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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 toward 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 $32,904 per year. If both spouses apply, the maximum income is $65,808 per year or $32,904 per spouse.
2022 Medicaid Income Limits for Seniors in Alabama
| Household Size | Number of Applicants | Income Limits Per Year* | Asset Limits: Applicant(s) | Asset Limits: Non-Applicants |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,000 | |
| Two People | 1 | $32,904** | $2,000 | 148,620 |
| Two People | 2 | $65,808*** | $4,000**** |
*All monthly income except for a $30/mo. personal needs allowance and Medicare premiums must go toward nursing home costs. There may also be a monthly needs allowance for a non-applicant spouse, .
**Income limit is for applicant only.
***Income is limited to $2,742 per month per spouse.
****$2,000 per spouse
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
There are many resources in Alabama that assist seniors in their retirement. caring.com 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.
| Program Name | Phone Number | Description |
|---|---|---|
| Alabama Area Agency on Aging | Alabama's Area Agencies on Aging (AAA) serve as critical access points to numerous resources designed to meet the needs of older adults. Seniors contacting the AAA may receive access to benefits such as senior nutrition programs, transportation assistance and referrals to local assistance programs. It can also connect seniors to services for home-delivered meals, discounted prescriptions and assistance with household chores. Seniors can also be empowered through legal and insurance counseling services or be provided advocates through long-term care ombudsmen. |
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.
| Program Name | Phone Number | Description |
|---|---|---|
| Alabama Lifeline Program | 800-234-9473 | The LifeLine Program offers a discount on landline or mobile telephone service, ensuring that participants can stay in contact with loved ones. |
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.
| Program Name | Phone Number | Description |
|---|---|---|
| Alabama Elderly and Disabled Waiver | 877-425-2243 | The Elderly and Disabled Waiver helps seniors pay for services at home and in alternative residential care instead of nursing home admission. The waiver provides home- and community-based services, including housekeeping, dressing, grooming, meal prep and transportation. It doesn't cover the cost of room and board. This program isn't an entitlement program, which means only a limited number of individuals receive the waiver each year. |
| Alabama Senior Discounts | 205-333-2990 | Many retailers, restaurants and other companies give elderly Alabama residents discounts on their products and services. Older adults can find information on Alabama senior discounts via the Area Agency on Aging of West Alabama. The agency lists each organization together with the discount or special offer provided and the age requirements that seniors have to meet to qualify for individual discounts and deals. |
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.
| Program Name | Phone Number | Description |
|---|---|---|
| Alabama Elderly Nutrition Program | 877-425-2243 | The Alabama Elderly Nutrition Program offers nutritious meals to seniors aged 60 and above across the state. With over 335 senior centers providing congregate meals and home-delivered options for those who qualify, ENP aims to fulfill at least a third of seniors' dietary needs. The facility, managed by registered dietitians, also offers nutrition education and wellness programs, promoting overall health and well-being among Alabama's elderly population. |
| Alabama Food Assistance | 866-465-2285 | The Alabama Food Assistance program strives to combat food insecurity by providing essential benefits to eligible low-income seniors and others who may be struggling to get proper nutrition. Through this initiative, Alabama takes a significant step toward addressing food insecurity, underscoring its commitment to the well-being of its residents. |
| Alabama Meals on Wheels | Meals on Wheels operates in multiple communities throughout Alabama to address isolation and hunger in older adults. The program delivers meals five days a week to individuals incapable of preparing their own food, accessing food sites that offer food or those unable to afford meals. |
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.
| Program Name | Phone Number | Description |
|---|---|---|
| Alabama CARE Project | 334-387-3261 | The CARE Project helps connect seniors with no-cost medical equipment that it has cleaned, disinfected and refurbished. Equipment types include wheelchairs, wheelchair ramps, seat lift chairs, breathing equipment, canes, crutches and walkers. The organization also distributes communication devices such as computers and computer equipment. |
| Alabama Statewide Technology Access and Response (STAR) | STAR is a program administered by the Alabama Department of Rehabilitation Services. It connects disabled adults with assistive technologies, including specialized computer software, communication devices, adaptive switches, auditory trainers, Braille readers, scooters, wheelchairs, adaptive vehicles and lifts and ramps. | |
| Alabama Waste-Not Program | 256-837-2373 | The Waste-Not Program provides free assistive technologies and free medical equipment, including wheelchairs, scooters, hospital beds, bath and shower aids, canes and walkers to needy individuals. The program serves individuals in Huntsville and Madison Counties and works to improve the overall quality of life of seniors and families throughout the community. |
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.
| Program Name | Phone Number | Description |
|---|---|---|
| Alabama Single Family Housing Repair Loans and Grants | This program provides loans to households with very low incomes for repairs and improvements and to help modernize their dwellings. Recipients may use loan and grant proceeds to remove health and safety hazards. | |
| Alabama Weatherization Assistance Program | 334-242-4909 | This program provides weatherization assistance to help households reduce their energy costs. Assistance typically includes installing attic, wall and floor insulation, sealing ductwork, HVAC repairs and replacements, repairing leaky faucets, upgrading windows and doors and replacing incandescent lighting with energy efficient bulbs. |
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.
| Program Name | Phone Number | Description |
|---|---|---|
| Alabama Social Security | Social Security is a source of income available to retirees and people who can no longer work because of a disability. The money for Social Security comes from a payroll tax levied on employers, employees and self-employed individuals. When you retire, you'll receive monthly payments based on how much you earned when you were working. |
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.
| Program Name | Phone Number | Description |
|---|---|---|
| Alabama Low Income Home Energy Assistance Program (LIHEAP) | 800-392-8098 | LIHEAP helps families on limited budgets pay their heating and cooling bills, especially those who are under threat of disconnection. The program makes a one-time payment directly to the utility company for one season based on past energy usage. |
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.
| Program Name | Phone Number | Description |
|---|---|---|
| Alabama VA Benefits and Health Care | Alabama VA Benefits and Health Care, a comprehensive resource for senior veterans, provides various medical and financial resources, from primary care to general benefits information. In addition to physical therapy, mental health support, caregiver assistance and prescription drugs, Alabama veterans can access help with disability compensation, pensions and VA home loans. The program also assists with burials and memorials, ensuring respect and support for survivors during difficult times. |
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. |
Facilities in Alabama
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