How Virginia Regulates Senior Care in Hampton Roads

Last verified: October 2026. Figures and rules are re-checked against primary sources.

Who regulates senior care in Virginia?

The Virginia Department of Social Services (VDSS) licenses assisted living facilities and adult day care centers. The Virginia Department of Health (VDH) licenses nursing homes, hospices, home health agencies and hospitals. The Department of Medical Assistance Services (DMAS) runs Medicaid, which pays for much of the long-term care program.

The split matters in practice. A complaint about a Norfolk assisted living facility goes to VDSS, while one about a Hampton nursing home goes to VDH. Federal rules add another layer for nursing homes, which are also certified by Medicare and Medicaid. Our who-to-call guide sorts the numbers by locality and problem, including the long-term care ombudsman offices and the Adult Protective Services hotline.

How do the assisted living rules shape what families can expect?

Virginia assisted living is governed by 22VAC40-73, the Standards for Licensed Assisted Living Facilities, and by Chapters 17 and 18 of Title 63.2 of the Code of Virginia. The rules set licensing levels, who can be admitted, how long a license lasts and what residents are owed.

Start with licensing levels to learn what the label on a license means, then read the admission limits so you understand what conditions a facility cannot keep. The Uniform Assessment Instrument guide explains the assessment behind every placement and why it also opens the door to public programs. Most of these standards were written for the whole state, so how a Virginia Beach community applies them can differ from one in Gloucester, which is why your own questions matter.

What does Virginia require for memory care?

Virginia has no separate memory care license. Instead, a facility that offers a safe, secure environment must follow special care unit rules covering placement approval, reviews, activities, staffing, doors and outdoor access. Many Hampton Roads families first meet these rules when a parent with dementia begins to wander.

Our page on memory care safe, secure units sets out the requirements in plain language. Pair it with a visit and a list of questions, since the rule says what must exist and not how well it is done. A community can meet every minimum on paper and still feel understaffed on a weekend, so ask to visit in the evening.

How do I check a facility's record before I tour?

Look up assisted living facilities on the VDSS public search, where inspection findings and violation notices are posted, and look up nursing homes on Medicare's Care Compare. Doing this at the kitchen table before touring saves you a drive across the Hampton Roads Bridge-Tunnel and keeps you from relying on a brochure.

We explain how to read VDSS inspection reports and how nursing home oversight and star ratings work. We are a referral service paid by communities when a referred family moves in, so we encourage you to check each record yourself.

Where do rules end and cost and payment begin?

The rules decide what a facility may provide, and payment programs decide who can afford it. Medicaid, the Auxiliary Grant and veterans benefits each have their own eligibility tests, covered in our <a href="/costs/">cost guides</a>. A facility that is licensed to serve your parent may still not accept the payer your family has, and even a facility that accepts a program may have no open bed for it.

Last verified October 2026. Rules and rates change, sometimes twice a year, so confirm any figure or phone number with the agency before acting on it. Browse the directory for Hampton Roads communities, or visit the questions page for what families ask most. Nothing here replaces advice from an elder law attorney or the agency that decides your case.