How Virginia Regulates Memory Care Safe, Secure Units

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

What is a safe, secure unit in a Virginia assisted living facility?

A safe, secure environment is a self-contained special care unit for residents with serious cognitive impairments due to a primary psychiatric diagnosis of dementia who cannot recognize danger or protect their own safety. A facility may have one or more such units or be entirely a special care unit (22VAC40-73-10).

The words "memory care" on a sign are marketing. What matters is whether the unit meets the state's special care standards. Ask the administrator to show you where the facility's license and unit approval are posted. Before you tour, read the comparison of assisted living and memory care.

Who has to approve a move into a Virginia memory care unit?

Written approval must come before placement: from the resident if capable, otherwise from a guardian or legal representative, otherwise a relative in a set order of priority. The order is spouse, adult child, parent, adult sibling, adult grandchild, adult niece or nephew, then aunt or uncle (22VAC40-73-1100).

If no relative is available, an independent physician skilled in dementia can give the approval. This rule matters when siblings live in Richmond, San Diego and Chesapeake and disagree. The person highest in the order signs, not the one who lives closest. Appropriateness of the placement is reviewed at six months, annually after that, and whenever the resident's condition changes (22VAC40-73-1110).

What activities and staffing must a Virginia secured memory unit provide?

A unit must offer at least 21 hours of scheduled activities each week, no less than two hours each day, with a designated activities coordinator on site in the unit at least 20 hours a week (22VAC40-73-1120). Staffing is set separately in 22VAC40-73-1130.

Outside night hours, at least two direct care staff must be 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. A single staff member is allowed only when no more than five residents are present and two other direct care staff are in the building. Ask what the schedule looks like on a Sunday afternoon.

What door, window and outdoor rules apply to memory care units?

Doors to unprotected areas must be monitored or secured with alarms, cameras, constant staff oversight, alarm bracelets, pressure pads, delayed egress, locks or perimeter gates, and resident and common-area windows need protective devices (22VAC40-73-1150). The rule lets facilities choose the method, so methods vary.

There must also be a secured outdoor area or staff supervision outdoors, with a daily chance to be outside, weather permitting (22VAC40-73-1160). In Hampton Roads, ask how residents get outside during a hot, humid August and what the facility's plan is when a hurricane or tidal flooding forces an evacuation.

What should Hampton Roads families ask a memory care unit about these rules?

Ask whether the unit is approved as a safe, secure environment, who signed the placement approval, when the first six-month review is due, and how many direct care staff are awake overnight. Ask to see the weekly activity calendar and the outdoor area, and ask how doors are secured.

Then ask the harder question: what happens when my parent's needs go beyond what the unit can do. The admission limits guide lists conditions Virginia assisted living cannot keep. A unit that answers specifically, with names and numbers, is usually one that has thought it through.

How much does memory care cost in Hampton Roads?

Nobody can quote a reliable median. CareScout does not survey memory care as a separate category, so any average you read online is an estimate. Get a written quote from each community for your parent's care level, with every tier and fee spelled out.

For context on adjacent costs, see what senior care costs in Virginia. For wandering concerns at home, see dementia and wandering. Use the memory care directory to build a call list, and use the contrast table on this page to compare a unit with a general assisted living area.