Virginia Nursing Home Costs in 2026: Average Monthly Price

How much does a Virginia nursing home cost per month?

The survey reports six care settings. The two nursing home rows are the ones families budget against, but the comparison only makes sense next to the alternatives, because the choice is usually between a nursing home, assisted living and hours of help at home.

Source: CareScout Cost of Care Survey, 2025 edition, median cost data tables, Virginia and national rows. Monthly figures are the annual median divided by twelve, as published.

How does Virginia compare with the national median?

Virginia is above the national line for the two settings that involve a building and staff on site: about $669 a month above national for a semi-private room and about $882 above for a private room. Assisted living sits $745 a month above the national median. Adult day health care is the exception, $308 a month below national, and in-home hourly rates match the national medians exactly at $35 for homemaker services and $90 for a home health aide.

A median is the middle of a distribution, not a typical bill. CareScout collects rates at the metropolitan statistical area level and the state figure is the median across those markets, which is why the same room can be quoted well above the state number in Fairfax County and well below it in southwest Virginia. Treat the state median as a planning baseline and get two local quotes before committing to a budget.

Semi-private or private room

The private room premium in Virginia is about $1,430 a month, or $17,155 a year, on the medians. Whether that is available at all matters more than the price: a facility with a waiting list for private rooms may only be able to offer a shared room at admission, and a shared room is the only type that Medicaid payment typically covers in full.

Ask how the room assignment works after admission. A resident who enters on Medicaid in a shared room generally cannot be required to move to a private room, but the reverse request, moving from shared to private, is a new rate and sometimes a new room.

What moves the number

Four things explain most of the gap between one Virginia quote and another.

• Location. Labor cost and real estate set the floor. Northern Virginia facilities compete with hospital and home-care wages in the same labor market, and the survey collects those markets separately.
• Level of care. The base rate usually covers room, board, nursing oversight and help with activities of daily living. Physical therapy, occupational therapy, wound care and specialised memory care are priced separately at many facilities.
• Room type and occupancy. A private room carries a premium; a shared room may be the only option at admission.
• Contract terms. Annual increases, a community fee, a bed-hold charge when a resident is in hospital, and whether the quoted rate is all-inclusive or a base plus levels of care.

Who pays: Medicare, Medicaid and the Auxiliary Grant

Medicare covers skilled nursing facility care for up to 100 days per benefit period, after a qualifying hospital stay and with a daily coinsurance from day 21. It does not cover custodial care, which is the help with bathing, dressing, meals and supervision that makes up most of a long nursing home stay. Families who assume Medicare will pick up the bill usually discover this in week three.

Virginia Medicaid, run by the Department of Medical Assistance Services, pays for nursing facility care for residents who meet both the medical and the financial criteria, and applications go through the local department of social services. Two rules shape the planning: transfers of assets in the five years before application are reviewed, and the community spouse is allowed to keep a resource allowance that is set annually. A facility must be Medicaid-certified for a resident to use Medicaid there, so the number of certified beds is a question worth asking early.

Assisted living works differently. Virginia Medicaid does not pay for assisted living the way it pays for a nursing facility. The state Auxiliary Grant is the program that helps: an income supplement for people receiving Supplemental Security Income, and certain other older or disabled Virginians, who live in a participating assisted living facility, adult foster home or supportive housing. According to the state legislative review of assisted living, the grant rate is $2,130 a month outside Northern Virginia and $2,450 inside it, with a personal needs allowance of $87 and a resource limit of $2,000 for one person or $3,000 for a couple. Not every facility accepts it.

Everything else is private pay: savings, the sale of a house, long-term care insurance, or a veteran benefit such as Aid and Attendance for those who qualify. Virginia's long-term care ombudsman and the local Area Agency on Aging can review a specific situation at no cost.

What to ask before signing

1. Is the quoted rate all-inclusive, or does it rise with each level of care?
2. What is the private room premium, and is a private room available now?
3. How many beds are Medicaid-certified, and does the facility accept Medicaid at admission or only after private pay?
4. What happens to the rate if the resident is hospitalised for a week? Is there a bed-hold fee?
5. Which services are billed separately: therapy, pharmacy, incontinence supplies, transport, laundry?
6. What is the annual increase policy, and when was the last increase?
7. What is the current staffing ratio on the evening and night shifts?
8. Can I see the most recent state inspection report, and what were the deficiencies?

Where these numbers come from

Virginia and national cost figures are medians from the CareScout Cost of Care Survey, 2025 edition, fieldwork July through November 2025, median cost data tables for Virginia and the United States. The 100-day Medicare limit, the coinsurance from day 21 and the distinction between skilled and custodial care come from Medicare.gov. Virginia Medicaid administration and the nursing facility application route are described on the DMAS and Virginia Department of Social Services sites. Auxiliary Grant rates, the $87 personal needs allowance and the $2,000 and $3,000 resource limits come from the Joint Legislative Audit and Review Commission review of assisted living in Virginia, which also cites the $6,945 assisted living median used above. This is general information about program rules, not financial, legal or tax advice for a particular situation.