Memory Care in Virginia

Virginia has earned the nicknames “Old Dominion” and “Mother of Presidents” due to the state’s long and storied history. Founded as one of the oldest British colonies, Virginia has also been the birthplace of 8 former U.S. presidents. From the breathtaking Blue Ridge Mountains in the west, to its scenic beaches along the Atlantic coast as well as its proximity to the Washington, D.C. metropolitan area, Virginia truly has something for everyone and is a great place to retire.

Currently, A Place for Mom partners with more than 230 senior living facilities that provide Alzheimer’s care in Virginia. The median monthly cost of memory care in Virginia is about $5,500.

Virginia’s assisted living facilities provide memory care for those with dementia. As a result, memory care units follow assisted living regulations, in addition to specific memory care guidelines. The Virginia Department of Social Services licenses and regulates assisted living facilities while also enforcing the state’s memory care policies.

Facilities don’t require a specific license to provide care for those with Alzheimer’s and other forms of dementia, but the memory care unit must be a “safe, secure environment.” The state defines this by certain security features being in place and establishing specific staffing patterns. Memory care units must feature the following:^[01]

• Doors leading to the outside have a system of security monitoring, such as door alarms, cameras, constant staff oversight, security bracelets, or delayed exiting mechanisms
• Limited environmental hazards for residents who can’t recognize danger
• Protective devices on bedroom and bathroom windows, and on windows in common areas to prevent residents from opening them and crawling through
• Free access to an indoor walking corridor or other indoor areas
• Potentially limiting, but not prohibiting, residents with serious cognitive impairments from exiting the facility unless behavioral observations suggest they pose a danger to themselves or others

Notably, residents also need to be evaluated by an independent clinical psychologist licensed to practice in the Commonwealth or an independent physician prior to admission. This assessment must conclude the resident has a serious cognitive impairment due to dementia, along with an inability to recognize danger or protect their own safety and welfare. The facility also needs written permission from either the resident (if they are capable of making an informed decision), their guardian or legal representative, or a relative.^[02]

Facilities must develop a personalized care plan for residents within 30 days of admission. It needs to include a written description of the resident’s physical condition, any identified needs, and what services/types of care they will receive. If appropriate, it will also contain a behavioral assessment and a fall risk rating. The facility reviews and updates the care plan annually, or sooner if changes in the resident’s condition warrant it.^[02]

Memory care staff education and training requirements

In memory care units, there isn’t an exact staff-to-patient ratio, but two direct care staff must be awake and on-duty at all times. During trips outside the facility, sufficient direct care staff must be present to be provide “sight and sound” supervision to all residents who can’t recognize danger or guarantee their own safety and welfare. A staff member who is responsible for managing or coordinating facility activities must be on-site at least 20 hours a week.

Staff training depends on whether there is a mixed population or if the memory care unit is isolated. In mixed units, direct care staff must complete four hours of training in cognitive impairment within four months of being hired. A qualified health care professional or licensed social worker must develop this training, and it needs to be relevant to the facility’s current population. Topics should include:^[03]

• An overview of cognitive impairments
• Resident care techniques
• Behavior management
• Communication skills
• Activity planning
• Safety standards

In secure memory units, direct care staff must attend at least four hours of training in cognitive impairments due to dementia within two months. Staff must undertake six more hours of training within the first year of employment. At minimum, the training must cover:^[03]

• Information about cognitive impairment
• Communicating with residents
• Managing dysfunctional behavior and identifying safety risks associated with it
• Assessing resident needs and how to implement care plans
• Resident care techniques and using them in a therapeutic environment
• Communicating with families
• Planning and engaging in activities appropriate for each resident
• Common behavioral problems and management techniques

Virginia Department of Health contact information

Virginia Department of Health
109 Governor Street
Richmond, Virginia 23219

Phone Number: 804-864-7000

How to look up the latest inspection and complaint reports

The Virginia Department of Social Services conducts unannounced assisted living facility inspections at least annually, though it can occur sooner if someone files a complaint. The inspection involves:^[03]

• An initial meeting of the inspection team with facility staff
• A facility tour
• Resident, family member, and staff interviews
• Staff activity observations, including medication administration
• Documentation review
• An exit interview

If the department discovers any violations, a facility must submit a Plan of Correction (PoC) within 15 calendar days detailing how the problem(s) will be resolved. Facilities may then request the department review the PoC and the facility to ensure compliance.

The department has a comprehensive online tool you can use to view a memory care unit’s licensure, complaint, and violation reports. To do so, select the “special care unit” option and then hit the search bar, or you can look for a facility by its name, town/city, or zip code. The long-term care ombudsman service can also answer any questions you have about a facility’s violation history.