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.

Paying For Assisted Living in Alabama

The Cost of Assisted Living in Alabama

The monthly median cost of assisted living in Alabama is $3,057, which is fairly low compared to the national average of $3,750. According to Genworth’s 2017 Cost of Care Survey, assisted living in Alabama is also less expensive than the median in all of its neighboring states in the Southeast other than Georgia.

Within Alabama, costs can vary greatly between different regions. The average monthly cost in the Montgomery is almost double the cost of the Gadsden area. However, all of the areas in the state are below the national average.

At just over half the cost of nursing home care, assisted living is one of the more affordable options for long-term care in Alabama. It’s also considerably less expensive than home care when the cost of rent or a mortgage and upkeep is taken into consideration.

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 Assisted Living Resources in Alabama

Governmental and nonprofit organizations throughout Alabama offer free assistance and services to seniors and their families. These services include help finding long-term care facilities, investigating elder abuse, legal assistance, and more. The organizations listed below are a great resource for seniors in Alabama looking for the right long-term care facility, or when they need assistance with other aspects of their health and well-being.

Long-Term Care Ombudsman Program

The Alabama Department of Senior Services maintains a Long-Term Care Ombudsman program. Some duties of the Ombudsman include:

• Identifies problem areas in long-term care facilities and advocates for change
• Provides state residents with information about long-term care options
• Educates long-term care facility residents, their families, facility staff, and the community about elder abuse, neglect, and exploitation
• Routinely visits long-term care facilities to monitor conditions and talk to residents
• Represents residents’ interests and works with federal and state lawmakers to change policies that affect long-term care facility residents

Area Agencies on Aging

Area Agencies on Aging (AAA) is a network of hundreds of nonprofit organizations across America that provide federally funded services to adults over 60 in their local areas.

In Alabama, some areas have an Aging and Disability Resource Center (ADRC) rather than an AAA. Like AAAs, ADRCs offer comprehensive information on various kinds of programs and community support for seniors.

Veterans Affairs Programs

Veterans Affairs programs are designed to support veterans and their families with a variety of their needs, including medical care. Some veterans may be able to utilize VA programs to help finance long-term senior care. To find out what VA programs you or your loved one are eligible for, contact or visit your local VA office.

Social Security Offices

There are over 20 Social Security offices located throughout Alabama. By contacting or visiting your local office, you can gain a better understanding of the Social Security benefits that are available for yourself or a loved one. Some Social Security benefits may be able to go towards paying for assisted living or other long-term care expenses. Below is a list of Social Security offices in Alabama:

Assisted Living Association of Alabama

The Assisted Living Association of Alabama (ALAA) is a nonprofit organization that promotes education, advocacy, and excellence in senior care throughout the state. The organization offers educational events for caregivers, and maintains a list of “member facilities” that are licensed by the Department of Public Health. Seniors or their loved ones can easily search the list of ALAA member communities.

Alabama SeniorRx Prescription Assistance Program

The SeniorRx program aims to make the management of chronic conditions easier for seniors by offering financial assistance for prescription medications. Seniors who qualify for the program can get their prescriptions for free or at a very reduced cost. Eligible applicants must be over the age of 55, have a chronic medical condition, and meet certain income guidelines. For assistance, contact your local Area Agency on Aging or call 1-800-AGE-LINE (1-800-243-5463).

Alabama Senior Nutrition and Wellness Programs

The Alabama Department of Senior Services coordinates multiple nutrition and wellness programs for residents over the age of 60 and their spouses. These programs include community meals, meal delivery services, and nutrition education services. All of the programs are overseen by a team of Registered Dieticians. Eligibility and events are coordinated by local Area Agencies on Aging. To find out if you are eligible or learn about the programs available in your area, contact your local AAA or call 1-800-AGE-LINE (1-800-243-5463).

Alabama Legal Assistance Program

The Legal Assistance Program assists Alabama residents age 60 and over with non-criminal legal matters. The program is staffed by lawyers licensed by the State Bar of Alabama, and offers representation free of charge. The program assists with legal matters such as elder abuse, advanced directives, powers of attorney, accessing long-term care, and more. To find out if you are eligible or obtain assistance, contact your local AAA or call 1-800-AGE-LINE (1-800-243-5463).

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).