Who licenses assisted living facilities in Birmingham, AL?
The Alabama Department of Public Health (ADPH), through its Bureau of Health Provider Standards, licenses every assisted living facility (ALF) in Birmingham and the rest of the state under Alabama Administrative Code chapter 420-5-4, adopted by the State Board of Health under Code of Ala. 1975, Sections 22-21-20 and following.
Neither the City of Birmingham nor Jefferson County issues a care license. Local government still controls zoning, business licenses and fire inspections of the building, but whether a place may legally call itself assisted living is decided in Montgomery. The license certificate is signed by the State Health Officer and must hang in the facility.
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. That count comes from ADPH's own facilities directory export, which is the only roster we use.
What are the family, group and congregate ALF classes in Alabama?
Alabama sorts assisted living by size: a group assisted living facility is licensed for 3 to 16 adults, a congregate facility for 17 or more, and a family facility for two or three adults exists only if it was licensed before October 1, 2015.
| ADPH class | Licensed for | Notes |
|---|---|---|
| Family assisted living facility | 2 or 3 adults | Only facilities licensed before October 1, 2015; they may renew yearly but cannot be relicensed as family ALFs once closed (r. 420-5-4-.01(2)(m)) |
| Group assisted living facility | 3 to 16 adults | Smaller homes, often in converted houses (r. 420-5-4-.01(2)(n)) |
| Congregate assisted living facility | 17 or more adults | Larger communities (r. 420-5-4-.01(2)(i)) |
The class matters more than it looks. Group homes are frequently converted houses with a handful of staff and shared bathrooms; congregate facilities look like apartment buildings with dining rooms and activity calendars. Both follow the same chapter 420-5-4 rules on admission, medications and resident rights, but building standards differ, and in a three-bedroom group home the culture is closer to a family household than to a community.
How long does an Alabama assisted living license last?
Every Alabama ALF license is issued for the calendar year and expires at midnight on December 31 unless the owner renews it, so a license you see in October covers only the rest of that year.
ADPH grants a regular license when it finds the operator willing and able to stay in substantial compliance. It may instead grant a probational license when a facility has deficient practices that are serious, chronic or uncorrected but the operator has shown it can fix them. Probation lasts no more than one year, and a facility on probation may not add beds during that time (r. 420-5-4-.02).
A closure longer than 30 days that ADPH did not authorize voids the license, and reopening means a brand-new application with plan review and a building inspection. If a facility you are considering recently changed owners, ask when the change was filed: the rules require notice to ADPH at least 30 days before a change of ownership.
What can't an Alabama ALF do that a nursing home can?
A regular ALF in Alabama cannot provide or retain residents who need ongoing skilled nursing, cannot lock residents in or restrict their exit, and cannot let its own unlicensed staff perform skilled tasks such as wound care or catheter insertion.
Those three limits shape almost every placement decision. If a parent wanders and needs a secured door, the right license is a specialty care assisted living facility (SCALF), covered in our memory care rules guide. If a parent needs daily skilled nursing, the right setting is a nursing home or home health brought in by a licensed agency. The full admission and retention list is in our admission and discharge guide.
At a glance
| An Alabama ALF license does | An Alabama ALF license does not | |
|---|---|---|
| Size | Fix a class: group (3-16) or congregate (17+) | Allow new family-class (2-3 bed) licenses since 2015 |
| Term | Run January 1 to December 31 | Carry over automatically without renewal |
| Care | Cover personal care and help with medications | Cover skilled nursing by facility staff |
| Doors | Require free, unhindered exit for residents | Allow a locked or secured unit (that needs a SCALF) |
Sources: Ala. Admin. Code chapters 420-5-4, 420-5-10 and 420-5-20; ADPH Bureau of Health Provider Standards; ADPH Health Care Facilities Directory and Deficiencies applications; Alabama DHR Adult Protective Services. See our editorial standards.
