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Guide to Senior Living in Alabama

Alabama is a warm Southern state that’s rich with history and very welcoming to seniors. Nearly 17% of Alabama’s 4.9 million people are seniors aged 65 and over. Most of the state enjoys warm, balmy summers and some of the mildest winters in the United States. First joining the nation in 1819, Alabama’s landscape is rich with history and numerous cultural sites where seniors can volunteer. Several Civil War sites can be found between Birmingham and Mobile, with local monuments to the Civil Rights era a century later.

Alabama’s seniors can expect to pay less than the national average for all care types. For instance, the cost for room and board in one of the state’s 196 assisted living facilities averages $3,250 a month, according to Genworth Financial’s 2019 Cost of Care Survey. This is significantly less than the $4,051 seniors pay nationwide for similar senior living services, and it’s well below the price paid in many other nearby Southern states. This guide is written to help seniors and their loved ones find safe and comfortable senior living in the state of Alabama. It also lists several local resources that seniors in Alabama can use to help pay for many of the costs of senior living.

Paying for Senior Living in Alabama

Alabama seniors who choose assisted living communities are likely to have some of the least expensive senior care available. At $3,250 a month, the average cost of assisted living is somewhat lower than both in-home care and homemaker services, which cost an average of $3,394 and $3,432 a month, respectively. Adult day care is comparatively affordable in Alabama, at just $758 a month. Skilled nursing is one of the state’s most expensive senior care options, at an average cost of $6,388 a month for a semiprivate room.

$3250

Assisted Living

$3394

In-Home Care

$3432

Home Health Care

$758

Adult Day Care

$6388

Nursing Home Care

The Cost of Assisted Living in Alabama

Assisted living in Alabama is substantially less expensive than the national average and several other Southern states. Assisted living in Alabama costs an average of $3,250 a month, which is $801 a month less than the national monthly average of $4,051. Seniors in Georgia pay around $85 a month more than seniors in Alabama, or an average of $3,335. Florida and Mississippi are somewhat more expensive, at $3,500 and $3,524 a month, respectively. Of the states that border Alabama, Tennessee averages the highest prices for assisted senior living, at $3,900 a month for seniors across the state.

$3250

Alabama

$4051

United States

$3524

Mississippi

$3900

Tennessee

$3335

Georgia

$3500

Florida

The Cost of In-Home Care in Alabama

Seniors in Alabama are fortunate to pay $896 below the U.S. average for in-home care. Even surrounded by states with low-cost in-home care, Alabama still remains the least expensive option. Mississippi, at $3,432 per month, costs $38 more than Alabama. Tennessee and Georgia, both at $3,813 per month, exceed prices in Alabama by $419, and Florida, at $4,004, costs $610 more.

$3394

Alabama

$4290

United States

$3432

Mississippi

$3813

Tennessee

$3813

Georgia

$4004

Florida

The Cost of Nursing Home Care in Alabama

At $6,388 per month, nursing homes in Alabama are inexpensive, ranging from $296 – $2,159 cheaper per month than the surrounding states. Georgia ($6,684), Mississippi ($6,844) and Tennessee ($6,836) all have average costs fairly similar to those in Alabama. Florida, however, reports costs of $2,159 more than Alabama. In addition to having the lowest nursing home care costs among its neighboring states, nursing home care in Alabama is also lower than the U.S. average.

$6388

Alabama

$7513

United States

$6844

Mississippi

$6836

Tennessee

$6684

Georgia

$8547

Florida

Financial Assistance for Senior Living in Alabama

Elderly and Disabled Waiver

The Alabama Department of Senior Services offers an Elderly and Disabled waiver to seniors who meet the state’s income and asset guidelines for financial and medical eligibility. The waiver assists with paying the monthly cost of board and care in a senior living facility and is available to seniors in Alabama who would otherwise qualify for placement in a nursing home or other level of care covered by Medicaid. Waivers are not available to seniors residing in nursing homes or hospitals at the time of application, though discharge planning costs may be reimbursed on approval and acceptance into the program at a participating senior living community.

In addition to senior living costs, the waiver program also pays for case management services and reasonable expenses related to discharge and transfer to a senior living facility from a nursing home. Homemaker and personal care services are paid by the program, as are adult day care and respite care if deemed necessary in the resident’s long-term care plan. Meal service and companion visits are provided under the Elderly and Disabled waiver at no cost to the beneficiary. However, a limited charge may apply for other services that is not to exceed the average cost without the waiver.

Financial eligibility for an Elderly and Disabled waiver is automatically extended to all seniors in Alabama who meet program standards for receiving SSI or who have already been accepted into the Medicaid program for low-income health insurance. Seniors are considered medically eligible to participate in the waiver program upon certification by a licensed physician that senior living is an acceptable alternative to placement in a skilled nursing or another long-term care facility.

The Elderly and Disabled waiver application process requires an initial referral to a case manager from a physician, nurse or staff member at a nursing home or other responsible medical practitioner, followed by a preadmission screening and endorsement from a doctor. Physicians and case managers then draft a care plan that includes waiver services and submit a request to the state Medicaid office.

Contact: Applications for the Elderly and Disabled waiver program may be downloaded online and submitted to a participating care provider. Applications may also be requested by calling 1-800-362-1504.

Senior Living Laws and Regulations in Alabama

Note: All these rules typically apply to non-clinical senior living facilities, such as independent living, assisted living, and memory care facilities. Nursing homes and other senior living facilities with a clinical setting may have additional or slightly different requirements and regulations.

Senior living and personal care homes in Alabama are licensed by the Department of Public Health, Bureau of Health Provider Standards. This bureau sets statewide standards, conducts inspections of licensed facilities and develops best practices for Alabama residential care facilities, including assisted living communities. Licensed facilities in the state are required to comply with Bureau standards for admissions, Alzheimer’s and dementia care, medication handling and staff training.

Admission Requirements

Prior to admission to an Alabama senior living community, prospective residents must undergo a preadmission health screening by a licensed physician. A doctor must certify that the resident doesn’t require a higher level of care than the facility can provide, such as continuous wound care or behavior management beyond the scope of the admitting facility. Senior living residents must not require skilled nursing for more than 90 days unless they have been diagnosed with a terminal illness and can be admitted to a hospice program in the facility. Medical evaluations must be repeated annually or after any observable change in the resident’s condition. Residents must be able to evacuate unsafe conditions, such as fire, alone or with minimal assistance.

Memory Care Regulation

Facilities may not admit residents with Alzheimer’s disease or other forms of dementia unless they are licensed as specialty care facilities. Unlicensed facilities are not permitted to advertise or to represent themselves as providing Alzheimer’s care or dementia/behavior management without a specialty care license. Specialty care may be licensed for an entire facility or for a designated wing inside of an otherwise unlicensed facility. Specialty care units are subject to memory care inspections and requirements. New residents must pass a medical and psychological screening prior to admission that includes a clinical history, examination of mental status, aphasia screening, geriatric depression screening and a physical function evaluation. Current memory care residents must be reevaluated annually or after a noticeable change in behavior or ability.

Medication Management

Residents of senior living facilities may keep, manage and self-administer medications with the written permission of a physician. Approval is also required for facility nursing staff to assist with medication for residents who need it. No approval is necessary for over-the-counter medications that the resident can self-administer without assistance. Medications must be stored in unit dose containers and kept in accordance with state medication management protocols. Residents who have trouble managing their medication, or who cannot remember their own names or respond to instructions, may have their medication administered by staff. Authorized staff includes registered nurses, licensed practical nurses or physicians only.

Staffing Requirements

Licensed senior living communities must have a designated administrator who is responsible for the day-to-day operation of the facility and sufficient staff on duty to adequately care for every resident. Senior living facilities that aren’t licensed to provide specialty care don’t have a set staffing ratio, though at least one member of the staff who has current CPR certifications must be on duty at all times. Facilities licensed to provide specialty care must employ an administrator, a medical director, a minimum of one registered nurse and a certified care coordinator. At least two staff members must be present and on duty 24 hours a day, seven days a week. CPR-certified staff must be available at all times and close enough to the specialty care unit to respond rapidly to emergencies. Staff ratios are specified by the facility’s license, though more staff may be required to adequately manage evacuations in the event of a fire.

Facility administrators must be licensed by the Alabama Board of Examiners of Assisted Living Administrators. Administrators must be high school graduates aged 19 and over. They must also have either two years of experience working in administrative or care positions in a senior living, hospital, skilled nursing or other residential care facility or two years of college and at least one month of experience in a residential care setting. Administrators must report 12 hours of continuing education each year for licensing in a senior living facility or 18 hours a year for special care facilities.

Staff members in licensed facilities must be high school graduates who have completed an initial training program with state-specified coursework. Limited continuing education requirements apply to all resident-care positions, as does the requirement to pass a preemployment background check.

Alabama Senior Living Free Resources

Alabama Agencies

Alabama Medicaid

Alabama Medicaid offers eligible seniors free and low-cost medical insurance that can help cover many of the costs associated with senior care. Though Medicaid doesn’t directly pay for the cost of senior living, seniors who meet the income and asset limitations of the program may get help paying for prescriptions, medical supplies and personal health services.

To qualify for Alabama Medicaid, seniors must earn an income below the state threshold and possess less than $2,000 in countable resources.

Contact: Seniors can apply for Medicaid in Alabama online or by calling a program office at 1-800-362-1504. In-person applications may be filled out and submitted at a local Social Security office.

Area Agencies on Aging in Alabama

Alabama’s Area Agencies on Aging offer referrals and locally focused programs that can help seniors engage with their communities and stay active with other seniors. AAA workers can advise seniors and their loved ones about financial resources they may be eligible for, and they can assist with applications for local programs. Seniors in Alabama can find a local AAA office by calling 1-800-AGE-LINE (1-800-243-5463), or online here.

Veterans Affairs Offices in Alabama

The Alabama Department of Veterans Affairs operates 50 offices around the state to assist honorably discharged veterans and their qualifying family members find the help they need. Veterans and their spouses can appeal to the local VA for preadmission health screenings and limited financial aid. Find a local Alabama office with the VA’s online locator tool.

VETERAN’S OFFICEADDRESSPHONE NUMBER
Birmingham Vet Center400 Emery Drive, Suite 200
Hoover, AL 35244
205-212-3122
Huntsville Vet Center415 Church Street, Bldg H, Suite 101
Huntsville, AL 35801
256-539-5775
Mobile Vet Center3221 Springhill Ave Bldg 2, Suite C
Mobile, AL 36607
251-478-5906
Montgomery Vet Center4405 Atlanta Highway
Montgomery, AL 36109
334-273-7796

Social Security Offices in Alabama

Alabama offices of the Social Security Administration can be helpful resources for seniors who need help signing up for means-tested assistance programs, such as Medicaid and nutritional support. Social Security offices also assist seniors applying for Medicare, disability benefits and caregiver help. Seniors in Alabama can find their local Social Security office online.

Frequently Asked Questions

How much does assisted living cost in Alabama?

Assisted living in Alabama costs an average of $3,250 per month. This is less than the $4,051 national average and also less than many of the surrounding states, including Georgia, Mississippi and Tennessee.

Does Alabama Medicaid pay for assisted living?

Medicaid doesn’t directly support the cost of board and care in a residential assisted living community. Alabama’s low-income health insurance plan does, however, cover many of the costs associated with assisted living, such as prescription drugs and medical supplies.

Does Medicare pay for assisted living?

Medicare doesn’t provide a long-term residential care benefit as part of its regular health services for qualifying seniors. Some Medicare Advantage or supplemental Medigap plans may offer a long-term care option. Plan details vary, and so it’s best to consult with a plan representative before making financial decisions about senior care.

What are “activities of daily living”?

The term “activities of daily living” describes the regular daily chores many seniors need personal caregivers to help out with. Common activities of daily living include personal hygiene, dressing, meal preparation and light housekeeping. The term is sometimes expanded to include shopping and other tasks outside of the home.

What is the difference between assisted living and nursing homes?

Assisted living is a largely nonmedical choice of senior living, while nursing home care is designed to meet residents’ medical needs in a residential care setting. Residents in a nursing care home can expect skilled nursing care, physical and occupational therapy services and lift assistance while moving. Seniors in assisted living generally lead more independent lifestyles with daily help performing normal activities of daily living.

The Top Cities for Senior Living in Alabama

Learn more about the cost of senior living in the top Alabama cities. Additionally, find reviews and information about assisted living facilities and other senior living communities across the state.

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