Nursing Homes in Virginia: Cost & Medicaid (2026)

A semi-private nursing-home room in Virginia runs about $123,005 a year, more than most families can pay out of pocket for the years a long-term stay can last.1 What makes it survivable for most long-term residents is Virginia Medicaid, which pays for nursing-facility care for those who qualify.

This guide covers what a nursing home is, how to check a facility's quality before you choose one, what it actually costs in Virginia, and how Virginia Medicaid pays for long-term care.

In This Guide

• Key Takeaways
• What a Nursing Home Is
• How to Check a Facility's Quality
• What a Nursing Home Costs in Virginia
• Does Medicaid Pay for Nursing Homes?
• Frequently Asked Questions

What a Nursing Home Is

In Virginia, a nursing home is a skilled nursing facility. It provides 24-hour licensed nursing care, help with daily activities like bathing and dressing, and rehabilitation services such as physical, occupational, and speech therapy. That round-the-clock nursing is the line that separates it from assisted living. An assisted living facility is built for people who need help with daily tasks but not constant skilled care. A nursing home exists for medical needs those settings can't meet, like managing a feeding tube, IV medications, or an open pressure wound.

People arrive at a nursing home along two different paths, and it pays to keep them straight because they're funded differently. The first is short-term rehabilitation, often after a hospital stay for a stroke, a fall, or surgery, where the goal is to recover and go home. Medicare helps with that short rehab stay under specific conditions, covering up to 100 days per benefit period, generally after a qualifying three-day inpatient hospital stay (an ACO waiver, a Medicare Advantage plan, or re-entering a skilled nursing facility within 30 days can lift that requirement), with a daily coinsurance starting on day 21.4 The second path is long-term custodial care, where someone needs ongoing nursing and supervision they can't safely get at home. Medicare does not pay for that long-term custodial stay.4 That's the care families worry about affording, and it's where Medicaid becomes the main payer.

How to Check a Facility's Quality

Quality varies widely from one nursing home to the next, and Virginia gives you several free tools to vet a place before you commit. Use more than one. Each shows you something the others don't.

Start with state oversight. Virginia's roughly 300 licensed nursing homes are licensed and inspected by the VDH Office of Licensure and Certification, through its Division of Long-Term Care Services, which also runs the federal certification surveys at the direction of CMS.2 State-licensed facilities are inspected about every two years, and Medicare- and Medicaid-certified facilities are surveyed about once a year on average.2 When you tour a facility, ask to see its most recent survey results and look for a pattern of repeat deficiencies rather than reacting to a single old citation.

Next, check the federal star rating on Medicare Care Compare. For every Medicare- and Medicaid-certified nursing home, CMS publishes an overall rating from 1 to 5 stars.2 That overall rating combines three things: health inspection results, staffing levels, and quality measures. The staffing component deserves a close look on its own, because how many nurses and aides a facility keeps per resident shapes day-to-day care more than almost anything else.

Finally, know who to call for help. Virginia's Long-Term Care Ombudsman Program advocates for residents of nursing homes and assisted living facilities and investigates complaints.2 A local ombudsman can be a candid, on-the-ground source of information about specific facilities in your area before you ever sign anything.

What a Nursing Home Costs in Virginia

Nursing-home care is expensive everywhere, and Virginia is no exception. Its rates jumped sharply in the most recent survey and now sit above the national midpoint. According to the CareScout 2025 Cost of Care Survey (released March 2026, the most recent state-level data), the statewide medians were about $123,005 a year for a semi-private room and about $140,160 a year for a private room.1 Both now run above the national medians, which were about $114,975 for a semi-private room and $129,575 for a private room. These are medians from an industry survey, not government rates and not maximums. The figure at any one facility can land higher or lower depending on location, room type, and level of care.

To put that in context, the same survey put Virginia assisted living at a median of about $83,340 a year (roughly $6,945 a month).1 A semi-private nursing-home room costs close to half again as much. The gap is the reason families look hard at whether assisted living or in-home care can meet the need before moving to a nursing home, and at these prices it's the reason most long-term nursing-home residents in Virginia end up relying on Medicaid rather than paying privately for years.

Does Medicaid Pay for Nursing Homes?

Yes, and this is the single most important thing to understand about paying for a Virginia nursing home. Virginia Medicaid is run by DMAS, and it covers long-term care in a nursing facility for those who qualify.3

Qualifying turns on two findings that run on separate tracks. Here's how the pieces fit together.

Level of care. Anyone seeking Medicaid long-term care in a nursing facility must first complete an LTSS screening that confirms they meet the nursing-facility level of care.3 This is the medical side of eligibility, separate from the money side below. The same screening is the gateway to community-based options, principally the CCC Plus waiver under Cardinal Care, which can deliver long-term care in your own home instead.

The financial test. For 2026, the long-term-care income limit is 300% of the SSI federal benefit rate, about $2,982 a month for an individual, and the resource limit is $2,000 for a single person.3 Someone whose income runs over the limit can still qualify by spending the excess income down on the cost of their care. A married couple with one spouse staying in the community is protected by spousal-impoverishment rules, which let that community spouse keep a share of the couple's resources and income. Because these rules depend on your household and can change, confirm the current figures with DMAS before you apply.

The five-year look-back. Virginia reviews asset transfers made for less than fair market value during the 60 months (five years) before the first date a person is both in a nursing facility and has applied for Medicaid.3 Gifts or below-value sales in that window can trigger a penalty period during which Medicaid won't pay for nursing-facility care, so this is one area where planning well ahead matters.

Estate recovery. After a resident dies, Virginia pursues Medicaid estate recovery against the estates of members who were 55 or older when they received benefits.3 There is no recovery if there is a surviving spouse who has not been a Medicaid member, or if the member is survived by a child who is under 21, blind, or disabled, and DMAS can waive all or part of a claim that would cause undue hardship, so recovery is not automatic in every case.

Learn More

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The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.