Virginia Residential Alzheimer’s Care (Memory Care): Rules, Costs & Financial Help

Legal Definition of Assisted Living / Memory Care in Virginia

In Virginia, memory care is called special care units within assisted living residences. These communities are specifically for people with Alzheimer’s disease or related dementia. They provide personal and healthcare services, 24-hour supervision, social and recreational activities, and anything else in residents’ personal service plans. Staff are trained to provide assistance with activities , like eating, bathing, managing money or and medications.

Anyone considering assisted living in Virginia is entitled to a disclosure statement from the home, with the following information:

– Ownership structure of the residence

– Description of services offered, including healthcare

– Description of fees, including an explanation of what’s provided for the base fee and all possible additional fees

– Criteria for admission

– Reasons a person can be evicted

– Residence’s liability insurance

An administrator at any memory care home in Virginia is required to give written assurance to a new resident that the facility can adequately provide for all health needs, based on the Uniform Assessment Instrument (see Admissions Requirements below).

Assisted living homes in Virginia are regulated by the Department of Social Services. There are about 240 memory care homes in Virginia. There are also 145 board and care homes, which offer the same services as assisted living for 12 or fewer residents in a more house-like setting. For free help finding memory care of any size to meet your family’s needs and budget, click here.

How Much Does Memory Care Cost in Virginia?

The average cost of memory care per month in 2024 in Virginia is $6,877. This puts Virginia slightly higher than the national average of $5,884. The most expensive place for memory care in Virginia is Roanoke, running about $7,752 per month. The least expensive memory care is in Lynchburg costing $6,043 monthly. In Virginia Beach, the state’s most populated city, memory care costs $6,121 per month.

People living in the western or southern areas of Virginia might be able to find more affordable memory care across the state border. West Virginia and North Carolina both have less expensive overall memory care costs. West Virginia averages $5,446 per month and North Carolina’s averages are even lower, at $5,248 per month. These figures vary, but if cost is your top concern it might be smart to widen your search to areas outside Virginia. Maryland, to the east, memory care is $6,400 monthly.

Virginia Assisted Living Laws & Regulations

Admissions Process & Requirements

Virginia memory care homes use the Uniform Assessment Instrument to evaluate the health and abilities of all residents. The assessment is usually filled out by a doctor or registered nurse who works for the residence. A personal doctor may also fill out this assessment. Anyone receiving state subsidies (see Financial Assistance below), will also be assessed by a health professional working for the state’s Department of Social Services. The Uniform Assessment Instrument, available via this link, must be completed 90 days before admission. All residents must also have a physical exam before admission.

The cost of assessments may be included in the base rate at the residence, or there may be a one-time community fee. If so, that would cover up front move-in costs like assessment, deep cleaning and painting a new resident’s room. Community fees usually run between $1,500 and $2,500.

Anyone with these conditions cannot be in assisted living in Virginia:

– Ventilator dependency
– Stage III or IV dermal ulcers
– Need for intravenous therapy or injections directly into veins
– Airborne infectious diseases requiring isolation
– Psychotropic medications without appropriate prescription
– Need for continuous nursing care
– Any physical or mental health needs that the residence cannot provide

Facility / Residence

Private units must be at least 100 square feet for a single, or 80 square feet per person if there are multiple occupants. Two is the maximum number of people allowed per bedroom, unless the residence was constructed before 2006. Assisted living older than 2006 can have up to four people in one bedroom. There must be one toilet and sink for every four residents, and a tub or shower for every seven.

Memory care units (within assisted living residences) must also have:

– Security monitoring for all doors that lead outside
– Protective devices on windows
– An easily accessed walking area

There are other physical design elements in memory care homes that you should look for, but are not explicitly required by Virginia regulations. Studies have shown that easily navigated layouts, bright lighting and paint colors, and circular hallways that don’t dead-end are beneficial for people with dementia.

Staff & Training

Every assisted living community in Virginia must have on its staff a licensed healthcare professional qualified to provide oversight on the care of residents. They also need someone licensed to review medications, special diets, and a licensed nurse. Each staff member must be certified in first aid, and must keep the certification current. One CPR-certified employee must be working at all times.

There is no specific staff-to-resident ratio in Virginia. Rather, regulations say there must be a sufficient number of workers, each with adequate knowledge and skills, to provide for the well-being of every resident and implement a fire plan or emergency evacuation.

Anyone working directly with residents must have 18 hours of annual training in skills and knowledge directly related to the residence’s population. Administrators must be at least 21, with a high school diploma and at least 30 credit hours from a college or university, in classes directly related to the job. They also must be licensed by the Virginia Board of Long-Term Care Administrators. Twenty hours of state-approved training are required annually.

Evictions & Discharges

Unfair evictions can be a problem nationwide, so it’s important before moving into a memory care home as to their rules about evictions before signing a contract. Virginia requires that anyone who might move into an assisted living home be given a written statement with information including criteria for discharge. This means Virginia residences have their own rules for kicking someone out, and they must be provided in writing.

Generally, someone can be evicted if they need medical care that staff are unable to provide. If a memory care home can’t care for someone who is non-ambulatory then a person who loses the ability to walk would need to be evicted. Other examples might be someone who needs to be fed intravenously, or develops an illness requiring full-time nursing care. It’s also important to know if aggressive behavior might get someone evicted.

Can your loved one be asked to leave if bills are not paid on time? And what is the process of eviction? How much warning is provided? The standard is 30 days. And what is the process for appeal?

Again, it’s important to be clear on how and why your loved one can be evicted before moving into a memory care home. Ask these questions and get the answers in writing. If you receive an eviction notice and need to know next steps, click here.

Financial Assistance For Residential Alzheimer’s Memory Care

Commonwealth Coordinated Care Plus Medicaid Waiver (CCC+)

This program serves over 250,000 people in Virginia by providing help with medical, behavioral health, and long-term care services. To receive this waiver, a person must be Medicaid-eligible (click here for VA Medicaid eligibility test), require a level of care at the hospital or nursing home level, or be considered medically complex. Someone with dementia who lives in memory care may qualify based on an assessment. Other eligibility requirements in 2024 include a monthly income of less than $2,829 and have countable assets that are less than $2,000. Benefits of this program include case management, personal care assistance, help covering costs of assistive devices, physical therapy, lab tests, and more. Eligible recipients are assigned a care coordinator who works with providers in their parts of the state. Apply by contacting your local Department of Social Services office. A waitlist can apply because there is an annual enrollment cap of 47,283 participants accepted into the program. More information about eligibility requirements for Medicaid can be found here.

Virginia Adult Services

The non-Medicaid state program helps people in low-income families pay for a number of specific services with the intention of keeping a person out of full-time nursing care. These include nutritional counseling, assessments for assisted living residences, transportation to appointments, case management, chore services, and more. An assessor for the state will determine the amount of care, including how many hours weekly, a person receiving this benefit requires. Financial eligibility depends on where someone lives in the state. For more information, contact the Virginia Department for Aging and Rehabilitative Services.

Virginia Auxiliary Grants

Virginia Auxiliary Grants can help cover assisted living costs for people who also receive Supplemental Security Income. The application criteria are incredibly complex, but among the qualifiers are a need for help with activities of daily living (like bathing, eating, and dressing), a need for assistance with taking medications, and difficulty controlling disruptive behavior (as people who have Alzheimer’s are known to exhibit). Someone must already be in assisted living or adult day care to apply. People who receive auxiliary grants must be assessed annually by the Department of Social Services. For a brochure on the program, click here. Apply through the Department of Social Services.

Veterans Affairs (VA)

Veterans are statistically more likely to develop dementia. Among the reasons for this is that traumatic brain injuries and posttraumatic stress disorder lead to a higher probability of developing the condition. The VA offers many benefits for Alzheimer’s and dementia as well as different pension types.

VA Pensions

There are three types of VA Pensions available. The benefits change annually and are valid from December 2023 to December 2024. The benefits (and their maximum allowance) are as follows:

1) Basic Pension – This benefit is also known as a death pension. It is for veterans and surviving spouses who are aged or disabled. The qualifying disability does not need to be related to their military service. On an annual basis, the Basic Pension pays:

– Veterans without spouses or children up to $16,551

– Veterans with dependent spouses or children up to $21,674

– Surviving spouses without dependent children up to $11,102

2) Aid & Attendance – Abbreviated as A&A, this is an important program for veterans and their surviving spouses who require assistance with activities of daily living. This means they need assistance with activities like bathing, dressing, and eating. A&A is particularly helpful for people with dementia, especially in the middle and later stages of the disease, when the need for more assistance becomes necessary. A&A is intended to help with the long-term care costs of adult day care, in-home care, assisted living, memory care, and skilled nursing. Based on an individual’s need and the progression of the disease, most of these additional services that support your loved one will become necessary. Annually, the A&A pays:

– Veterans without spouses or children a maximum of $27,609

– Veterans with dependent spouses or children a maximum of $32,729

– Surviving spouses without dependent children a maximum of $17,743

3) Housebound – For veterans and surviving spouses who are permanently disabled and unable to leave their homes, making them require additional assistance. The definition of “home” can include assisted living, memory care, and nursing home. The Housebound pension, like the A&A pension, is meant to help cover long-term care costs. Annually, the Housebound pays:

– Veterans without spouses or children a maximum of $20,226

– Veterans with dependent spouses or children a maximum of $25,348

– Surviving spouses without dependent children a maximum of $13,568

Veterans Homes

There are also two veterans’ homes in Virginia, which are residential care facilities that provide long-term care for veterans. They are the Virginia Veterans Care Center in Richmond and the Sitter & Barfoot Veterans Care Center in Roanoke. In addition to nursing home care and assisted living, memory care is provided. Neighboring states have more veterans’ homes, so a loved one might consider looking there for more options as there are no requirements that one must live in the state. For example, North Carolina has four veterans homes statewide and several are located relatively close to their shared border. Additionally, West Virginia has two facilities and Maryland has one home. More info.

Other Options

1)Elder care loans exist for families to cover the costs of moving into memory care while waiting for other financial resources to become available. For example, if one is waiting for a VA pension to be approved or waiting to sell a home. More on bridge loans for memory care.

2) Tax credits and deductions like the Credit for the Elderly and the Disabled, or the Child and Dependent Care Credit (if you can claim your elderly loved one as a dependent). Remember also that medical and dental expenses can be deducted, and that can include assisted living costs.

3) A reverse mortgage can be an option for a married person moving into memory care, if their spouse continues to live in the home. However, if the spouse moves from their home, the reverse mortgage becomes due.