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Which type of care actually fits?

Direct comparisons, using Virginia's own definitions.

Quick answer

Start with what help the person needs each day and whether they are safe alone: help with one or two daily activities often fits home care or residential living care, dependency in two or more points to assisted living care, serious cognitive impairment with safety risk points to a special care unit, and daily skilled nursing needs point to a nursing home.

Home›Comparisons

Most families are not choosing between communities first -- they are choosing between categories, and the categories in Virginia are defined by law, not by marketing. Each comparison below uses the state's definitions and the licensing records behind our directory.

How do I know which level of care a parent needs in Virginia?

Start with what help the person needs each day and whether they are safe alone: help with one or two daily activities often fits home care or residential living care, dependency in two or more points to assisted living care, serious cognitive impairment with safety risk points to a special care unit, and daily skilled nursing needs point to a nursing home.

A doctor's evaluation and, for assisted living, the Uniform Assessment Instrument confirm the level.

How do Virginia's payment programs change which option makes sense?

Payment often decides between two settings that both fit clinically: the CCC Plus Waiver favors care at home for Medicaid-eligible people, the Auxiliary Grant makes licensed assisted living possible on SSI-level income, and Medicaid favors nursing homes for long-term skilled needs.

Read the comparison guides with the costs section open alongside; the cheapest-looking option on paper can be the most expensive once hours or care levels are added.

Where do the comparison figures come from?

Costs come from CareScout's 2025 Virginia survey, licensing definitions from the Code of Virginia and 22VAC40-73, and program rules from DMAS, DARS and VA; no comparison uses a Richmond-specific price, because none is published.

Do these comparisons apply outside the Richmond region?

The licensing definitions and payment programs apply across Virginia, while the facility counts, agencies and hospitals referenced are specific to Richmond, Henrico, Chesterfield, Hanover and the Tri-Cities.

Comparisons

Care levels at a glance
Lighter needsHeavier needs
At homeHome care a few hours a weekFull-time or live-in care
In a facilityResidential living careAssisted living care, special care unit, nursing home

Want a short list instead of a long one?

Tell us about care needs, budget and the part of the Richmond area you are focused on, and a local advisor will come back with a few licensed options worth touring. It costs your family nothing.

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