What laws govern senior care facilities in Birmingham?
State law does: the Alabama Department of Public Health licenses assisted living under Ala. Admin. Code chapter 420-5-4, specialty care memory care under chapter 420-5-20 and nursing homes under chapter 420-5-10, all adopted under Code of Ala. 1975, Sections 22-21-20 and following.
Last verified: October 2026The City of Birmingham and the county commissions do not license care settings. ADPH's Bureau of Health Provider Standards issues the licenses, runs the inspections and posts statements of deficiencies online. Certified nursing homes are also inspected for CMS and rated on Medicare's Care Compare.
How is Alabama's approach different from other states?
Alabama separates regular assisted living (ALF) from specialty care assisted living (SCALF) for dementia, sets numeric staffing minimums only for SCALFs, requires free exits in every regular ALF, and has no Medicaid waiver that pays for either.
ADPH's directory export of October 30, 2026 lists 35 regular assisted living licenses in Jefferson, Shelby, St. Clair, Walker, Blount, Chilton and Bibb counties, with 1,675 licensed beds: 24 congregate, 10 group and 1 family facilities. ADPH lists 25 specialty care assisted living licenses in the seven Birmingham-area counties, with 898 licensed beds; 13 are in Jefferson County and 7 in Shelby. See the memory care roster.
Where do Birmingham families report problems?
Assisted living complaints go to ADPH at 1-866-873-0366, nursing home complaints to 1-800-356-9596 or ADPH's online form, suspected abuse or exploitation to DHR Adult Protective Services at 1-800-458-7214, and residents can get free advocacy from the long-term care ombudsman at their area agency on aging.
The guides below cite the rule behind each step.
Alabama Rules guides
How Alabama licenses assisted living
How the Alabama Department of Public Health licenses assisted living facilities under chapter 420-5-4: family, group and congregate classes, yearly licenses and probation.
Read →Alabama's memory care license: the SCALF
What Alabama's specialty care assisted living facility (SCALF) license requires: RN and medical director, DETA dementia training, Table A staffing minimums and PSMS limits.
Read →Who Alabama assisted living can admit, keep or discharge
Alabama's admission and retention rules for assisted living: the nine admission exclusions, the 90-day skilled-care rule, hospice exceptions and transfer to a higher level of care.
Read →Medication help in Alabama assisted living
Alabama's ALF medication rules: self-management, assistance with self-administration by unlicensed staff, unit-dose packaging, and what only nurses may do.
Read →How to read an ADPH inspection report
Where to find ADPH inspection reports for Birmingham assisted living and memory care, what a deficiency tag means, and how to read the plan of correction.
Read →How to check an Alabama care license
Use ADPH's Health Care Facilities Directory to verify an Alabama license, bed count, class and status, and what a probational license means.
Read →Resident rights in Alabama assisted living
Key resident rights in Alabama assisted living rules: 30-day notice of fee increases and room changes, posted inspection reports, personal possessions and grievances.
Read →Where to report a problem in Alabama senior care
Where Birmingham-area families report assisted living and nursing home problems: ADPH complaint hotlines, Alabama DHR Adult Protective Services and the long-term care ombudsman.
Read →How Alabama nursing homes are licensed and rated
Alabama nursing homes hold an ADPH license and, for Medicare and Medicaid, federal certification rated by CMS Care Compare. What each layer means for Birmingham families.
Read →At a glance
| Alabama's rules do | Alabama's rules do not | |
|---|---|---|
| Assisted living | License ALFs by size class: group or congregate | Set a staffing ratio for regular ALFs |
| Memory care | Require a SCALF license, an RN and DETA training | Allow secured exits in a regular ALF |
| Inspections | Make statements of deficiencies public | Fix a set inspection cycle for ALFs |
| Payment | Let Medicaid pay nursing homes and home waivers | Provide a Medicaid assisted living waiver |
