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Alabama Residential Alzheimer’s Care (Memory Care): Laws, Costs & Financial Help

Last Updated: November 13, 2022

 

Memory care in Alabama provides room, board and personal care for people with Alzheimer’s disease or dementia. State regulations say that memory care is officially called “specialty care assisted living facilities for residents with dementia or Alzheimer’s symptoms.” These homes are also known as “Dementia Care Facilities” or “Alzheimer’s Care Facilities”. They fall under three categories:

– Family: Cares for two to three residents. This is often called “adult foster care.”
– Group: Cares for three to 16 residents. These are often called “board and care homes.”
– Congregate: Cares for 17 or more residents. These are often called “assisted living.”

Every resident in Alabama’s specialty care receives general supervision and health services. These communities do not provide medical care, instead they assist with daily living activities like eating, bathing, getting dressed and safely moving around. A detailed screening is required before admittance, to assess someone’s physical and mental states. The screening must also determine whether the home can fulfill that person’s needs. People with chronic health conditions requiring medical or full-time nursing care may not be admitted into specialty care homes.

There are almost 100 memory care residences in Alabama, regulated by the Department of Public Health’s Bureau of Health Provider Standards. These residences are equipped to handle the needs of people with Alzheimer’s, frontotemporal, vascular, Lewy body, and other forms of dementia. There are more than 100 board and care homes, many (but not all) offering memory care.

 Did You Know? In Alabama, free assistance is available to help families locate a memory care home to meet their needs and budgets. Get help here.

 

How Much Does Memory Care Cost in Alabama?

Alabama has some of the least expensive assisted living in the nation. The average cost of memory care per month is $4,233 monthly. The state’s most expensive place for memory care is the Birmingham area, where memory care costs about $4,859 monthly. The least expensive city for memory care is Tuscaloosa, for about $3,828 per month.

These costs are less than care in Florida, Mississippi, and Tennessee. They run on average slightly more than in Georgia. Residents in Auburn and other cities in eastern Alabama, may be able to find more affordable memory-care options on the other side of the nearby border with Georgia.

Alabama Memory Care / Assisted Living Costs (updated June 2022)
Region / City Daily Cost Monthly Cost
Statewide $139 $4,233
Birmingham $160 $4,859
Huntsville $133 $4,049
Montgomery $139 $4,233
Mobile $140 $4,270
Tuscaloosa $126 $3,828

For help finding a living option to meet your family’s needs and budgets, click here.

 

Alabama Assisted Living Laws & Regulations

Admissions Requirements & Process

 Covid-19 Related Vaccine, Testing & Mask Requirements (as of June 2022):
-There are no mask mandates even though the Department of Public Health recommends them.
-State law prevents having to show proof of vaccination. Many rights given additionally for medical and religious exemptions. 

Someone can move into assisted living with memory care in Alabama on short notice but must have a medical examination within 30 days of entry. This creates an individual care plan. The cost of this screening is most likely the responsibility of the resident. Medicare recipients can have some of the costs covered. Medicare offers an annual free wellness visit (also called a cognitive assessment) that screens for dementia symptoms. This is a good way to begin getting the information necessary to move into memory care.

The process requires a two-part assessment: a Physical Self Maintenance Scale and a Behavior Screening Form. Every specialty care assisted living home must have a minimum score for residents on their Physical Self Maintenance Scale. Additional screening is also required that looks at:

– Clinical history
– Mental status examination including an aphasia screening (to assess communication ability)
– Geriatric depression screen
– Physical functioning screen
– Behavior screen

A person must go through an in-depth process similar to receiving a diagnosis of dementia before moving into Alabama memory care. For more on diagnosing Alzheimer’s disease and related dementias, click here.

 Regulations in Alabama require every resident (or resident’s caregiver) to receive a financial agreement prior to admission that includes a list of regular charges and any possible additional charges. File this document as defense against unexpected costs.

Residents with the following issues may not live in Alabama specialty care:

– Requires restraints for confinement
– Chronic health conditions requiring extensive nursing care
– Requires daily professional observation
– Requires care beyond assistance with activities of daily living
Someone who needs skilled nursing care for less than 90 days may be allowed to stay in specialty care if certain obligations are met.

 

Facility / Residence

Private living units or bedrooms must be at least 80 square feet for one person and 130 square feet for two people. Two is the maximum allowed in one unit in specialty care. There must be a toilet and sink for every six residents and one shower for every eight residents. Alarm systems and fire detection including sprinklers and smoke alarms must be up to building codes.

Alabama does not have specific rules about the design itself. For instance, no dementia-friendly circular hallways (that don’t come to a dead end) or outdoor spaces are required by regulations. You’ll want to inspect the buildings yourself to make sure they’re good for your loved one.

 

Staff & Training

At least two employees must be on-duty at all times in specialty care assisted living homes. Every specialty care home must have a medical director who is a physician licensed to practice medicine in Alabama, and who is responsible for implementation of care policies and coordination of medical care in the residence. Additionally, every residence needs to employ a registered nurse and a unit coordinator who manages daily routine operations. All staff who have contact with patients must receive appropriate training, including the Dementia Education and Training Series on dealing with issues related to Alzheimer’s and other dementias, and at least six hours of continuing education annually. During the Covid-19 pandemic, all employees must be screened for signs and symptoms of the virus at the beginning of their shifts.

 Did You Know? Alabama is projected to go over 100,000 cases of Alzheimer’s disease by the year 2025. And even though it ranks near the middle of American states in terms of percentage of residents with dementia, the state had the most Alzheimer’s-related deaths in the nation, per-capita, in 2018.

 

Eviction Rules

A person can be evicted if their medical condition (including the level of cognitive impairment) cannot be managed by the care facility. For example, someone who suffers a medical emergency and needs full-time nursing care would be discharged to a residence that could care for them. If someone’s mental state got so bad that they needed to be physically restrained for the safety of others, this would be another reason for eviction.

Regulations do not say that residents can be evicted for nonpayment. The reason must be stated in the agreement signed at move-in. This document will help clarify whether failing to pay on time is a possible reason for being asked to leave. If your loved one goes on Medicaid, this may also affect their eligibility for living in memory care. This happens because Medicaid does not offer help with paying for memory care in Alabama. Checking your move-in agreement or asking management is the key to understanding the rules of your loved one’s care facility.

Regulations do not say a residence must help you find a new, more appropriate home for your loved one if eviction becomes necessary. For tips on evictions, including what to do if you receive an eviction notice, click here.

 

Financial Assistance for Residential Alzheimer’s Memory Care

In Alabama, unlike other states, there are no Medicaid programs that help pay for costs of assisted living. However, Medicaid will pay for nursing home care for residents with dementia that require that level of care. The American Council on Aging provides a free, fast and non-binding Medicaid eligibility test on their website.

 

Veterans Affairs (VA)

Veterans are statistically more likely to develop dementia. Among the reasons for this is that traumatic brain injuries and posttraumatic stress disorder lead to a higher probability of developing the condition. The VA offers many benefits for Alzheimer’s and dementia as well as different pension types.

 

VA Pensions

There are three types of VA Pensions available. The benefits change annually and are valid from December 2022 to December 2023. The benefits (and their maximum allowance) are as follows:

1) Basic Pension – This benefit is also known as a death pension. It is for veterans and surviving spouses who are aged or disabled. The qualifying disability does not need to be related to their military service. On an annual basis, the Basic Pension pays:

– Veterans without spouses or children up to $16,073

– Veterans with dependent spouses or children up to $21,001

– Surviving spouses without dependent children up to $10,756

2) Aid & Attendance – Abbreviated as A&A, this is an important program for veterans and their surviving spouses who require assistance with activities of daily living. This means they need assistance with activities like bathing, dressing, and eating. A&A is particularly helpful for people with dementia, especially in the middle and later stages of the disease, when the need for more assistance becomes necessary. A&A is intended to help with the long-term care costs of adult day care, in-home care, assisted living, memory care, and skilled nursing. Based on an individual’s need and the progression of the disease, most of these additional services that support your loved one will become necessary. Annually, the A&A pays:

– Veterans without spouses or children a maximum of $26,751

– Veterans with dependent spouses or children a maximum of $31,713

– Surviving spouses without dependent children a maximum of $17,191

3) Housebound – For veterans and surviving spouses who are permanently disabled and unable to leave their homes, making them require additional assistance. The definition of “home” can include assisted living, memory care, and nursing home. The Housebound pension, like the A&A pension, is meant to help cover long-term care costs. Annually, the Housebound pays:

– Veterans without spouses or children a maximum of $19,598

– Veterans with dependent spouses or children a maximum of $24,562

– Surviving spouses without dependent children a maximum of $13,145

 More information on VA Pensions’ eligibility criteria, payment rates and the application process is available here.

Veterans’ Homes

There are four veterans’ homes in Alabama, which are residential care facilities that provide long-term care for veterans. They are in Alexander City, Minette, Huntsville, and Pell City. Neighboring states have more veterans’ homes, so a loved one might consider looking there for more options as there are no requirements that one must live in the state. For example, Florida has almost twice as many VA homes coming in at seven statewide and several are located quite near the Alabama border in the Panhandle. More info here.

 

Other Options

1) Elder care loans exist for families to cover the costs of moving into memory care while waiting for other financial resources to become available. For example, if one is waiting for a VA pension to be approved or waiting to sell a home. More on bridge loans for memory care.

2) Tax credits and deductions like the Credit for the Elderly and the Disabled, or the Child and Dependent Care Credit (if you can claim your elderly loved one as a dependent). Remember also that medical and dental expenses can be deducted, and that can include assisted living costs.

3) A reverse mortgage can be an option for a married person moving into memory care, if their spouse continues to live in the home. However, if the spouse moves from their home, the reverse mortgage becomes due.