(1) Legal Authority for Adoption of Rules. Under and by virtue of the
authority vested in it by the Legislature of Alabama, Code of Ala., 1975, Sections 22-21-
20, et. seq., the Alabama State Board of Health does hereby adopt and promulgate the
following Rules governing all assisted living facilities.
(a) “Advisory Board” means the Licensure Advisory Board established by law
to serve as consultants to the State Health Officer and to assist in rule making necessary to
carry out the provisions of Code of Ala., 1975, Section 22-21-20, et. seq.
(b) “Assisted Living Facility” means an individual, individuals, corporation,
partnership, limited partnership, limited liability company or any other entity that
provides, or offers to provide, residence and personal care to two or more individuals who
are in need of assistance with activities of daily living. Exceptions to this definition are:
1. Individuals who provide residential and personal care services solely to
persons to whom they are personally related, shall not be deemed to be an assisted living
facility. “Personally related” means that the person receiving the residential and personal
care services is the spouse, parent, sibling, adult child, adult grandchild, grandparent,
great-grandparent, adult niece, adult nephew, aunt, uncle or first cousin of the person
providing such services, or stands in that relation to the current spouse of the person
providing the services. This exception is only for individuals, and does not apply to
corporations, partnerships, limited partnerships, limited liability companies, or any other
organized entity or business.
2. Facilities whose residents are under the care, oversight or protection of
another governmental agency shall not be deemed to be assisted living facilities and shall
not be subject to these rules, if both of the following conditions are satisfied:
(a) A federal, state, or other governmental body, agency or authority has a
fiduciary relationship or some other legally recognized and enforceable relationship to the
residents of the facility which carries an obligation to oversee the health, safety and
welfare of the residents; and
(b) The federal, state, or other governmental body, agency, or authority
licenses, certifies, or otherwise legally authorizes the facility to provide accommodations
and care for the residents.
(c) “Bed Capacity” means the maximum number of beds which can be
installed or set up in an assisted living facility at any given time for use of residents. The
bed capacity shall be based upon space designed or specifically intended for such use,
whether or not the beds are actually installed.
(d) “Bed Complement” means the number of beds normally installed in an
assisted living facility for use of the residents.
(e) “Board”, or “State Board of Health” means the Alabama State Board of
(f) “Congregate Assisted Living Facility” means an assisted living facility
authorized to care for 17 or more adults.
(g) “Department” means the Alabama Department of Public Health.
(h) “Division” means the Division of Health Care Facilities, Alabama
Department of Public Health.
(i) “Family Assisted Living Facility” means an assisted living facility
authorized to care for 2 or 3 adults.
(j) “Group Assisted Living Facility” means an assisted living facility
authorized to care for 4 to 16 adults.
(k) “License” means the legal authority granted by the State Board of Health to
operate a facility.
(l) “License Certificate” means the document issued by the State Board of
Health and signed by the State Health Officer that constitutes rebuttable evidence of the
facility’s legal authority to operate.
(m) “Licensed Practical Nurse” means a person currently licensed in the State
of Alabama in accordance with Code of Ala., 1975, Sections 34-21-1, et. seq.
(n) “Pharmacist” means a person currently licensed to practice pharmacy in
Alabama under the provisions of Code of Ala., 1975, Sections 34-23-1, et. seq.
(o) “Physician” means a person currently licensed by the Medical Licensure
Commission of Alabama to practice medicine and surgery in Alabama. The use of the
word, “physician” in these rules shall not be deemed to preclude a properly licensed nurse
practitioner or a physician assistant from performing any function in an assisted living
facility that is within that individual’s scope of practice.
(p) “Qualified Dietitian” means a person who is currently licensed in the State
of Alabama in accordance with the provisions contained in current state statutes as
governed by the Board of Examiners for Dietetic/Nutrition Practice.
(q) “Registered Professional Nurse” or “RN” means a person currently licensed
as a Registered Professional Nurse by the State of Alabama Board of Nursing in accordance
with Code of Ala., 1975, Section 34-21-21.
(3) Procedure Governing Adoption, Amendment, and Recision of Rules.
(a) Authority. The State Board of Health, with the advice and approval of the
Advisory Board defined in Code of Ala., 1975, Section 22-21-27, has the legal authority to
adopt, reasonable rules governing the operation and conduct of assisted living facilities,
and it may amend or rescind any rules previously adopted.
(b) Procedure. In adopting, amending, or rescinding rules, the Board shall
follow the provisions of the Alabama Administrative Procedure Act. The effective date of
any rules adopted, amended or rescinded shall likewise be governed by the Administrative
(c) Joint Hearings. All hearings shall be joint hearings set by the State Board
of Health and the Advisory Board, at which time any interested member of the public may
(a) Inspections Required. Each assisted living facility for which a license has
been granted may be inspected by the State Board of Health, or by its authorized
representatives at such intervals as the Board may direct. The State Board of Health and
its authorized representatives may inspect construction work including new facilities,
additions, and alterations at any time the construction work is in progress or after it has
(b) Information Disclosure. Official reports, such as statements of deficiencies
generated by the State Board of Health as a result of on-site inspections, and plans of
correction submitted in response to those statements of deficiencies, are subject to public
disclosure. Information received through other means and reports other than statements of
deficiencies shall be deemed to be confidential and shall not be publicly disclosed except
in response to a valid subpoena or court order or in proceedings involving the affected
facility’s license or proceedings involving the license of another facility operated by the
same governing authority. Confidential records in the possession of the Department are
deemed to be records in the possession of the State of Alabama, and shall be freely shared
with any other State of Alabama agency that presents a good reason for access to the