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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.
Beckley
$12106
Charleston
$12106
Morgantown
$11482
Parkersburg
$9384
Wheeling
$7528
Huntington
$6844
Weirton
$6570
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.
In-Home Care
$3527
Home Health Care
$3527
Adult Day Care
$2243
Assisted Living Facility
$4000
Nursing Home Care
$11376
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 $32,904 per year. If both spouses apply for Medicaid, the limit is $32,904 each or $65,808 per year for both people. Asset limits are $2,000 per person or $3,000 when both spouses apply.
| Household Size | Number of Applicants | Income Limits Per Year* | Asset Limits: Applicant(s) | Asset Limits: Non-Applicants |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,000 | |
| Two People | 1 | $32,904** | $2,000 | $148,620 |
| Two People | 2 | $65,808*** | $3,000 |
* Except for a $50/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient's monthly income must be put toward the cost of nursing home care.
** Income limit is for applicant only.
*** Income is limited to $2,742 per month per spouse.
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 |
|---|---|---|
| Benefits.gov | (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. |
| West Virginia PATH | (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. |
| West Virginia Consumer Assistance | (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.
| Program | Contact | Service |
|---|---|---|
| West Virginia Bureau of Senior Service (SHIP) | (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. |
| Bureau for Children and Families | (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. |
| HealthInsurance.org | (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.
| Name | 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
There are many resources in West Virginia that assist seniors in their retirement. Caring.com has compiled information on local organizations, programs and agencies and categorized them into care types for easy reference.
Area Agency on Aging
Retirees can find support and advice on various senior-related issues from their local Area Agency on Aging. The agency provides advice on topics such as financial assistance programs, in-home care and long-term care planning. It also connects seniors and caregivers with community-based resources.
| Program Name | Phone Number | Description |
|---|---|---|
| West Virginia Area Agencies on Aging | West Virginia's Area Agencies on Aging cover four regions and are vital for helping older adults maintain their independence and age in place. Services include the Lighthouse program, which provides personal care, nutrition and mobility support and assistance with light housekeeping chores. West Virginia's AAAs also include help with Medicare planning, respite care and caregiver services. |
Cash Assistance Programs
Cash assistance programs in West Virginia provide financial support to help low-income retirees remain in their own homes for as long as possible. Seniors and caregivers can apply for tax rebates and reductions, discounts on vital services and help covering the cost of heating and cooling their home.
| Program Name | Phone Number | Description |
|---|---|---|
| West Virginia Lifeline Program | 800-234-9473 | The LifeLine Program offers a discount on landline or mobile telephone service, ensuring that participants can stay in contact with loved ones. |
Food Assistance Programs
Local organizations help ensure elderly citizens have a balanced diet and receive essential vitamins and minerals to remain healthy. Through nutrition programs, congregate meals, home-delivered meals and food pantries, these programs help West Virginia seniors afford the nutritious food they need.
| Program Name | Phone Number | Description |
|---|---|---|
| West Virginia Seniors Farmers Market Nutrition Program | 304-558-3550 | West Virginia Department of Agriculture administers this federal funded grant program to provide low-income seniors with access to locally grown fruits, vegetables, honey and herbs; and to increase the domestic consumption of agricultural commodities through farmers markets and roadside stands. This program also aids in the development of new and additional farmers markets and roadside stands. Program period for eligible seniors to sign up is June – October. Farmers trained for this program April – July. |
| West Virginia Supplemental Nutrition Assistance Program (SNAP) | 304-205-6357 | The Supplemental Nutrition Assistance Program (SNAP) is administered by DHHR and governed by federal law and regulations of the U.S. Department of Agriculture, Food Nutrition Services. SNAP provides monthly benefits to help eligible households buy food. |
| West Virgnia Meals on Wheels | West Virginia Meals on Wheels helps seniors in their communities by providing nutritious meals and other support services. Deliveries are available to eligible homebound seniors ages 60 and over as well as those unable to prepare their own food. The program also offers balanced meals in congregate settings with peers. Additional services vary by location but may include emergency deliveries during inclement weather, pet food delivery, transportation to medical appointments and hospital readmission programs. |
Free Used Medical Equipment
Due to the high cost of purchasing new medical equipment, several organizations in West Virginia collect lightly used medical devices such as wheelchairs, ramps and walkers and distribute them to local seniors and residents in need.
| Program Name | Phone Number | Description |
|---|---|---|
| West Virginia Assistive Technology System | 800-841-8436 | Through the West Virginia Assistive Technology System's device reuse program, seniors can receive free gently used medical equipment. Seniors who have a short-term need for medical equipment can borrow devices for up to 30 days. |
| West Virginia Community Living Services Program (CLSP) | 304-525-3324 | Mountain State Centers for Independent Living operates an assistive technology loan program. Seniors can borrow the devices they need for a short time. If seniors need help financing a device, staff can provide referrals and help with applications. |
| West Virginia Telephonic Communication Device Loan Program | 304-558-1675 | The West Virginia Commission for the Deaf and Hard of Hearing distributes free telecommunications equipment. Seniors who have a verified hearing loss can borrow an amplified phone, captioned phone or teletypewriter. |
Home Repair and Modifications
Seniors and those with disabilities can access a variety of local resources to help them pay for home repairs and modifications. Programs in West Virginia have different eligibility criteria and often assist retirees by providing grants or loans.
| Program Name | Phone Number | Description |
|---|---|---|
| The West Virginia Homeowner Rescue Program (WVHR) | 211 | The West Virginia Homeowner Rescue Program uses funding from the U.S. Department of the Treasury to help seniors and other homeowners in West Virginia cover the cost of critical home repairs that make their homes livable. Homeowners can receive up to $10,000 in funding for work completed by a licensed, insured contractor. To qualify, applicants' income must not exceed 150% of the area median income, and they must have experienced financial hardship related to the COVID-19 outbreak. |
| West Virginia Housing Rehabilitation Program | 304-562-5896 | The city of Hurricane, WV, works with a variety of work camp organizations that provide home rehabilitation services for seniors, disabled individuals and those in financial need. These groups travel to various cities, including Hurricane, and typically spend a week fixing and modifying local homes in need. Groups are made up of youth and adult volunteers. Local residents can contact City Hall to apply for this free service, offered periodically throughout the year. |
| West Virginia Section 504 Home Repair Program | 800-295-8228 | The Section 504 Home Repair program provides loans to help eligible homeowners repair or modify their homes. Senior homeowners (62+) may qualify for grants to eliminate safety hazards around the home. |
Legal Resources
Many organizations offer free or low-cost legal services to West Virginia seniors. Older adults can access advice on issues such as estate planning, living wills and power of attorney. Some firms also act as long-term care ombudsmen, advocating for the rights of seniors in senior living communities.
| Program Name | Phone Number | Description |
|---|---|---|
| Legal Aid of West Virginia | 866-255-4370 | Legal Aid of West Virginia provides free civil legal services to those aged 60 and over statewide. This agency has licensed legal professionals who specialize in applying for public benefits, understanding assisted living contracts and preparing for future care and medical needs. The agency also serves as the long-term care ombudsman for the Hurricane region and advocates on behalf of those in assisted living facilities. |
Social Security Offices
Social Security offices in West Virginia help seniors and disabled people access the benefits they're entitled to. Older adults can contact their local office for information about receiving retirement benefits, disability allowance and Supplemental Security Income.
| Program Name | Phone Number | Description |
|---|---|---|
| West Virginia Social Security | Social Security is a source of income available to retirees and people who can no longer work because of a disability. The money for Social Security comes from a payroll tax levied on employers, employees and self-employed individuals. When you retire, you'll receive monthly payments based on how much you earned when you were working. |
Tax Assistance
Seniors can apply for tax assistance from several West Virginia resources. Elderly residents and those with disabilities could be eligible for tax exemptions on medical expenses, reductions on property tax and other tax assistance programs.
| Program Name | Phone Number | Description |
|---|---|---|
| West Virginia Homestead Exemption | 800-982-8297 | This property tax exemption program helps reduce the cost of homeownership for eligible seniors. It exempts the first $20,000 of a home's value from property taxes. If approved, they will see the exemption on their next tax bill. |
Utility & Energy Bill Assistance
Low-income seniors who are struggling to meet the costs of maintaining their homes can find support from organizations that offer assistance with utility and energy bills. West Virginia retirees could also qualify for emergency funding programs if they're in danger of losing utility services due to unpaid invoices.
| Program Name | Phone Number | Description |
|---|---|---|
| West Virginia Low Income Energy Assistance Program (LIEAP) | 304-205-6357 | The West Virginia Bureau for Family Assistance administers two programs that support low-income seniors. The Low-Income Energy Assistance Program covers heating and cooling costs via cash benefits or payments sent directly to utility providers. The Low-Income Household Water Assistance Program assists those whose water services have been disconnected due to nonpayment. LIHWAP covers the costs of water and sewer charges. Income limits apply to both programs. |
Veteran's Services
West Virginia retirees who have served in the U.S. military can find support from local veteran services. These offices and organizations help vets access the benefits they're eligible for and provide advice and information on a variety of issues.
| Program Name | Phone Number | Description |
|---|---|---|
| West Virginia VA Benefits and Health Care | Senior veterans can access physical and mental health care through West Virginia VA Benefits and Health Care. Outpatient clinics provide medical services, along with vet centers in cities, including Beckley and Charleston, where counseling is available. At multiple benefits' offices in West Virginia, seniors can file claims and get help accessing veterans' benefits. |
Nursing Home Laws and Regulations in West Virginia
| Topic | Rule |
|---|---|
| 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. |
Facilities in West Virginia
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