Virginia's Joint Legislative Audit and Review Commission delivered a blunt message to state lawmakers this week: assisted living and in-home care services for the state's most vulnerable older residents need drastic improvement. The commission, known as JLARC, presented its findings at a meeting of legislators on Monday, describing weak oversight of in-home care and ill-prepared businesses.
Much of the alarm centered on affordability. Older Virginians generally do not have enough income to afford assisted living or more than a few hours of in-home care each week, according to the findings reported by WRIC ABC 8News. The average monthly cost of assisted living was nearly $7,000 in 2025, a 32 percent increase since 2021, and for most older adults that expense eats up more than 90 percent of their income, per the same report.
The demographic pressure behind those numbers is significant. Adults 65 and older make up 17 percent of Virginia's population, and people 85 and older are roughly three to five times more likely to need support with daily services than younger seniors, the station's report notes.
Inspections Years Behind Schedule
Oversight of the industry fared no better in JLARC's assessment. Hal Greer, the commission's staff director, said Virginia Department of Health regulation of in-home care is very weak and needs to be much stronger, according to the article. Joe McMahon, JLARC's chief legislative analyst, went further, saying oversight procedures are weak and understaffing is an issue.
McMahon said the state's licensure process allows ill-prepared businesses to operate and that required inspections are years overdue for most home care organizations, the outlet reported. Ninety percent of home care organizations have not been inspected in two years, and several have gone more than a decade without an inspection, per the same account.
Those gaps stand against a existing state requirement. Virginia's regulations for licensing home care organizations call for an Office of Licensure and Certification representative to conduct periodic unannounced on-site inspections as necessary, but no less often than biennially, according to the Virginia Administrative Code.
Recommendations and the State's Response
McMahon offered several fixes to lawmakers, suggesting additional funding for local areas and more in-home care services to address affordability, the station's report states. He also recommended that oversight include contacting clients, shadowing providers, and observing care quality firsthand.
The Virginia Department of Health responded to the findings in a statement posted to its site. “We agree with the report's central finding: the current system needs substantial improvement. That improvement needs to be significant, and it needs to be urgent. The report's recommendations align with our own assessment and with work already underway,” the agency said, according to vdh.virginia.gov.
The department is reportedly working on operational efficiencies that officials believe could be addressed within months, per WRIC's reporting. Longer-term fixes, however, will require support from Virginia lawmakers during the next General Assembly cycle, the report notes.
