Virginia Assisted Living


Virginia Assisted Living: How to pay, Licensing and Questions to ask…

Virginia has got metropolis’ for the city folk and smaller, slower towns for those looking to live a more laidback lifestyle. The population is well educated, the economy is bustling. For these reasons and many others, people enjoy living in Virginia. Of the nearly 9 million residents of the state, 14% are aged 65 and older. As people age, some may require long-term care, and others may require only some assistance while lessening responsibilities. Typically, when people think of senior care or housing they envision a nursing home. But nursing homes are far from the only option for aging adults who may need a change of scenery or some care. When the time comes to move into a new housing situation, Virginia assisted living communities offer your loved one the benefit of security and peace of mind. These communities are a specific level of care in a community setting.

Virginia is home to several cities offering excellent healthcare for seniors: Norfolk, Virginia Beach, Richmond, Williamsburg. Jamestown, Roanoke, among many others.

Assisted living in Virginia is not the only senior care option available to you and your loved one. There are a variety of types and levels of care aside from a nursing home or an assisted living community. It’s good to be informed as you find the right fit for your loved one.

Common terms that differentiate levels and types of senior living: 

  • Continuing Care Retirement Communities (CCRCs)- typically include independent living, assisted living, residential care and skilled nursing services all on one campus.  
  • Independent Living Communities – provide residents a setting without the burden of home ownership. Residents commonly live in fully equipped private apartments or cottages from a studio to large two-bedroom units.  
  • Care Home or Adult Family Care Home- are private residences in a home-like setting that provide care services to a smaller more limited number of residents (typically 5-12 residents, depending on each state’s regulations). 
  • Assisted Living- provides housing and supportive care in a community setting, but the residents do not require 24-hour nursing care. 
  • Memory Care- a care setting for residents with memory loss or confusion. The community typically has a “secured” entry for residents that may wander. This care can be provided in different care settings depending on the state licensing requirements. 
  • Skilled Nursing is state licensed to provide a safe, therapeutic environment for people who require rehabilitative care 24 hours a day.

Assisted Living in Virginia

Most Assisted Living Communities will provide a bedroom, restroom, meals, and assistance with care. Additionally, the size and amenities of each community can vary greatly and affect cost. Assisted living may be ideal for residents who want to experience increased socialization, classes for health and fitness, and quality nutrition plans.

Assisted living in Virginia is referred to as “Assisted living facilities.” Federally, The most common universal term is assisted living. The lay person sometimes groups all senior housing into the term of “nursing home.” Assisted living communities are NOT nursing homes.

There are conditions in which assisted living in Virginia cannot take in residents:

If the individual requires care the facility is not licensed to provide, like continuous licensed nurse care, or if the person is reliant on a ventilator, or if they require any intravenous injections, or if they pose a threat to themselves or others.

What services are offered in assisted living in Virginia?

Aging adults may move into assisted living communities to receive help with activities of daily living (ADLs):

  • Dressing
  • Bathing
  • Medication assistance and reminders
  • Eating 
  • Toileting and incontinence management
  • Transferring

Typically, assisted living communities provide meals, light housekeeping, and activities program. Additionally, some may also offer support such as scheduled transportation and linen service.

Other possible services and amenities in Assisted Living

*Particular amenities and services will only be available in certain communities. Not all communities will offer special amenities.

Life enrichment: Activities should be provided for the enrichment of residents. Typically, these include light exercise, social opportunities, or spiritual programming.

Additional activities and amenities may include:

  • Clubs
  • Game nights
  • Classes 
  • Parties and other social events
  • Planned outings

Laws and regulations in Virginia


In Virginia, ALFs must meet specific criteria as put forward by the Virginia Uniform Statewide Building Code. A maximum of two residents per bedroom; bathtubs and showers are required to have handrails, grab-bars, and non-slip surfaces; all bedroom should have easy access to signaling devices to get in contact with direct care staff.


All facilities are required to have an administrator responsible for the day to day operations. Two care workers must be present and awake to perform duties at all times.

Employees must be 21 years of age, graduates of high school and have minimum one year caring for adults in a long-term care facility. All employees must be trained in CPR and have training dealing aggressive residents who may require restraints.

Expected monthly costs of assisted living in Virginia

The cost of assisted living in Virginia is roughly $750 more than the national monthly average. In Virginia, assisted living costs $5,250 per month; the national average per month is $4,500.

Nearby states – North Carolina and West Virginia are comparable in cost.

  • National average cost of assisted living per month: $4,500
  • Virginia: $5,250
  • North Carolina: $5,400
  • West Virginia: $5,050
  • Kentucky: $4,025
  • Maryland: $3,775

Washington D.C. is one of the most expensive places in the United States for assisted living and other forms of senior housing and care, at nearly $6,000 per month. Roanoke is similarly costly at about $5,950 per month. The rest of the state is still generally more expensive than what you see around the country.

  • Virginia average cost of assisted living per month: $5,250
  • Washington D.C.: $6,000
  • Roanoke: $5,950
  • Charlottesville: $5,700
  • Richmond: $4,925
  • Winchester: $5,025
  • Virginia Beach: $4,700

How to pay for assisted living in Virginia

You want to consider your payment options for assisted living, memory care, and care homes. For these services, Medicare is NOT an option for payment.

The most common payment for these services would be out of pocket Private Pay and assessing a combination of retirement funds, personal savings, and pension payments.

Medicaid can also be an option, be sure to see if you or a loved one qualifies.

Long-Term Care insurance is also a possible option in cases of chronic conditions, be sure to see if you or a loved one qualifies.

For our Veterans and spouses of veterans, be sure to assess Veteran Aid and your eligibility for these benefits.

Medicare – NO:

  • Medicare does NOT pay for Assisted Living.
  • People 65 years and older and individuals with end stage renal disease are eligible for Medicare benefits, no matter their income.
  • Coverage is meant for people in need of short-term care.

Private pay – YES:

  • Many families pay for assisted living with private funds.
  • Private pay can be a combination of retirement funds, personal savings, and pension payments.
  • Family members may contribute funds to pay for assisted living or other senior housing and care.

Medicaid – MAYBE:

  • Medicaid provides health coverage to millions of Americans. Eligible participants include: low-income adults, elderly adults and people with disabilities.
  • Medicaid is administered by state, according to federal requirements. The program is funded jointly by each state and the federal government.
  • Every state has their own individual Medicaid assistance program.
  • National guidelines are in place do decipher how states must spend Medicaid money, but with allowances toward the guidelines.
  • The state determines what levels of care will be covered by Medicaid, who is eligible, and how much the state will reimburse the care community.
  • If you are unsure whether you qualify for Medicaid, you should apply. You may be eligible depending on your household income, family size, age, disability and other factors.

Long-term Care Insurance – MAYBE:

Long term care insurance is a great way to pay for assisted living, and planning ahead is important when considering how to pay for senior housing and care. Nearly 75% of people over the age of 65 will require long-term care and services at some point. Buying into long-term care insurance when a person is in their 50s and 60s is the most common time to do so.

  • Long-term care insurance helps cover the costs of chronic medical conditions.
  • Individuals and couples with the ability to pay into long-term care insurance have the advantage of a head start in allocating funds for senior care.

Veteran Aid and Assistance – MAYBE:

This benefit is available to some military veterans and surviving spouses who live in an assisted living community and those who have in-home care.

  • There are specific guidelines, but a veteran may qualify for as much as $2,050 each month.
  • A veteran with a sick spouse may be eligible for $1,600 per month.
  • If a veteran has passed, their surviving spouse can qualify for $1,300 per month.

Questions to Ask

Finding an assisted living community can be overwhelming. Here are some tips on things to be observant of:

  • Make sure the facility is clean and well maintained. You can tell a lot about the operation by noting what is clean and maintained. Are doorknobs loose or damaged? Do you see any frayed carpet or trip hazards?
  • Visit during lunch hour to observe what the residents are eating. Ask questions about the nutrition program. Is there diversity in meals, healthy fruits and vegetables served at all meals, drink options?
  • Speak to residents and/or family members to learn their perspective.
  • Ask about staff and resident engagement. Get a feel for how staff interact with residents.
  • Ask about the life enrichment programs. Activities are crucial when it comes to quality of life and play a key role in care for older adults.
  • And finally (along with a plethora of more things to consider), get to know the leadership in the building. If you feel good around the Executive Director, Head Nurse, Lead Activities Director and even the Chef or Janitor, it is a good sign you can trust them with the care of your loved one.

Assisted Living: Questions and inquiries when visiting communities and facilities

  • Do the admission criteria match my needs?
  • Have I reviewed the terms of the financial/provider agreement?
  • Is the unused portion of the rent refunded upon transfer/discharge?
  • Do I have a choice in the selection of medical/health care providers if additional services are needed?
  • Are the specific services offered clearly identified in the agreement?
  • Have I reviewed house rules?
  • Have I reviewed all of the reasons for which I may be transferred of discharged?
  • Is the bedroom private or shared?
  • Is the bathroom private or shared?
  • Are the shared areas clean?
  • Is there space for personal belongings?
  • Does the floor plan allow for easy mobility for me?
  • Are there private areas other than the bedroom for visits?
  • Is bathroom safety equipment installed or available if needed? (grab bars, raised toilet seat)
  • Is there a call system?
  • Are walkers/wheelchairs permitted?
  • Are hallways and doorways wide enough for wheelchairs?
  • Am I involved in the care planning process?
  • Is my family/responsible party involved?
  • Is my physician or other health provider involved?
  • Are the care plans updated to reflect changes in care needs?

Eldercare Locator is a nationwide service that connects older Americans and their caregivers with trustworthy local support resources. Connect with services such as meals, home care or transportation, or a caregiver education or respite from caregiving responsibilities. The Eldercare Locator is a public service of the Administration on Aging (AoA), an agency of the U.S. Administration for Community Living.

Medicare provides a search feature to find & compare providers near you, most senior housing and care providers are included on Find & compare plans in your area. Determine if you qualify for premium savings

Medicaid offers information on how to apply for Medicaid, eligibility criteria, links to local state offices, and additional resources.

The Alzheimer’s Association is the leading voluntary health organization in Alzheimer’s care, support and research. Whether you are living with Alzheimer’s or caring for someone with the disease, information and resources are available. 

Long Term Care Ombudsman Program advocates for older persons receiving long term care services, whether the care is provided in a nursing home or assisted living facility, or through community-based services to assist persons still living at home.

Virginia Department of Social Services is a state supervised and locally administered social services system. Providing oversight and guidance to 120 local offices across the state, VDSS delivers a wide variety of services and benefits to over 1.7 million Virginians each year.

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Care Availability

Written by The Care Availability Team
Experts in the senior care & retirement living industries

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