Virginia senior care regulation is split across the Virginia Department of Health, Office of Licensure and Certification for skilled nursing and the Virginia Department of Social Services, Division of Licensing Programs (Assisted Living Facilities) for assisted living. Memory care carries a separate designation on top of the assisted living license. The full guide below covers nursing home licensing, assisted living and memory care, hospice licensure where applicable, common survey citation patterns, and how the state Long-Term Care Ombudsman fits in. Always verify specifics with each agency before acting.
Virginia regulates senior care across two state agencies. Nursing homes and hospice fall under the Virginia Department of Health Office of Licensure and Certification. Assisted Living Facilities (ALFs) fall under the Virginia Department of Social Services, Division of Licensing Programs. Memory care is delivered through the Safe, Secure Environment authorization under 22 VAC 40-73-1090 with specific staff dementia training and physical environment standards.
Regulatory reality in Virginia
Virginia's split between Department of Health (nursing homes, hospice) and Department of Social Services (assisted living) is a structural reminder that assisted living in this state is historically framed as a social-services residential category, not a clinical one. The Safe, Secure Environment designation under 22 VAC 40-73-1090 then layers a specific four-hour annual dementia training requirement on top, which surveyors verify when a community holds itself out as memory care. Operators bringing an out-of-state playbook into Virginia frequently miscalibrate the agency map on the first complaint call.
Skilled nursing licensure in Virginia
Skilled nursing facilities in Virginia are licensed by the Virginia Department of Health, Office of Licensure and Certification, which also acts as the State Survey Agency on behalf of CMS. Virginia SNFs hold CMS Certification Numbers issued through Virginia Department of Health Office of Licensure and Certification as the State Survey Agency.
Federal survey results are published on Medicare.gov Care Compare, tied to the community's CMS Certification Number (CCN). The state survey agency also publishes state-level enforcement information.
Common nursing home survey deficiency tags in Virginia
The following F-tag patterns are commonly cited on standard and complaint surveys in Virginia. The list is descriptive, not a prediction, and does not substitute for reading a community's actual recent survey results.
- F-tag 689 Free of Accident Hazards
- F-tag 880 Infection Prevention
- F-tag 600 Free from Abuse and Neglect
- F-tag 684 Quality of Care
- F-tag 657 Care Plan Timing
Assisted living licensure in Virginia
Assisted living in Virginia is regulated by the Virginia Department of Social Services, Division of Licensing Programs (Assisted Living Facilities). Admissions teams should know which agency takes complaints about a tour or move-in conversation, since it is often a different agency than the one taking complaints about clinical care.
Memory care in Virginia
Virginia requires a Safe, Secure Environment authorization for assisted living facilities serving residents with serious cognitive impairment under 22 VAC 40-73-1090, and a specific staff training requirement of at least four hours of dementia training per year for direct care staff in those units.
Source: official memory care rule reference.
Hospice licensure in Virginia
Virginia requires hospice agencies to hold a state license issued by the Virginia Department of Health Office of Licensure and Certification in addition to Medicare certification.
Source: state hospice licensure reference.
The Long-Term Care Ombudsman in Virginia
The Virginia Long-Term Care Ombudsman Program (Virginia Department for Aging and Rehabilitative Services) is the right first call for many family concerns about resident rights. The ombudsman office is independent of the survey agency and supports residents and their families through complaint processes when the issue is dignity, autonomy, or quality of life rather than a clinical or regulatory matter.
Phone coverage and admissions in Virginia senior care
Senior care admissions live on the phone, and Virginia's regulatory framework adds specific reasons that phone responsiveness matters to the community itself. State surveyors, ombudsman investigators, hospital discharge planners, and adult protective services workers all reach communities through their general intake line. A missed call from any of those callers, especially during a complaint investigation window, is a meaningful operational risk. See the senior living hub for how Jonson is built around senior admissions workflows.
Frequently asked questions about Virginia senior care regulations
Why does Virginia regulate nursing homes and assisted living through different agencies?
Virginia places nursing homes (clinical SNF setting) under the Department of Health, and Assisted Living Facilities (ALFs) under the Department of Social Services, Division of Licensing Programs. The split reflects Virginia's historical view of ALFs as a social-services residential category rather than a clinical one.
What is the Safe, Secure Environment designation in Virginia?
Under 22 VAC 40-73-1090, an ALF unit serving residents with serious cognitive impairment requires Safe, Secure Environment authorization. The designation requires physical environment standards (egress control), specific direct-care training (at least four hours of dementia training per year), and resident assessment documentation.
Where do I check Virginia nursing home survey results?
Medicare.gov Care Compare publishes federal results. The Virginia Department of Health Office of Licensure and Certification also publishes state-specific licensing actions.
How do I file a complaint about a Virginia assisted living facility?
Complaints about an ALF go to the Virginia Department of Social Services, Division of Licensing Programs. Complaints about a nursing home go to the Virginia Department of Health. The Virginia Long-Term Care Ombudsman can assist families through either process.
Sources and official references
- Virginia DOH Office of Licensure and Certification
- Virginia DSS Assisted Living Facilities
- Virginia Long-Term Care Ombudsman
- Virginia Administrative Code 22 VAC 40-73
- CMS Medicare.gov Care Compare
This page summarizes commonly-referenced Virginia senior care regulatory requirements as of 2026. It is not legal or clinical advice. Verify every detail directly with the relevant state agency and consult counsel for legal questions specific to a community. The ombudsman office is the right first call when the concern is resident rights rather than clinical care.