

Nursing Home Care

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

Annual Income Limits

Asset Limits

Single Applicant

$30,276

$2,000

Two-Person Household

(Only One Person Applying)

$30,276

$2,000 for applicant

$137,400 for non-applicant under the Spousal Impoverishment Act

Two-Person Household

(Both People Applying)

$60,552

$3,000

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.

Resource

Contact

Service

(800) 318-2596

Benefits.gov is a federal website that provides information on Medicaid and other benefit programs in each state. Information includes a brief description of Medicaid and what it’s used for, eligibility information and contact information to apply for the program.

(844) 451-3515

West Virginia PATH, the online resource for applying for and receiving public benefits, including Medicaid, is operated by DHHR. PATH allows applicants to check the status of an application, make changes and check additional account information.

(888) 879-9842

West Virginia Consumer Assistance provides information about health care options within the state. Consumer Assistance also directs individuals to the correct agency to apply for benefits.

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.

Resource

Contact

Service

(304) 558-3317

West Virginia’s SHIP program provides information on Medicare, including supplemental plans and monthly rate comparisons. SHIP also provides workshops for professionals and individuals who need additional information about Medicare.

(304) 558-0628

The Bureau for Children and Families is operated by the West Virginia DHHR. The bureau helps individuals sign up for Medicare and can explain the different parts, co-pays and deductibles.

(866) 677-9426

Licensed insurance agents provide information on Medicare and Medigap and can help individuals sign up for the services they need. The Marketplace also provides information on supplemental insurance that can offset additional costs not covered by Medicare.

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.

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 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.

Resource

Contact

Service

(877) 987-3646

The Lighthouse Program is a state-funded program that provides seniors with up to 60 hours per week of assistance with personal care, mobility, nutrition and housekeeping. Eligible individuals should be at least 60 and meet the functional eligibility needs.

(877) 987-3646

County Aging Providers operates senior centers in every county throughout the state. Services vary by county but may include health and fitness, games, hobbies, outings, transportation and meals.

(800) 834-0598

The West Virginia Long-Term Care Ombudsman resolves issues affecting long-term care residents related to health, safety, welfare and individual rights. The ombudsman educates individuals about their rights and good care practices and engages communities through volunteer opportunities.

(866) 255-4370

Legal Aid of West Virginia is a state nonprofit organization that provides free legal assistance to seniors and other low-income individuals. Legal Aid accepts cases involving consumer rights, elder rights, conservatorships and legal guardianships. The program holds free legal clinics to offer help to the community. Seniors may apply online or by calling the program.

(866) 981-2372

The West Virginia Aging & Disability Resource Network connects seniors with programs and services that help them remain in their homes as long as possible. A current list of available resources is on the network website, or seniors may contact the organization by phone for more information.

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

Rules for West 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?

Not Available*

Are visitors checked for elevated temperatures?

Yes

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

Yes

*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

Rules for West Virginia Communities

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

Not Available*

Are residents who leave required to quarantine when they return?

Not Available*

Are senior living communities required to cancel all group outings?

Yes

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

No

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

No

*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

Rules for West 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 West Virginia

NURSING HOME LAWS AND REGULATIONS IN WEST VIRGINIA
Licensing Requirements
West Virginia nursing homes are licensed through the Office of Health Facility Licensure & Certification. Licenses can be issued for periods of up to 15 months.
Staffing Requirements
West Virginia requires long-term care facilities to maintain a ratio of licensed nursing staff to residents as follows:No less than 1:15 during morning shiftsNo less than 1:20 during afternoon shiftsNo less than 1:30 during nighttime shiftsIn addition, facilities must maintain the following ratio of direct care staff to residents:No less than 1:5 during morning shiftsNo less than 1:10 on afternoon shiftsNo less than 1:15 during nighttime shifts
Staff Training Requirements
Although West Virginia doesn't have specific nursing home staff training requirements, nursing facility administrators must ensure that staff members are properly trained and licensed according to the services they provide to residents.
Admission Restrictions
Nursing homes are only required to admit residents they can care for. If a resident has a condition a nursing home isn't equipped to handle, the facility can deny their admission.
Care Planning Requirements
All nursing homes in West Virginia must create a comprehensive care plan for each resident. This plan must be put in place within 7 days of the initial assessment of the resident. It must be created with the help of a registered nurse, an attending physician, the resident and the resident’s family or legal representative.
Dietary and Nutritional Services Requirements
A registered dietitian must be consulted when making meal plans for a nursing home. Menus need to meet the nutritional needs of residents. This includes the requirement to accommodate the diets of residents with special feeding or nutritional needs.
Specialized Rehabilitative Services
If the facility can't provide specialized rehabilitative services on-site, it must make arrangements to have the resident taken to a location where they can receive such services.
Medication and Pharmaceutical Services
In West Virginia, medication may only be administered by approved medication assistive personnel (AMAP). These are staff members who have completed a nationally recognized model curriculum for medication distribution. Medications must be prescribed by an authorized physician.
Activities Requirements
West Virginia nursing homes must employ an activities director to plan activities that meet the social, physical and mental needs of residents. All residents have the right to pursue activities that are of interest to them.
Infection Control Requirements
West Virginia nursing homes must protect residents from infection by following best practices, including good hygiene, hand washing, facility cleaning and screening for communicable diseases.
Medicaid Coverage
Medicaid may pay for some or all of the costs of nursing home care for West Virginia residents who meet the program's financial guidelines and are deemed medically in need of a nursing facility level of care.