By Norfolk Senior Advisor Care Team · October 8, 2026
- Read the facility's VDSS record before you tour, then use Virginia's safe, secure unit rules as your question list.
- Ask who signed the placement approval, when the six-month review is due, and who runs activities inside the unit.
- Count staff on the floor yourself, test the doors, and ask to see the outdoor area in use.
What should Hampton Roads families ask on a Virginia memory care tour?
Ask questions that map to Virginia's safe, secure environment standards, because those are the rules a licensed special care unit must actually follow. Seven topics cover most of it: who approves placement, when the first review happens, weekly activity hours, staffing in the unit, how doors are secured, outdoor access, and what the latest state inspection found.
Marketing language such as "enriched living" or "secure neighborhood" is not a regulatory term. The terms that count come from the Virginia Department of Social Services (VDSS) rules, 22VAC40-73, and a tour guide who knows them will answer in specifics. One who deflects is telling you something.
Bring a notebook and ask the same questions at every community. Answers written down side by side are far easier to compare than impressions from three different Saturday mornings, and they give you something firm to take to the memory care directory comparison later.
Who must approve a placement in a Virginia safe, secure unit?
The resident approves in writing if capable. If not, a guardian or legal representative signs. If neither exists, a relative may approve in a set priority order: spouse, adult child, parent, adult sibling, adult grandchild, adult niece or nephew, then aunt or uncle. Without any of them, an independent physician skilled in dementia can approve (22VAC40-73-1100).
On the tour, ask to see a blank copy of the approval form and ask who at the community collects it. If your mother has two adult children who disagree, the order matters: you cannot simply pick the sibling who is easiest to reach.
Families sometimes learn this rule only after a hospital discharge, when the unit's bed is open and the paperwork is not. Ask what the community does when approval is missing on move-in day, and whether it will hold the bed. Our guide to safe, secure units covers the full rule set.
When does Virginia require a review of a resident's memory care placement?
Virginia requires a review of whether the safe, secure unit is still appropriate six months after placement, once a year after that, and any time the resident's condition changes (22VAC40-73-1110). A tour answer should name who performs the review and how the family hears the result.
Ask what a condition change looks like in practice. A fall, a hospital stay, a new medication or a sudden improvement can all qualify. Some residents settle after the first few months and no longer need a secured unit, which is why the review runs in both directions.
Also ask what happens to the monthly charge if the review moves your parent out of the unit. A community that quotes one fee for the unit and another for assisted living level should be able to say, in writing, how the switch is billed.
How many activity hours must a Virginia memory care unit provide each week?
A Virginia special care unit must schedule at least 21 hours of activities each week, with no fewer than two hours on any day. A designated activities coordinator must be on site in the unit at least 20 hours a week (22VAC40-73-1120). Ask to see this week's posted calendar and who led each session.
The number to test is the real one, not the monthly newsletter. Count the sessions on the posted schedule. Then ask a care aide, not the sales director, what actually happened yesterday afternoon. If the calendar is full and the day room is a television, you have your answer.
Look for activities matched to varied abilities: something for a resident who still walks the halls constantly and something for a resident who sits most of the day. Two hours a day is a floor, and a good unit usually fills more of the day than that.
| Rule topic | What to ask on the tour | What a solid answer includes |
|---|---|---|
| Weekly activities | Can I see this week's schedule? | At least 21 hours posted, never under two hours a day |
| Coordinator | Who leads activities in the unit? | A named person on site at least 20 hours weekly |
| Daily outdoors | When did residents last go outside? | A recent specific day and a supervised or secured space |
| Review timing | When is my parent's first review? | Six months after placement, then yearly |
What staffing should I count on a Virginia special care unit tour?
Outside night hours, Virginia requires at least two direct care staff awake and on duty in each unit when 20 or fewer residents are present, plus one more for every additional 10 residents or portion thereof. One staff member is allowed only when five or fewer residents are present and two other direct care staff are in the building (22VAC40-73-1130).
Do the arithmetic while you stand in the hallway. With 24 residents, the rule calls for three direct care staff, not two, because the 21st through 24th residents count as a portion of ten. Then ask how many people were on that shift last Tuesday.
Visit at a second time of day if you can, such as late afternoon when residents are often restless. A tour at ten in the morning shows a community at its best. Ask what the plan is when someone calls out, since a gap in a locked unit leaves residents with no one nearby.
How should I check doors and outdoor space in a Virginia memory care unit?
Virginia requires doors to unprotected areas to be monitored or secured, using methods such as alarms, cameras, constant staff oversight, alarm bracelets, pressure pads, delayed egress, locks or perimeter gates (22VAC40-73-1150). The unit also needs a secured outdoor area or staff supervision outdoors, with a daily chance to go outside, weather permitting (22VAC40-73-1160).
Stand at the exit doors and ask what happens when one opens. Does an alarm sound, and who responds? Check that resident and common-area windows have protective devices. Ask to walk the outdoor area: is it fenced, shaded and level, or a bare patch behind a door?
Hampton Roads weather matters here. In a humid August or after a nor'easter, ask what residents do when the yard is unusable, and how the unit handles a hurricane evacuation with residents who may not understand why they are leaving. That is the conversation to have in person, with the findings printed and in hand.
How do I check a memory care facility's VDSS record before touring?
Search the facility on the VDSS assisted living public search, which posts inspection findings including violation notices. A copy of the most recent findings must also be posted inside the building. According to VDSS records as of October 28, 2026, 50 of the 84 licensed assisted living facilities across the 13 Hampton Roads localities have a special care unit.
Read the license term first. VDSS records for the 84 facilities show 50 one-year licenses, 27 two-year, 2 three-year and 5 conditional. Then look for repeated citations, not a single old one. Individualized service plans and medication management appear most often across the region's recent violation notices.
Bring one or two findings to the tour and ask the administrator what changed. A calm, specific answer is a good sign. Our page on reading VDSS inspection reports walks through the search screen step by step. Ask also how the unit learned from the last inspection, and who owns the fix.
Frequently asked questions
Does a memory care unit in Virginia need a special license?
Memory care in Virginia is an assisted living facility with a safe, secure environment, which the rules call a special care unit. It operates under the facility's VDSS license and must meet the additional standards in 22VAC40-73. Ask the community to show how its license describes the unit.
Can the family refuse a placement in a safe, secure unit?
The approval has to come from the resident if capable, otherwise a guardian, legal representative, relative in the set order, or an independent physician. If you are the person with authority, you can decline, and you can ask the physician or the unit for the reasons behind the recommendation first.
Does Medicare pay for memory care in Virginia?
No. Medicare does not pay for assisted living or memory care room and board. It covers medical services and short skilled nursing stays after a qualifying hospital stay. Families usually pay privately, and some eligible residents get help from the Auxiliary Grant at communities that accept it.
Who can I call if I think a unit is breaking these rules?
Call the VDSS complaint line at 1-800-543-7545. You can also contact your regional long-term care ombudsman, who acts with the resident's consent. If someone is in immediate danger, call 911 first. Anyone can report a concern, and the call is a good first step.
