Nursing Homes in Alabama
As of July 2019, Alabama had more than 4.9 million residents, and seniors 65 and older made up 17.3% of the population. The Kaiser Family Foundation reports that 22,884 adults lived in Alabama’s certified nursing facilities during the same year. With more than 100 hospitals and 15,000 staffed beds throughout the state, Alabama has plenty to offer seniors who need health care. Alabama also has 228 skilled nursing facilities, ensuring that seniors have access to daily medical care and supervision when needed.
Nursing homes provide 24/7 care for seniors who are unable to live on their own due to medical or cognitive issues. Because nursing homes provide ongoing medical care, they cost more than assisted living facilities, home health services and adult day care facilities. In Alabama, nursing homes cost an average $6,540 per month for a semi-private room and $6,911 per month for a private room.
This guide provides an overview of nursing home care in Alabama, including a detailed cost breakdown and information on programs that may pay for skilled nursing. It also includes a summary of the Alabama laws governing the operation of skilled nursing facilities.
The Cost of Nursing Home Care in Alabama
When compared to nearby states, Alabama has the lowest average costs for skilled nursing care at $6,540 per month. Georgia costs slightly more at $6,722 per month, making it the only nearby state with average monthly costs under $7,000. With average costs of $8,669 per month, Florida — known for its large population of seniors — is the most expensive state in the region. Mississippi and Tennessee both have average costs just over the $7,000 mark: Mississippi averages $7,057 per month, and Tennessee averages $7,072 per month. Alabama’s nursing home costs are also well below the national average of $7,756 per month.
The cost of nursing home care within Alabama varies from one city to the next. Average costs depend on several factors, including the number of facilities in a region, the number of amenities offered and the type of care provided. Sitting less than 100 miles from the Alabama/Florida border, Dothan has the highest average costs ($6,996 per month). Huntsville, known as the home of the U.S. Space & Rocket Center, has monthly costs averaging $6,950. Mobile and Montgomery have average costs right in line with the state average — $6,540 per month for both states. Tuscaloosa and Birmingham have the lowest average costs at $6,235 and $6,388 per month, respectively.
Tuscaloosa
$6235
Birmingham
$6388
Mobile
$6540
Montgomery
$6540
Huntsville
$6950
Dothan
$6996
Alabama has several types of care available for seniors with varying needs. Nursing homes provide the highest level of care possible, making them the most expensive option at an average of $6,540 per month. Adult day care is a nonresidential option that focuses on socialization and companionship rather than medical care. As a result, adult day care costs an average of $655 per month in Alabama. Seniors who remain in their homes but need help with certain tasks may hire a home health aide or homemaker service, both of which cost an average of $3,432 per month. Like nursing home care, assisted living is a residential option; however, assisted living facilities don’t provide a nursing level of care. Therefore, they are less expensive than skilled nursing facilities, averaging $3,150 per month in Alabama.
Adult Day Care
$655
Home Care
$3432
Assisted Living
$3150
Nursing Home
$6540
Does Medicaid Cover Nursing Home Care in Alabama?
Alabama Medicaid pays for the cost of a nursing home for eligible individuals in Alabama. Approximately 1,053,268 people are enrolled in Medicaid throughout the state, and a portion of these individuals are seniors who require nursing home care. To accommodate these older adults, 231 nursing homes with 27,397 beds provide skilled nursing care 24/7. Medicaid can cover the cost of room and board, some medical equipment, personal care such as grooming and bathing, medication management, physician visits and general nursing.
For additional help paying for the cost of long-term care, Alabama offers the Elderly and Disabled Waiver Program (E&D), which is administered by the Alabama Department of Senior Services. This waiver helps pay for services that allow seniors to receive care at home or in the community so they can delay entry into a nursing home for as long as possible. The E&D pays for services such as home-delivered meals, respite care, transportation and personal care.
Medicaid Eligibility in Alabama
When applying for Medicaid, all applicants must meet certain income eligibility criteria. All forms of income are counted towards the total requirements, including disability, Social Security income, IRA withdrawals and stock dividends. When only one spouse applies, only their income is counted, with a limit of $30,276 per year. The non-applicant may receive a Minimum Monthly Maintenance Needs Allowance (MMMNA) of $137,400 under the spousal impoverishment rule. If both spouses apply, the maximum income is $60,552 per year or $30,276 per spouse.
2022 Medicaid Income Limits for Seniors in Alabama
| Income limits | Asset limits | |
|---|---|---|
| Single Applicant | $30,276 | $2,000 |
| Two-Person Household (Only One Person Applying) | $30,276 | $2,000 per applicant $137,400 for non-applicant |
| Two-Person Household (Both People Applying) | $60,552 ($30,276 per spouse) | $4,000 ($2,000 per applicant) |
There are additional eligibility requirements for Medicaid applicants. In addition to income, an applicant’s functional need is considered, and a physician must state nursing home care is required. Additional requirements include:
- Resident of Alabama
- U.S. citizen, permanent resident or legal alien
- 65 years of age or older; or
- Legally blind; or
- Permanently disabled
How to Apply for Medicaid in Alabama
An individual may apply for Medicaid in Alabama online through Insure Alabama or by calling 1-800-362-1504. Individuals may apply in person at their local Medicaid district office. Seniors may also download the appropriate forms and apply by mail by submitting the application to the Department of Medicaid, 687 North Dean Road Suite 300. Auburn, AL 36830 or by faxing the application to (877) 814-8309.
Information You Will Need:
- Copy of birth certificate
- Proof of citizenship or qualified alien status
- Valid Social Security number
- Government-issued ID cards
- Proof of income for the past 60 months
- Bank statements for the past 60 months
- Copies of retirement benefits
- Copy of mortgage or deed
- Proof of vehicle ownership
- Copies of health and life insurance policies
Additional Medicaid Support & Resources in Alabama
Individuals interested in applying for Medicaid can get help understanding the plan’s benefits, eligibility requirements and what’s covered by contacting one of several agencies that provide application assistance. These services are typically free of charge.
| Resource | Contact | Services |
|---|---|---|
| Benefits.gov | (866) 762-2237 | Benefits.gov is a federal website that enables searching for government benefits by category and agency. The site provides full details, including eligibility, how to apply and contact information for those who can provide additional help. |
| Alabama Department of Public Health | (888) 373-5437 | The Alabama Department of Public Health can answer questions concerning Medicaid and other healthcare and health insurance options in the state. Seniors may create an account on the site to make changes to their Medicaid application and check their status. |
| Alabama Department of Insurance | (800) 633-4227 | The Alabama Department of Insurance helps seniors locate the best insurance options to suit their needs. The agency has counselors who can help explain plan details and provide information on applying for Medicaid. |
Does Medicare Cover Nursing Home Care in Alabama?
Medicare provides limited coverage for short-term stays in a skilled nursing facility following a hospital stay, but seniors must meet a number of specific requirements. This benefit is available to beneficiaries who have been hospitalized for at least three days, excluding the date of discharge, so it’s most valuable for those who are recovering from an injury, illness or surgery.
Once seniors meet the hospitalization requirement, Medicare will pay for up to 100 days of skilled nursing per benefit period. The first 20 days are covered in full. Starting on day 21, beneficiaries must pay a daily coinsurance rate. After day 100, seniors are responsible for the entire cost.
What Does Medicare Cover?
Medicare covers a number of specific services, including:
- Meals
- A semiprivate room
- Medications
- Skilled nursing
- Physical therapy
- Occupational therapy
- Speech therapy
- Audiologist care
- Medical supplies
- Medical social services
- Nutritional counseling
- Ambulance transportation
What Isn’t Covered by Medicare?
Medicare does not cover long-term custodial care that addresses seniors’ day-to-day needs. This includes help with daily activities, such as bathing, dressing and using medical equipment.
For more information about Medicare and when it covers Nursing Home Care, read our Guide to Nursing Homes.
Medicare Support and Resources in Alabama
Alabama has a variety of resources that help seniors apply for insurance to pay for healthcare, nursing homes and other long-term care. Navigating Medicare can often be a challenging task, and these programs help seniors understand their options.
| Resource | Contact | Service |
|---|---|---|
| Alabama State Health Insurance Program (SHIP) | (334) 242-6743 | SHIP provides answers to questions about Medicare, Medigap, Medicare Advantage, Medicaid and other long-term care insurance. The program provides resources regarding home health benefits, claims and appeals, and it offers referrals to other programs and agencies that can assist with Medicare. |
| BenefitsCheckUp | (334) 242-0143 | BenefitsCheckUp is a federal site operated by the National Council on Aging. This free service helps seniors apply for and receive health insurance benefits. On the website, seniors answer a series of questions, and the site matches the individual to the best insurance options they most likely qualify for. |
| Health Markets | (800) 439-6916 | Health Markets helps seniors search for affordable health and life insurance options, including Medicaid and Medicare. The site helps seniors determine their eligibility and understand the different parts of Medicare. |
Other Financial Assistance Options for Nursing Home Care in Alabama
While Medicaid and Medicare are two of the most common programs used to pay for Nursing Home Care, there are other financial assistance options available, depending on your unique situation.
| Name | How To Apply | How It Works |
|---|---|---|
| Aid and Attendance | Learn more and apply online at va.gov. | Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for skilled nursing care. |
| Reverse Mortgages | Learn more about your options and how to apply at ftc.gov | If you own a home, you may be able to use a reverse mortgage to help pay for nursing care. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan. |
| Long-Term Care (LTC) Insurance | Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov. | Seniors who already have long-term care insurance may be able to use it to pay for skilled nursing care. Most policies cover at least a portion of the cost, but it depends on the specific policy terms. Note that older adults who are already in need of skilled nursing care will not typically be eligible to sign up for a LTC insurance policy. |
Free and Low-Cost Resources for Seniors in Alabama
Alabama offers resources that address a wide range of seniors’ needs and help them live happy, healthy and comfortable lives. Many resources assist seniors in nursing homes and other residential care communities, while others allow them to remain in their homes.
| Resource | Contact | Service |
|---|---|---|
| Alabama Long-Term Care Ombudsman | (334) 242-5753 | The Alabama long-term care ombudsman advocates for seniors in nursing homes and long-term care facilities. The ombudsman investigates claims of abuse and fraud and works to come to a resolution. The program also visits long-term care communities annually to ensure they are maintaining regulatory standards for quality of care. |
| Alabama Area Agencies on Aging | (800) 838-5645 | The local Area Agencies on Aging coordinates resources and services that help seniors remain independent for as long as possible. These services include home-delivered meals, help with chores, legal counseling and assistance with daily living tasks such as grooming, bathing, dressing and medication management. |
| Health Care Facilities Directory | (800) 252-1818 | The Health Care Facilities Directory is an interactive directory of licensed healthcare facilities, providers and suppliers throughout the state. Seniors may search by facility type, county, city and name. The search results give contact information and details about what the facility provides. |
| Alabama Nursing Home Association | (334) 271-6214 | The Alabama Nursing Home Association helps seniors, families and loved ones locate appropriate facilities to suit their needs. The search tool searches facilities by city or facility name and also offers statistical information on the number of beds and the types of care. |
| Alabama Veterans Administration | (251) 574-8578 | The Alabama Veterans Administration helps men and women who have served in the military receive benefits and compensation, including help locating healthcare, counseling, housing and education. Veterans may also sign up to receive the Aid and Attendance benefit that helps pay for services such as transportation, meals and activities of daily living. |
Nursing Home Laws and Regulations in Alabama
| Nursing Home Laws and Regulations in Alabama | |
|---|---|
| Licensing Requirements | All SNFs must be licensed by the Alabama Board of Health. A new facility must submit a completed application, pay a licensing fee and have a "permanent and distinctive name" to be considered for a regular license. The Alabama Board of Health doesn't grant SNF licenses to applicants with felony convictions for fraud or abuse/neglect of a vulnerable individual. If an owner operates several facilities, a separate license application must be submitted for each facility. |
| Staffing Requirements | Under state law, Alabama SNFs must meet several staffing requirements. An administrator must be appointed to oversee the general management of the facility, develop written personnel policies and maintain adequate staffing records. At minimum, every SNF must establish vaccination requirements for employees and ensure that employees with communicable diseases don't return to work until they are symptom-free or have been cleared for duty by a medical professional. |
| Staff Training Requirements | Every employee must complete an orientation that covers general policies as well as information specific to their roles. Employees must also participate in ongoing in-service training to gain new knowledge and skills. For nurse aides, a facility must provide at least 12 hours of in-service training per year. Facilities with feeding assistants must provide training on feeding techniques, infection control, safety procedures and safe ways to feed residents with dementia, among other topics. |
| Care Planning Requirements | Every SNF must have a comprehensive care plan for each resident. Facilities are required to complete this plan within seven days of a new resident's arrival. The care plan must address a resident's physical and psychosocial needs, be prepared by an interdisciplinary team of professionals and have measurable objectives. |
| Dietary and Nutritional Services Requirements | SNFs must provide well-balanced meals that meet the specific dietary requirements of each resident. These meals must be nutritious and palatable. Every facility must also employ a registered dietitian in some capacity. If the SNF doesn't have a full-time dietitian, then it must have a director of food service who frequently consults with a registered dietitian. At a minimum, a facility must provide three meals per day. |
| Specialized Rehabilitative Services | If a resident requires specialized rehabilitative services (e.g. occupational therapy or physical therapy), the facility must provide the services or hire an outside provider. Specialized rehabilitative services may only be provided if a physician orders them. |
| Medication and Pharmaceutical Services | Each facility must hire a pharmacist or consult with a pharmacist to ensure medications are administered safely. The pharmacist is responsible for reviewing resident drug regimens, keeping adequate pharmacy records and monitoring drug inventory. Facilities must store all medications in locked compartments, maintain records of the storage and disposal of controlled substances, destroy medications that have expired and label medications properly. |
| Activities Requirements | Each SNF must develop a comprehensive activities program to help residents maintain their physical, mental and social well-being. Activities must be planned at least one month in advance, and each facility must post an activities calendar in a prominent place. SNFs must keep records documenting the type of activity conducted, the person who conducted it and the number of residents who participated. |
| Infection Control Requirements | Every facility must have a formal infection control program to prevent disease transmission and ensure that residents live in a sanitary environment. |
| Medicaid Coverage | Medicaid for Institutional Care may cover room, board and medical care at a skilled nursing facility. Applicants must meet eligibility requirements to receive coverage. |