What is the difference between a group home and assisted living in Virginia?

Group homes (DBHDS)

DBHDS licensing rules define a group home or community residential service as a congregate service providing 24-hour supervision in a community-based home with eight or fewer residents. Services include supervision, supports, counseling and training in activities of daily living, based on each person’s individualized services plan.

When the Community Living waiver pays for group home residential service, Medicaid pays only in homes with no more than six licensed beds. Larger homes that became DD waiver providers before March 31, 2021 may keep operating under that rule.

Assisted living facilities (Department of Social Services)

Virginia law defines an assisted living facility as a congregate residential setting that provides or coordinates personal and health care services, 24-hour supervision and assistance for four or more adults who are aged or infirm or who have disabilities. Facilities licensed by DBHDS or the State Board of Health are excluded from that definition.

The Department of Social Services notes that assisted living facilities are not nursing homes. Nursing homes are regulated by the Virginia Department of Health.

A third option: adult foster care

Adult foster care is room and board, supervision and special services in the provider’s own home, for up to three adults. Caring for more than three adults requires an assisted living license from the Department of Social Services.

Questions to ask any home

• Which agency licenses this home, and for which service?
• How many people live here?
• Which waiver services, if any, can you provide for my family member?