Memory Care in Virginia

Table of Contents

Memory Care in Virginia

Table of Contents

• The Cost of Memory Care in Virginia
• Virginia Medicaid Programs for Memory Care
• Can You Use Medicare to Pay for Memory Care in Virginia?
• More Ways to Pay for Memory Care in Virginia
• Memory Care Laws and Regulations in Virginia
• Free and Low-Cost Resources for Seniors in Virginia
• Virginia COVID-19 Rules for Memory Care Facilities

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When figuring out how to pay for memory care, you first need to understand how much it will cost for your loved one to move to a quality community. As costs continue to rise, it's vital to have the latest details when planning for elderly care costs. In order to shed light on the impact of inflation on senior living costs, MemoryCare.com has gathered cost information from its network of over 75,000 senior living communities. These prices are based on the cost of Memory Care in Virginia and 45 other cities in Virginia.

How Inflation Has Impacted the Cost of Memory Care in Virginia

Inflation can have a significant impact on aging adults living in memory care communities, making it critical to monitor these changes. Average memory care costs increased by 10.5% nationwide in 2023, but Virginia fared slightly better with a 7% increase. Surrounding states like South Carolina and Maryland also had lower-than-average memory care cost hikes of 6% and 8%, respectively. However, Tennessee's cost rose by 21.5%, and West Virginia's growth of 45.5% could really hit home. Luckily, 2024 projections indicate a 1.5% drop in West Virginia's cost while other states continue to rise, including another potential increase of 7% in Virginia.

Memory Care Costs in Virginia's Top Cities

Stretching from the Chesapeake Bay to the Appalachian Mountains, Virginia's scenery varies more than the average memory care costs across the state. Many popular cities are close in cost to the state average of $5,667, with several coming in lower, including Virginia Beach at $5,403, Richmond at $5,433 and Arlington at $5,538. One exception among the more populated cities in the state is Norfolk, with its higher-than-average cost of $6,013.

The Cost of Other Types of Senior Living

Aging adults considering their senior living options must factor in their care level, current costs and future costs, as inflation potentially causes fluctuations over the long term. While independent living is the least expensive in Virginia at $3,194, it's not ideal for seniors needing personal care or assistance. For those wanting to remain as independent as possible but requiring some care, assisted living costs $4,604, while seniors needing dementia support pay an average of $5,667.

Virginia's Medicaid system may cover some memory care services as part of the Commonwealth Coordinated Care Plus (CCC Plus) Waiver. This managed care program pays for medical treatments and Long-Term Services and Supports (LTSS) in community settings. Medicaid does not pay for room and board at assisted living facilities that offer memory care, but there are grant programs that may do so. 

Commonwealth Coordinated Care Plus (CCC Plus) Waiver

The LTSS services covered for CCC Plus beneficiaries include assistive technology, environmental modifications, respite care, personal care and private-duty nursing. CCC Plus also covers medical and rehabilitative services commonly prescribed for dementia patients, such as occupational and speech therapies. Mental health services are also available. 

Who Is Eligible: Applicants must be 65 years or older and have full Medicaid benefits to qualify for CCC Plus. For some services, the senior must meet a nursing home level of care. How to Apply: Seniors can apply for CCC Plus or learn more about what the program covers by calling the CCC Plus Helpline at (844) 374-9159.

Medicaid Eligibility for Seniors in Virginia

The Department of Social Services (DSS) or Cover Virginia Central Processing Unit determines CCC Plus eligibility. Single applicants cannot earn more than $10,872 per year or own more than $2,000 in assets. The limits are the same for single applicants in a two-person household. Dual applicants in a two-person household may not earn more than $14,652 per year or own more than $3,000 in assets. Seniors already receiving Supplemental Security Income (SSI) are automatically eligible for coverage. 

2022 Medicaid Income Limits for Seniors in Virginia

In addition to financial limits, Medicaid in Virginia requires that applicants:

• Are U.S. citizens or legally documented immigrants
• Virginia residents
• Are aged 65 and older or younger with a disability

How to Get Help Applying for Medicaid in Virginia

Applying for Medicaid coverage can seem complicated, but the following resources can help families with the application process and obtaining services once they're approved. 

Unfortunately, Medicare does not generally cover the cost of Memory Care. Most Memory Care Facilities are considered to be "social settings," so Medicare does not cover the cost incurred in these facilities. The only exception to that is if you are receiving memory care services in a Nursing Home. While this situation is much less common, Medicare would sometimes cover the cost, depending on a number of circumstances.

That being said, Medicare does still cover qualified doctor visits, medications, etc., as it would if you were still at home, but it will not cover the cost of care received at the Memory Care Facility.

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.

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.

Residents Who May Be Admitted

Older adults and people with:

• Dementia
• Mental Health Conditions
• Cognitive Disabilities
• Physical Disabilities

Residents Who May NOT Be Admitted

Those who:

• Present an imminent physical danger to self or others
• Require continuous skilled nursing care
• Need maximum physical assistance and meet Medicaid nursing facility level of care criteria
• Are dependent upon a ventilator
• Are under the age of 18

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.

In Virginia, there is an abundance of resources designed to assist seniors throughout their retirement. MemoryCare.com has compiled information on a range of local organizations, programs, and agencies, categorizing them based on the care services they offer for easy browsing.

Area Agency on Aging

The Area Agency on Aging in is a crucial asset for retired individuals, providing advice on financial assistance, home-based care, and planning for extended care. It also connects seniors and their caregivers with local resources.

Cash Assistance Programs

Financial assistance initiatives exist in Virginia to help seniors with low income sustain their home living. These initiatives provide tax reductions, discounts on crucial services, and aid for home temperature regulation costs.

Financial Assistance for Senior Care and Senior Living

Elderly individuals in Virginia, living independently or in elderly care homes, can avail of numerous local financial support opportunities. These aid options help reduce in-home or long-term care costs and connect them to valuable community resources.

Food Assistance Programs

In Virginia, numerous community programs focus on enhancing the health of seniors via proper diet. These initiatives provide meal delivery, shared meals, and food bank services, guaranteeing that older citizens can obtain reasonably priced, healthy food.

Home Repair and Modifications

In Virginia, a variety of programs exist to support seniors and those with disabilities in funding home improvements and repairs. These initiatives, providing grants or loans, feature different eligibility criteria tailored for retired individuals.

Legal Resources

In Virginia, there are several organizations offering cost-effective or free legal aid to senior citizens. They provide advice on issues such as estate planning, living wills, and power of attorney. Some also champion the rights of the elderly in long-term care establishments.

Senior Engagement

In Virginia, numerous initiatives are in place to keep seniors involved and energetic. These encompass health programs, opportunities for volunteer work, and supportive communities, all designed to promote social participation and improve the quality of life.

Social Security Offices

In the city of Virginia, Social Security offices are crucial resources for the elderly and those with disabilities. They provide advice on retirement perks, disability benefits, and additional security income.

Tax Assistance

In Virginia, a variety of tax assistance options exist for seniors and people with disabilities. These encompass possible medical cost exemptions, property tax cuts, and other tax alleviation measures.

Utility & Energy Bill Assistance

In Virginia, there are establishments ready to assist seniors with limited income facing challenges with home upkeep expenses, such as energy and utility bills. Emergency financial support might be available for individuals threatened with utility disconnection due to outstanding payments.

Veteran's Services

In Virginia, retired military personnel can find essential support through local veteran services. These organizations help veterans access their deserved benefits and offer advice on a variety of issues.

Note: The following information was compiled and most recently updated on 2/15/2022. Since COVID-19 is a rapidly evolving crisis, be sure to contact your Memory Care Facility or local Area Agency on Aging for the most up-to-date information.