In Alabama, the license families see for assisted living is "Assisted Living Facility (ALF)", issued by the Alabama Department of Public Health, Bureau of Health Provider Standards. Within 30 days before admission, a physician must examine the person and report the findings to the facility in writing, including diagnoses, current medications and a statement that the person has no signs of infectious skin disease. The facility must give at least 30 days' prior written notice before an involuntary relocation or end of residence.
Key facts
- The median monthly cost of assisted living in Alabama was $4,425 in CareScout's 2025 Cost of Care Survey, or $53,100 a year, $1,775 below the national median of $6,200 a month. (CareScout, 2026)
- Alabama's Elderly and Disabled (E&D) Medicaid Waiver does not pay for services in assisted living facilities: the state's waiver application says no services are furnished in residential settings other than the individual's private residence. (Alabama Medicaid Agency, 2022)
- The admission exam record must document an evaluation for tuberculosis within the previous 12 months, and a person with active tuberculosis may not be admitted. (Ala. Admin. Code r. 420-5-4-.06, 2022)
- Only a physician, registered nurse or licensed practical nurse may give medications to a resident who cannot safely take them on their own. (Ala. Admin. Code r. 420-5-4-.06, 2022)
- Alabama licenses memory care separately as a specialty care assisted living facility, which is staffed to care for residents whose cognitive impairment would ordinarily make them ineligible for a regular assisted living facility. (Ala. Admin. Code r. 420-5-20-.01, 2022)
Alabama calls assisted living an assisted living facility (ALF), and the Alabama Department of Public Health licenses it under Ala. Admin. Code chapter 420-5-4. Memory care is a separate specialty care assisted living facility license under chapter 420-5-20, and the facts below cover the main ALF license except the dementia care row, which covers the specialty care license.
Rules change and communities can set stricter policies. Before you sign, confirm the details with the community and the Alabama Department of Public Health, Bureau of Health Provider Standards. This page is general information, not legal advice.
The rules at a glance
| Medical assessment before move-in | Within 30 days before admission, a physician must examine the person and report the findings to the facility in writing, including diagnoses, current medications and a statement that the person has no signs of infectious skin disease. The facility must also assess the prospective resident's eligibility within 30 days before admission. [4] More on this |
|---|---|
| TB test | The admission exam record must document an evaluation for tuberculosis within the previous 12 months, and a person with active tuberculosis may not be admitted. The rules do not name a specific TB test. [4][7] More on this |
| Notice before a move-out | The facility must give at least 30 days' prior written notice before an involuntary relocation or end of residence. The 30-day notice does not apply if the resident is a patient in a higher-care facility and no longer meets the stay rules, a physician requires an emergency move to more skilled care, or the resident's conduct is harmful or dangerous. [5] More on this |
| Who may give medications | Only a physician, registered nurse or licensed practical nurse may give medications to a resident who cannot safely take them on their own. Unlicensed staff may only remind, open containers, offer liquids or bring the container, and the rule bars them from giving injections of any kind, which includes insulin shots. [6] More on this |
| Memory care and dementia | Alabama licenses memory care separately as a specialty care assisted living facility, which is staffed to care for residents whose cognitive impairment would ordinarily make them ineligible for a regular assisted living facility. Staff must finish Dementia Education and Training Act (DETA) Care Series training before giving care, and the facility needs a registered nurse and a physician medical director. [8][9] |
| Long-term care ombudsman | Alabama's Office of the State Long-Term Care Ombudsman Program, part of the Department of Senior Services, serves residents of nursing homes, assisted living facilities, specialty care facilities and boarding homes, and can be reached at 334-242-5753 or through the department's toll-free line, 1-800-243-5463. [10] Official page More on this |
| Medicaid help | Alabama's Elderly and Disabled (E&D) Medicaid Waiver does not pay for services in assisted living facilities: the state's waiver application says no services are furnished in residential settings other than the individual's private residence. Waiver services are not an entitlement, only a CMS-approved number of people can be served, and no federal Medicaid money is claimed for room and board. [12][13][11] Official page More on this |
What assisted living costs in Alabama
The median monthly cost of assisted living in Alabama was $4,425 in CareScout's 2025 Cost of Care Survey, or $53,100 a year, $1,775 below the national median of $6,200 a month. [14]
A median is the middle of the rates communities reported, so many charge more or less. Rates differ between regions and by the care a resident needs, so ask each community for its full fee list in writing. More: assisted living costs in every state, a monthly budget and the costs that aren't in the base rate.
How to check a community in Alabama
The Alabama Department of Public Health's Health Care Facilities Directory lists currently licensed assisted living and specialty care assisted living facilities by county and city, and the Bureau's page links to survey deficiency reports. Each facility must post its state inspection reports from the past 24 months, and complaints go to the assisted living complaint hotline at 1-866-873-0366. Search Alabama's records. [2][1][3][5]
The licensing agency: Alabama Department of Public Health, Bureau of Health Provider Standards. [1] Our guide on how to read an inspection report explains what to look for.
Put Alabama's paperwork on a date
Parent Move Plan counts every task back from the move-in day, including the medical assessment and TB screening the community will ask for, so nothing lands in the last week.
Get your first 3 days freeFrequently asked questions
How much does assisted living cost in Alabama?
The median monthly cost of assisted living in Alabama was $4,425 in CareScout's 2025 Cost of Care Survey, or $53,100 a year, $1,775 below the national median of $6,200 a month. A median is the middle of the rates communities reported, so many charge more or less, and rates differ between regions and by the care a resident needs.
What medical assessment does Alabama require before moving into assisted living?
Within 30 days before admission, a physician must examine the person and report the findings to the facility in writing, including diagnoses, current medications and a statement that the person has no signs of infectious skin disease. The facility must also assess the prospective resident's eligibility within 30 days before admission.
Does Alabama require a TB test for assisted living?
The admission exam record must document an evaluation for tuberculosis within the previous 12 months, and a person with active tuberculosis may not be admitted. The rules do not name a specific TB test.
How much notice must an assisted living community in Alabama give before a move-out?
The facility must give at least 30 days' prior written notice before an involuntary relocation or end of residence. The 30-day notice does not apply if the resident is a patient in a higher-care facility and no longer meets the stay rules, a physician requires an emergency move to more skilled care, or the resident's conduct is harmful or dangerous.
Who can give medications in assisted living in Alabama?
Only a physician, registered nurse or licensed practical nurse may give medications to a resident who cannot safely take them on their own. Unlicensed staff may only remind, open containers, offer liquids or bring the container, and the rule bars them from giving injections of any kind, which includes insulin shots.
Who can help with a complaint about assisted living in Alabama?
Alabama's Office of the State Long-Term Care Ombudsman Program, part of the Department of Senior Services, serves residents of nursing homes, assisted living facilities, specialty care facilities and boarding homes, and can be reached at 334-242-5753 or through the department's toll-free line, 1-800-243-5463.
Does Medicaid pay for assisted living in Alabama?
Alabama's Elderly and Disabled (E&D) Medicaid Waiver does not pay for services in assisted living facilities: the state's waiver application says no services are furnished in residential settings other than the individual's private residence. Waiver services are not an entitlement, only a CMS-approved number of people can be served, and no federal Medicaid money is claimed for room and board.
Sources
- Alabama Department of Public Health: Bureau of Health Provider Standards (2026) (checked October 22, 2026)
- Alabama Department of Public Health: Health Care Facilities Directory (2026) (checked October 22, 2026)
- Alabama Department of Public Health: Filing Complaints (2026) (checked October 22, 2026)
- Ala. Admin. Code r. 420-5-4-.06(2)-(3), Care of Residents: medical examination record and initial assessment (official Alabama Administrative Code PDF, revised May 15, 2022), 2022 (checked October 22, 2026)
- Ala. Admin. Code r. 420-5-4-.05(3)(d), Records and Reports: residents' rights, including notice of involuntary relocation and posted inspection reports (official Alabama Administrative Code PDF, revised May 15, 2022), 2022 (checked October 22, 2026)
- Ala. Admin. Code r. 420-5-4-.06(5)-(7), Care of Residents: medications (official Alabama Administrative Code PDF, revised May 15, 2022), 2022 (checked October 22, 2026)
- Ala. Admin. Code r. 420-5-4-.06(11), Care of Residents: admission and retention of residents (official Alabama Administrative Code PDF, revised May 15, 2022), 2022 (checked October 22, 2026)
- Ala. Admin. Code r. 420-5-20-.01(2)(bb), Specialty Care Assisted Living Facilities: definition (official Alabama Administrative Code PDF, revised May 15, 2022), 2022 (checked October 22, 2026)
- Ala. Admin. Code r. 420-5-20-.04(6), (7) and (9), Personnel: medical director, registered nurse and dementia training (official Alabama Administrative Code PDF, revised May 15, 2022), 2022 (checked October 22, 2026)
- Alabama Department of Senior Services: Office of the State Long-Term Care Ombudsman Program (2026) (checked October 22, 2026)
- Alabama Department of Senior Services: Medicaid Waiver Programs (2026) (checked October 22, 2026)
- Alabama Medicaid Agency: Application for a 1915(c) Home and Community-Based Services Waiver, Elderly and Disabled Waiver AL.0068.R08.00, item 6-C and Appendix I-5 (posted by the Department of Senior Services), 2022 (checked October 22, 2026)
- Ala. Admin. Code r. 560-X-36-.01 and 560-X-36-.02, Home- and Community-Based Services for the Elderly and Disabled (official Alabama Administrative Code PDF, revised June 12, 2023), 2023 (checked October 22, 2026)
- CareScout: Cost of Care Survey 2025, Ranked Median Costs by State (2026) (checked October 22, 2026)