Memory Care in Virginia | MemoryCare.com

Memory Care in Virginia

Alzheimer's disease and other forms of dementia create challenges for families throughout the Commonwealth of Virginia. About 150,000 adults aged 65 and older were known to have the illness in 2020, and that number is expected to rise to 190,000 by 2025, an estimated change of 26.7%. According to data from the Alzheimer's Association, 2,631 Virginia seniors died from Alzheimer's disease in 2019, and it anticipates that number will increase. Research from the CDC shows that death certificates underreport Alzheimer's disease, so these numbers are likely to be higher. 

Memory care facilities provide those living with Alzheimer's and dementia with care that is tailored to their unique needs. Memory care can take place in its own facility, or as part of a designated wing of another residential care community. Staff members of memory care units or facilities undergo specialized training in caring for those with memory impairment, and the facilities often coordinate social activities and schedules specifically for the needs of those living with Alzheimer's or dementia.

This guide will cover the cost of memory care in Virginia, financial assistance options for paying for memory care, free memory care resources in the state, and a directory of memory care facilities in Virginia.

The Cost of 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.

We calculated Virginia's average memory care expenses by adding 25% to the average assisted living costs reported in the 2021 Genworth Cost of Care Survey. The median price of memory care in Virginia is $6,563 per month. This cost is about $900 higher than the national average and more than states in the Midatlantic region except Delaware ($7,494). Neighboring Maryland has very similar memory care costs at $6,560, but West Virginia and North Carolina are significantly less expensive at $5,200 and $5,013, respectively.

Within the commonwealth, rates range from $5,863 in Virginia Beach to $7,406 in Roanoke. Harrisonburg ($7,139), Charlottesville ($7,125) and Blacksburg ($6,994) also have relatively high costs. Richmond ($6,126), the state capital, and Lynchburg ($5,781) have lower memory care prices than the state average. 

Virginia Medicaid Programs for Memory Care

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

family sizeannual income limitsasset limits
Single Person$10,872$2,000
Two-Person Household (Single Applicant)$10,872$2,000
Two-Person Household (Dual Applicants)$14,652$3,000

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. 

resourcecontactdescription
CCC Plus Enrollment Helpline(844) 374-9159Helpline agents help with the enrollment process and answer benefits questions. Authorized representatives can also call the helpline for assistance.
Virginia CommonHelpOffice LocatorThe Virginia Department of Social Services operates Virginia CommonHelp to assist residents with their Medicaid applications and other benefit programs. Support is available over the phone or in person at a local office.
Project ConnectList of LocationsProject Connect helps families dealing with Alzheimer's and other cognitive impairments apply for Medicaid and find other memory care payment options. Outreach workers provide one-on-one assistance to ensure clients get the most out of their benefits.

Can You Use Medicare to Pay for Memory Care in Virginia?

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.

More Ways to Pay for Memory Care in Virginia

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.
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Memory Care Laws and Regulations in Virginia

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.

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Free and Low-Cost Resources for Seniors in Virginia

Public and private organizations in Virginia provide free and low-cost assistance for seniors and families who need help with memory care issues. Support is available for adults from the first sign of cognitive decline to the end stages of Alzheimer's disease.

resourcecontactdescription
Senior Legal Helpline(844) 802-5910Seniors with dementia can face many legal challenges. The Statewide Senior Legal Helpline provides free assistance with a variety of relevant topics, including long-term care issues, public benefits, guardianship, age discrimination and financial exploitation. The Virginia Poverty Law Center runs the hotline.
Memory Assessment CentersList of LocationsThe Virginia Alzheimer's Commission AlzPossible Initiative and its government partners recognize several state memory care centers that offer diagnostic services, support groups, clinical trials and other services that can benefit seniors with cognitive diseases. Many centers have a sliding scale fee, which means families with limited incomes can access low-cost services.
Area Agencies on Aging (AAA)List of AAAsThe Virginia Association of Area Agencies on Aging (AAA) oversees 25 AAAs in the commonwealth. These agencies offer a variety of programs that can help families who need memory care, including nutrition support, transition services, legal assistance, benefits counseling, respite and other caregiver resources.
Memory and Aging Care Clinic (MACC)(434) 924-2706The University of Virginia’s Memory and Aging Care Clinic (MACC) is considered one of the leading care providers for adults with Alzheimer's and other cognitive diseases. Neurologists conduct vital research while clinicians take a patient- and family-centered approach to treatment.
Alzheimer’s Association – Central and Western Virginia(800) 272-3900This chapter of the Alzheimer's Association hosts support groups, virtual education programs and tips for families and caregivers. Care consultations are also available for families who need help finding memory care in their community.

Virginia COVID-19 Rules for Memory Care Facilities

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.

questionanswer
Am I allowed to visit my loved one in person?Yes (Conditions Apply)
Is my loved one required to quarantine after I visit him or her?No
Am I required to wear a mask if I visit my loved one in person?Yes
Are visitors screened for elevated temperatures?Yes
Are residents allowed to leave the facility at-will?Yes
Are residents of senior living facilities who leave required to quarantine when they get back?No (Conditions Apply)
Are staff members and contractors checked for elevated temperatures?Yes
Are staff members and contractors tested for COVID-19?Yes (Conditions Apply)
Do staff members have to regularly screen residents for COVID-19 symptoms?Yes
Do staff members have to regularly check residents for elevated temperatures?Yes
Do staff members have to regularly test residents for COVID-19?Yes (Conditions Apply)
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