Assisted Living in Alabama

When it comes to popular places to retire, Alabama is often overlooked in favor of its neighbor-state Florida. But, those who do choose Alabama for retirement and assisted living reap many of the same benefits as their peers across the state line, such as retirement-friendly tax policies and a comfortable climate. The 16 percent of Alabama residents who are age 65 and over benefit from the advantages of retiring in the state.

Directory of Assisted Living Facilities in Alabama

When it comes to popular places to retire, Alabama is often overlooked in favor of its neighbor-state Florida. But, those who do choose Alabama for retirement and assisted living reap many of the same benefits as their peers across the state line, such as retirement-friendly tax policies and a comfortable climate. The 16 percent of Alabama residents who are age 65 and over benefit from the advantages of retiring in the state.

How to Pay for Assisted Living in Alabama

Determining how to finance assisted living often starts with the question, “What’s the cost?” In today’s economy, where inflation plays a significant role, having current data is crucial for senior living financial planning. AssistedLiving.org has gathered cost information from its expansive network of over 75,000 senior living providers. This data offers a glimpse into the average expenses for assisted living in Alabama and 16 additional cities within Alabama.

How Inflation Has Impacted the Cost of Assisted Living in Alabama

Inflation has had a significant impact on assisted living costs in Alabama. From 2022 to 2023 the average price rose 14.5% to $3,798. Costs in the state remain lower than the national average of $4,459. Prices in Tennessee rose 24%, however increases in other neighboring states are smaller. Florida and Mississippi had similar increases of 9% and 8%, respectively, while Georgia’s costs rose 6%.

It’s expected that costs will continue to rise. In 2024, the Alabama average is likely to reach $4,045, and the U.S. average will be $4,802. A good financial plan can help seniors prepare for these expenses.

Assisted Living Costs in Alabama's Top Cities

Location has a large impact on assisted living costs, even within the same state. In Alabama, many major cities are more affordable than the state average. Seniors in Sheffield pay $2,985 per month. Costs in Mobile and Decatur are similar, sitting at $3,255 and $3,353, respectively. Birmingham is an exception, with prices significantly higher than the state average. Seniors there pay $6,040 per month.

The Cost of Other Types of Senior Living

The cost of different types of senior care varies depending on the level of care provided and the amenities that are offered. This can help seniors find the right option for their needs. Independent living is the most affordable choice at $2,754, while assisted living provides a higher level of care and costs $3,798. Memory care, which includes specialized dementia care services, has a higher cost of $4,769.

Financial Assistance for Assisted Living in Minnesota

Alabama Medicaid Elderly and Disabled Waiver

The Alabama Medicaid Elderly and Disabled Waiver is a Home and Community Based Waiver designed to help elderly and disabled residents of the state maintain some independence while still accessing the care that they need. Seniors who participate in the waiver program will work with a case manager, who develops a plan of care to meet their needs. Some of the services offered through the program include meal delivery, companion services, and personal care services. The waiver can help bridge the gap for seniors who need daily assistance, but are not ready for nursing care.

Who Is Eligible?
Applicants must require a “nursing facility level of care,” and have a maximum income of $2,250 per month. The resource limit for recipients is $2,000 per month.

How to Apply
Interested applicants can contact the Alabama Department of Senior Services online or by phone at 1-800-243-5463 to apply.

Supplemental Security Income

Supplemental Security Income is a federally-funded monthly payment that low-income seniors can use towards the cost of assisted living and other senior care needs. Though SSI is a federal program, applications and approvals are conducted on the state level. The payment amount recipients receive varies based on a variety of factors, including state of residence.

Who Is Eligible?
Applicants must be 65 years of age or older, be blind or disabled, have limited income and resources, and meet certain citizenship requirements.

How to Apply
Some applicants can apply online via the Social Security Administration website. Others must visit their local SSA office for in-person assistance.

More Ways to Finance Assisted Living

Some additional ways to finance assisted living costs include:

• Veterans Benefits
• Life Insurance Policy
• Long-Term Care Insurance
• Reverse Mortgage

Free and Low-Cost Resources for Seniors in Alabama

There are many resources in Alabama that assist seniors in their retirement. Assistedliving.org has compiled information on local organizations, programs and agencies and categorized them into care types for easy reference.

Area Agency on Aging

Retirees can find support and advice on various senior-related issues from their local Area Agency on Aging. The agency provides advice on topics such as financial assistance programs, in-home care and long-term care planning. It also connects seniors and caregivers with community-based resources.

Cash Assistance Programs

Cash assistance programs in Alabama provide financial support to help low-income retirees remain in their own homes for as long as possible. Seniors and caregivers can apply for tax rebates and reductions, discounts on vital services and help covering the cost of heating and cooling their home.

Financial Assistance for Senior Care and Senior Living

Whether living in their own home or in a senior living community, Alabama seniors can find financial assistance from numerous local resources. These organizations help residents cover some of the costs associated with in-home or long-term care and connect them with other helpful community-based resources.

Food Assistance Programs

Local organizations help ensure elderly citizens have a balanced diet and receive essential vitamins and minerals to remain healthy. Through nutrition programs, congregate meals, home-delivered meals and food pantries, these programs help Alabama seniors afford the nutritious food they need.

Free Used Medical Equipment

Due to the high cost of purchasing new medical equipment, several organizations in Alabama collect lightly used medical devices such as wheelchairs, ramps and walkers and distribute them to local seniors and residents in need.

Home Repair and Modifications

Seniors and those with disabilities can access a variety of local resources to help them pay for home repairs and modifications. Programs in Alabama have different eligibility criteria and often assist retirees by providing grants or loans.

Social Security Offices

Social Security offices in Alabama help seniors and disabled people access the benefits they’re entitled to. Older adults can contact their local office for information about receiving retirement benefits, disability allowance and Supplemental Security Income.

Utility & Energy Bill Assistance

Low-income seniors who are struggling to meet the costs of maintaining their homes can find support from organizations that offer assistance with utility and energy bills. Alabama retirees could also qualify for emergency funding programs if they’re in danger of losing utility services due to unpaid invoices.

Veteran’s Services

Alabama retirees who have served in the U.S. military can find support from local veteran services. These offices and organizations help vets access the benefits they’re eligible for and provide advice and information on a variety of issues.

Assisted Living Laws and Regulations in Alabama

In Alabama, assisted living facilities are governed by the state’s Department of Public Health (DPH). The DPH has comprehensive regulations in place to ensure that residents of assisted living facilities are safe and that the services provided are clear to all potential residents.

Assisted Living Definition

Assisted living facilities in Alabama fall into one of two categories: assisted living facilities, or specialty care assisted living facilities.

• Assisted living facilities (ALFs) are communities with two or more residents. The ALF must provide, or offer to provide, these residents assistance with activities of daily living.
• Specialty care assisted living facilities are assisted living facilities that are specially licensed to provide care for residents with cognitive impairment that would normally make them ineligible for admission to an ALF.

Assisted living facilities and specialty care assisted living facilities are both further classified by the number of residents they serve:

• Family assisted living facilities care for 2-3 residents
• Group assisted living facilities care for 4-16 residents
• Congregate assisted living facilities care for 17 or more residents

Assisted Living Resident Agreements

A resident agreement must be provided to and signed by residents prior to or at the time of their admission. These written agreements must include:

• Charges for room and board, laundry, personal care services, and other basic and optional services
• Refund and discharge policies
• The bed hold policy
• Documentation that the resident and sponsor understand that the facility is not authorized to provide skilled nursing care nor care for those with cognitive impairment (specialty care assisted living facilities can care for residents with cognitive impairment)
• Documentation that the resident and sponsor agree that if the resident at any point needs skilled nursing care or care for a cognitive condition and will need this care for more than 90 days, they will be discharged by the facility after written notice
• Information about the local ombudsman program

Resident agreements for specialty care assisted living facilities are the same as those for assisted living facilities, other than the fact that specialty care assisted living facilities can provide care for those with cognitive impairment.

Assisted Living Service Planning

Prior to admission, all residents must undergo an examination by a physician. The results of this exam must then be used by the facility to determine the resident’s needs and develop a plan of care. The resident, and their representative if they choose to use one, must also be involved in the planning process.

Residents of specialty care assisted living facilities must undergo a screening prior to admission. The screening includes a clinical history, mental status examination, geriatric depression screen, physical functioning screen, and behavior screen.

Assisted Living Admission Requirements

All assisted living facilities must provide residents with assistance with activities of daily living (ADLs), which includes basic daily tasks such as eating, bathing, and dressing. In Alabama, assisted living facilities may not admit residents who require care beyond assistance with ADLs, such as medical care or skilled nursing care. Residents must be able to understand the facility’s dose medication system, and if they are unable to understand due to dementia, may be denied admission. Additionally, residents may not:

• Have chronic conditions requiring skilled nursing care or daily professional observation
• Require confinement or limitations on egress from the facility

Exceptions may be made for residents who require skilled nursing care, medical care, or administration of oral medications for a period of less than 90 days. In these cases, the facility is responsible for delivering the appropriate care to the resident for up to 90 days.
While specialty care assisted living facilities can care for residents with cognitive impairment, they cannot provide medical or skilled nursing care for acute conditions or exacerbated symptoms chronic conditions for longer than 90 days.

Assisted Living Scope of Care

Assisted living facilities in Alabama must provide residents with daily assistance with ADLs, including:

• Eating
• Bathing
• Dressing
• Oral hygiene
• Toileting
• Other basic tasks

Other services they provide assistance with include:

• Laundry
• Medication services
• Housekeeping
• Coordination of transportation for medical services
• Social activities

Additionally, facilities must observe and supervise residents in order to identify changes in health status and general functioning.

In addition to all of the services provided in standard ALFs, specialty care assisted living facilities must also provide residents with daily activity programs designed to meet their individual needs.

While there are statewide requirements for all ALFs in Alabama, the services provided by individual facilities still vary to a certain degree. To make sure a facility can meet the needs of yourself or a loved one, be sure to discuss what services the specific facility can provide.

Assisted Living Medicaid Policy

Eligible residents may be able to use the Alabama Medicaid Elderly and Disabled Waiver to cover some costs of care in an assisted living facility. However, not all facilities accept Medicaid or Medicaid-related programs. If you or your loved one plans to use the Medicaid waiver to help pay for assisted living, be sure to check with the facility to see if they accept the waiver program as payment.

Assisted Living Facility Requirements

Units in assisted living communities in Alabama are not required to be apartment-style. Units may be single-or-double occupancy, and bathrooms and bathing facilities may be shared. In facilities with shared bathrooms, there must be at least one bathtub or shower for every eight residents, and one sink and toilet for every six residents.

Medication Management Regulations

Residents who are aware of their medications may administer their own medication or receive assistance with self-administration from any staff member, including those who are unlicensed. “Aware” means that the resident can possess their medications and self-administer medications without causing risk to their health or safety, or that the resident has a reasonable understanding of the facility’s unit dose packaging system and is unlikely to make errors with their medication administration.

Assistance with medications means bringing the medication to the resident, opening the bottle or package, and offering water; it does not mean physically assisting residents with ingesting the medication, or special preparation of the medication (crushing pills, mixing liquids).

Residents of specialty care assisted living facilities may receive assistance with medication administration. Medication administration must be provided by a physician, osteopath, physician assistant, registered nurse, or licensed practical nurse.

Staffing Requirements

Facilities must employ an administrator to oversee the facility and handle operational duties, and personal care staff to work directly with residents and meet their care needs. If any residents of the facility require assistance with medication administration, the facility must hire an RN or LPN. The facility also must be staffed at all times by at least one employee with CPR certification, and facilities equipped with an automated external defibrillator (AED) must be staffed at all times by at least one person with a current certification from the American Heart Association or the American Red Cross in AED utilization.

There are no minimum staff-to-resident ratios for assisted living facilities in Alabama. Individual facilities may have their own policies in place for staff ratios.

Staff Training Requirements

All staff of assisted living facilities must receive an initial training at their time of hire as well as ongoing training that covers specific topics. Topics that must be covered during training include:

• Applicable rules and statutes
• How to identify and report abuse, neglect, and exploitation
• Needs of the elderly, mentally ill, and intellectually disabled
• First-aid
• Advance directives
• Confidentiality
• Nutritional needs of the elderly
• Fire and environmental safety
• Signs and symptoms of dementia

Additionally, all facility administrators must complete 6 hours of continued education per year, although licensed nursing home administrators are exempt.

Background Checks for Assisted Living

Anyone working in an adult care facility in Alabama must be fingerprinted and undergo a background check. Assisted living facilities must not hire any individual whose name appears on the Alabama Department of Public Health Nurse Aide Abuse Registry.

Requirements for Reporting Abuse

All caregivers in Alabama are required by law to report all cases of elder abuse, neglect, or exploitation. Anyone who suspects elder abuse should report the incident to Adult Protective Services as soon as possible via the abuse hotline at 1-800-458-7214.

Concerns about assisted living facilities violating state regulations or not providing residents adequate care can be reported to the office of the Long-Term Care Ombudsman. The ombudsman investigates complaints about ALFs and ensures residents in long-term care facilities receive the care that they need. To find your local ombudsman, contact your region’s Area Agency on Aging or call 1-800-AGE-LINE (243-5463).