Memory Care in Virginia

Because of the specialized staff training and resources required to provide high-quality memory care, memory care typically costs more than other types of residential care. On average, memory care will cost 20-30% more than assisted living.

Across Virginia, assisted living costs an average of $4,800 per month, which is more than $700 above the national median of $4,051. Given that memory care is, on average, about 25% more expensive than assisted living, seniors can expect to pay approximately $6,000 each month for memory care.

Compared to its neighboring states, Virginia has a higher average price for assisted living. The next highest is North Carolina, at $4,000 per month. By contrast, the most affordable bordering state is Kentucky, at $3,497.

Keep in mind that costs vary significantly across the state. In Richmond, the average monthly cost of assisted living, at $4,848, is slightly above the state average. More affordable cities include Roanoke and Virginia Beach at $3,808 and $4,627, respectively. It’s important to keep in mind that these are standard assisted living rates. Families should expect to pay an additional $1,000 to $2,000 per month for memory care services.

Virginia Medicaid Programs for Memory Care

Virginia’s Alzheimer’s Assisted Living Waiver program expired in 2018 and was not renewed. Currently, Virginia does not have a Medicaid waiver program that helps cover the cost of assisted living.

Non-Medicaid Financial Assistance Programs for Memory Care in Virginia

Virginia Adults Services

Adult Services is a program sponsored by the state of Virginia that helps adults with an impairment gain services to maximize their independence and improve their quality of life. Some of the assistance applicants may qualify for include homemakers, help with chores and companion services. While the program focuses on providing these services in the individual’s home, the program may also assist those who are receiving services in the community.

Who is Eligible: Individuals requesting to be screened for long-term services funded by Medicaid, adults who qualify for the Auxiliary Grant and those who need services to avoid institutionalization may be eligible. The program is intended to help low-income individuals.

How to Apply: Those interested in applying can fill out an Application for Adult Services. The application must be completed by the person who is requesting services or someone authorized to act on their behalf. The applicant’s eligibility will be determined by financial requirements, need and the availability of the services.

Auxiliary Grant Program

Virginians who reside in one of the state’s assisted living facilities may be eligible to receive financial assistance under the state’s Auxiliary Grant program. Individuals in the program receive monthly payments from their local social services department, which may be used to help cover costs for personal care, maintenance and medical transportation, as well as room and board. It is also important to note that not all ALFs accept the Auxiliary Grant.

Who is Eligible: Auxiliary Grant recipients must meet all of the state’s requirements for eligibility, including being 65 years of age or older, blind or disabled. They must have been residents of Virginia for a minimum of 90 days, and reside in a licensed ALF or adult foster care home. They must also be U.S. citizens or aliens who meet specific guidelines. To meet financial criteria, recipients’ taxable assets must be valued at not more than $2,000 per individual or $3,000 per couple. An individual’s monthly income must also be below the approved Auxiliary Grant rates. For information on current rates, contact the department of social services for the jurisdiction where the assisted living facility is located.

How to Apply: Those interested in the grant should fill out an application and apply to their local department of social services.

More Ways to Pay for Memory Care

In addition to the state programs mentioned above, those looking for resources to finance memory care may consider:

• Long-Term Care Insurance: Depending on the policy details, long-term care insurance may be used to pay for memory care services. It’s best to sign up for a policy early, as coverage will likely be denied if one already has long-term care needs. More information about the intricacies of long-term care insurance can be found at longtermcare.acl.gov.
• Reverse Mortgages: Reverse mortgages allow some homeowners to take out a loan as an advance from the eventual sale of their primary residence. This can be a good way to fund memory care in the short-term, but the loans will need to be paid back after the sale of the home. The most commonly used type of reverse mortgages for seniors is the Home Equity Conversion Mortgage, which is the only reverse mortgage insured by the federal government.
• Veterans Benefits: The Department of Veterans Affairs offers several programs that veterans and their spouses may use to cover health care needs such as memory care. More information about these programs can be found on the VA website.
• Life Insurance: Some life insurance policies allow policyholders to cash out their policy before a qualifying death. There may be some downsides to accessing a life insurance benefit early, so be sure to read more about the process.

Memory Care Regulation

In Virginia, facilities that provide memory care fall under the umbrella of assisted living facilities (ALFs). The Virginia Department of Social Services, Division of Licensing Programs, licenses and regulates these facilities.

ALFs that admit and provide care for people with dementia or other serious cognitive impairments must follow special state guidelines. These include providing secure, monitored indoor and outdoor areas for residents. Staff members must also receive training and continuing education on caring for individuals with cognitive impairments.

Facility Scope of Care

ALFs in Virginia provide 24-hour supervision, assistance and coordination of personal and healthcare services to adults who may have physical or mental impairments and require a moderate level of care with the activities of daily living. Virginia defines moderate assistance as a resident being dependent on caregivers for two or more of the activities of daily living. ALFs are allowed to admit and serve persons with dementia, but not those who require continuous or advanced nursing services.

Admissions Requirements

To be admitted to an ALF, a prospective resident must meet certain criteria. The table below provides an overview of who may or may not be admitted.

Care Plan Requirements

Within 90 days before admission to an ALF in Virginia, applicants must complete an in-person assessment to determine their mental and physical condition, as well as their care needs. After admission, these universal assessments are completed annually, or any time there is a significant change in behavior warranting reassessment of the resident’s needs.

On, or within one week prior to, the date admission, a licensed ALF staff member must develop a preliminary plan of care detailing the resident’s needs and identifying ways to protect his or her health, welfare and safety. If a comprehensive individualized service plan has already been created, it can be used in place of a preliminary plan. Regardless, a comprehensive individualized service plan must be completed within 30 days of admission. This plan must include a written description of the resident’s physical examination results, identified needs and an interview with the resident. If appropriate, it will also include a fall risk rating and behavioral assessment. It must also include which services the resident will receive and detail the expected outcomes. This plan is reviewed and updated once a year or more frequently if necessary.

Medication Management Requirements

ALFs are required to have written medication management plans for each resident. Residents may be permitted to administer their own medications if they are competent to do so. Otherwise, staff members licensed and registered as medication aides administer medication under supervision. Medications must be reviewed every six months for residents in assisted living, except for those residents who self-administer all of their own medications.

Facility Requirements

Newer ALFs that were approved for construction or a change in use after December 28, 2006, can offer private or double-occupancy rooms to residents. In these buildings, floors with resident rooms are required to have at least one toilet and sink available for every four residents, and one bathtub or shower for every seven residents. Older licensed facilities may have up to four residents share a bedroom. They are required to have at least one toilet and sink available for every seven residents, and one bathtub or shower for every 10 residents.

For safety, all facility steps, ramps and stairways are required to have nonslip surfaces, and any windows that can be opened must be screened. The building must also be designed with signaling and call systems that allow residents to summon help.

Staffing Requirements

Staff who are involved in direct patient care are subject to background checks. As part of their training, direct care team members receive six hours of specialized instruction on caring for residents with dementia. Administrators must complete 12 hours of applicable training. Both direct care staff and administrators are also required to complete yearly continued education.

In ALFs with more than 10 residents, to ensure safety, a minimum of two staff members must be present and awake at all times. All staff and volunteers must be familiar with and ready to implement the facility’s emergency preparedness plan in case of an actual emergency.

Reporting Abuse

There are several ways to report suspected abuse. To report elder neglect or abuse in Virginia, call the state’s 24-hour, toll-free hotline at 888-832-3858. To file a complaint against an assisted living home in the state, go to Virginia’s Department of Social Services website. Under their Division of Licensing Programs, there is an online form for reporting complaints or concerns. Reports can be made anonymously if desired. One may also contact the Office of the State Long-Term Care Ombudsman at 800-552-3402 or 804-565-1600.