The 10 Worst Nursing Homes in Alabama

Updated as of August 01, 2023

A list of the ten worst skilled nursing homes in Alabama. Based on the Weighted Health Inspection Score developed by the Centers for Medicare and Medicaid Services.

Click here to see the best skilled nursing facilities in Alabama.

Compare the Worst Nursing Homes in Alabama

Every year, thousands of seniors, their families, and friends are faced with the difficult decision of choosing a skilled nursing facility, either because someone is recuperating after a hospital visit or for end-of-life care. This is usually an issue that arises suddenly, and the decision makers are not equipped with the right knowledge and information to make a good decision. Not knowing how to decide, they turn to others for recommendations. Word of mouth, along with geography, are constantly cited as the most important factors in choosing a skilled nursing facility. Choosing a facility with such limited information can lead to significant problems. Not all skilled nursing facilities are the same and the people that you trust to recommend a facility may not know enough about the facility and the alternatives to be a competent guide.

Providing the type of care that residents of skilled nursing facilities require is very difficult. The range of issues that are being treated is vast and the needs cover both people recuperating and recovering as well as those facing end-of-life issues. Residents require significant help with basic daily activities as well as supplemental needs like oxygen and 24/7 monitoring.

To help people who are facing this difficult situation, we have compiled a list of the worst Alabama skilled nursing facilities and the the best skilled nursing facilities. (We have also compiled the best and worst nursing homes by city for most cities in the United States, links are shown at the bottom on this page.) The lists are based on data provided by The Centers for Medicare & Medicaid (“CMS”) and include information gathered from detailed annual inspections, monthly reporting, complaint histories, deficiency reports and much more.

The list below calls out the worst skilled nursing facilities in Alabama. For the most part these facilities should be avoided. All the facilities have issues with cleanliness and safety and a large number of the facilities have been flagged by CMS as locations where abuse has either occurred or is highly likely.

Avoiding these facilities may not always be an option either because of geographic, monetary, or occupancy constraints. However, being in a bad nursing home does not mean that the resident will not improve. If you have a loved one in one of these facilities, we encourage you to visit often and to ask that friends and other family visit too. It is well documented that positive outcomes for skilled nursing residents is highly correlated with the number and diversity of people visiting the resident. Being there, getting to know the staff, showing the staff that the resident has people that care about him or her is critical. There may not always be a better option, but your direct involvement can make a difference.

Nursing Home Rating
Birmingham Nursing and Rehabilitation Ctr LLC
1000 DUGAN AVENUE
BIRMINGHAM, AL 		411.00
Rating Not Available
Attalla Health and Rehab
915 STEWART AVENUE SOUTHEAST
ATTALLA, AL 		335.17
Signature Healthcare of Whitesburg Gardens
105 TEAKWOOD DRIVE SW
HUNTSVILLE, AL 		272.83
Diversicare of Foley
1701 NORTH ALSTON STREET
FOLEY, AL 		249.50
Nhc Healthcare, Moulton
300 HOSPITAL STREET
MOULTON, AL 		228.50
Oak Knoll Health and Rehabilitation, LLC
824 SIXTH AVENUE WEST
BIRMINGHAM, AL 		185.83
Selma Health and Rehab, LLC
11 BELL ROAD
SELMA, AL 		160.33
Oak Crest Health and Wellness
325 SELMA ROAD
BESSEMER, AL 		135.83
Village at Cook Springs Skilled Nursing Facility
415 COOK SPRINGS
PELL CITY, AL 		124.50
Azalea Health and Rehab LLC
1758 SPRINGHILL AVE
MOBILE, AL 		120.00

Nursing Homes with the warning icon () have been flagged by CMS for abuse.

How We Compile Nursing Home Ratings in Alabama

Every month, we rank all of the skilled nursing facilities in Alabama. These rankings are based on data provided by The Centers for Medicare & Medicaid measures ("CMS"), including the CMS 5-Star Rating System and the Health Inspection Scores. The list of the Worst Skilled Nursing Facilities in Alabama is based on the weighted overall health inspection score which is a composite of CMS's three most recent skilled nursing home inspection scores weighted to give the most recent inspection more importance.

The CMS 5-Star Rating System rates skilled nursing facilities from one to five stars, with one star being the lowest and five stars being the highest. The rating system also rates Alabama nursing homes across five different dimensions including overall rating, health inspection rating, quality measures rating, overall staffing rating, and RN staffing rating (RN is an acronym for Registered Nurse).

In addition to the 5-Star Rating System, CMS provides numerical metrics that summarize:

  • Health Inspection Domain. The health inspection rating is based on the three most recent standard surveys for each nursing home, results from any complaint investigations during the most recent three-year period, and any repeat revisits needed to verify that required corrections have brought the facility back into compliance. CMS calculates a weighted deficiency score based on points assigned to health deficiencies identified in each active provider’s current health inspection survey and the two prior surveys (including revisits), as well as deficiency findings from the most recent three years of complaint investigations. More recent surveys are weighted more heavily than older surveys: the most recent period (cycle 1) is assigned a weighting factor of 1/2, the previous period (cycle 2) has a weighting factor of 1/3, and the second prior survey (cycle 3) has a weighting factor of 1/6. The weighted time period scores are then summed to create the survey score for each facility.
  • Staffing Domain. Using multiple reporting methods, CMS calculates the amount of time that the nursing staff spends with residents. This is measured across multiple dimensions, one each for three different levels of nursing, including Registered Nurses (“RNs”), Licensed Practical Nurses (“LPNs”), and Certified Nursing Assistants (“CNAs”), plus one metric that totals all contributions. These metrics are expressed in hours per resident per day. CMS also provides state-level and national averages for the metrics to allow for additional comparisons.
  • Quality Measures Domain. A set of quality measures (QMs) has been developed from MDS-based indicators to describe the quality of care provided in nursing homes. These measures address a broad range of functioning and health status in multiple care areas. The facility rating for the QM domain is based on performance on a subset of 11 (out of 18) of the QMs. Ratings for the QM domain are calculated using the three most recent quarters for which data are available. This time period specification was selected to increase the number of assessments available for calculating the QM rating, increasing the stability of estimates and reducing the number of facilities that do not have enough data to report QM ratings.
  • Abuse Flag. Abuse is always a concern in skilled nursing facilities. To highlight the issue, CMS has extracted this feature as its own flag. Facilities with an actual abuse event or where the potential for abuse has been shown for the past two years are flagged. The Health Inspection Score is capped at 2-stars for nursing homes that have been flagged for abuse.

Skilled nursing facilities that are new and do not have at least two surveys completed are not rated by CMS. These facilities may have health inspection scores that can be used to evaluate the facility.

One complication in Alabama nursing home inspections is the COVID-19 pandemic. Although inspections should be performed every 12 months, COVID has decreased this frequency. While CMS admits that only in “rare cases” do these inspections increase to 15 months, our analysis suggests that this time frame may be even longer. This report shows that the time between inspections is now just under 500 days (more than sixteen months). There are now hundreds of skilled nursing homes in the United States that have not been inspected in more than 24 months. This list shows the skilled nursing homes with the longest period since being inspected. According to the CMS data, these homes have not been inspected since 2018!

Skilled Nursing Home Abuse in Alabama

Abuse is always going to be an issue with skilled nursing facilities. Skilled nursing facility residents need help with so many basic things and they are suffering, confused, and frustrated. If you are the friend or relative of a nursing home resident, we guarantee that you will be constantly fretting about whether your loved one is receiving proper and timely care. Abuse feels like a violation of your trust, but it happens. CMS actively monitors nursing homes not just for actual abuse but also for indicators that suggest that abuse might be occurring. Homes where abuse has either occurred or might be occurring are flagged. A very high percentage of the worst skilled nursing facilities in Alabama have been flagged for abuse. We have marked these facilities both on the list of the worst skilled nursing facilities and on the detailed page for each of the facilities.

Skilled Nursing Homes in Alabama Compared to Nationwide

We have compared Alabama nursing homes to the nationwide average on several metrics. Alabama performed better than the national average on several metrics and worse on other metrics.

Cycle 1 Total Number Of Health Deficiencies 3.00 Lower
Cycle 1 Total Number Of Fire Safety Deficiencies 3.20 Lower
Cycle 2 Total Number Of Health Deficiencies 3.20 Lower
Cycle 2 Total Number Of Fire Safety Deficiencies 3.30 Lower
Cycle 3 Total Number Of Health Deficiencies 3.90 Lower
Cycle 3 Total Number Of Fire Safety Deficiencies 3.30 Lower
Average Number Of Residents Per Day 92.70 Higher
Reported Nurse Aide Staffing Hours Per Resident Per Day 2.34 Higher
Reported Lpn Staffing Hours Per Resident Per Day 0.85 Lower
Reported Rn Staffing Hours Per Resident Per Day 0.58 Lower
Reported Licensed Staffing Hours Per Resident Per Day 1.43 Lower
Reported Total Nurse Staffing Hours Per Resident Per Day 3.78 Higher
Total Number Of Nurse Staff Hours Per Resident Per Day On The Weekend 3.12 Lower
Registered Nurse Hours Per Resident Per Day On The Weekend 0.32 Lower
Reported Physical Therapist Staffing Hours Per Resident Per Day 0.03 Lower
Total Nursing Staff Turnover 51.00 Lower
Registered Nurse Turnover 42.90 Lower
Number Of Administrators Who Have Left The Nursing Home 0.60 Lower
Case-mix Rn Staffing Hours Per Resident Per Day 0.31 Lower
Case-mix Total Nurse Staffing Hours Per Resident Per Day 2.90 Lower
Number Of Fines 1.10 Lower
Fine Amount In Dollars 9,546.00 Lower
Percentage Of Long Stay Residents Whose Need For Help With Daily Activities Has Increased 12.67 Lower
Percentage Of Long Stay Residents Who Lose Too Much Weight 6.59 Higher
Percentage Of Low Risk Long Stay Residents Who Lose Control Of Their Bowels Or Bladder 43.06 Lower
Percentage Of Long Stay Residents With A Catheter Inserted And Left In Their Bladder 1.96 Higher
Percentage Of Long Stay Residents With A Urinary Tract Infection 3.09 Higher
Percentage Of Long Stay Residents Who Have Depressive Symptoms 1.17 Lower
Percentage Of Long Stay Residents Who Were Physically Restrained 0.62 Higher
Percentage Of Long Stay Residents Experiencing One Or More Falls With Major Injury 3.47 Higher
Percentage Of Long Stay Residents Assessed And Appropriately Given The Pneumococcal Vaccine 92.30 Higher
Percentage Of Long Stay Residents Who Received An Antipsychotic Medication 20.26 Higher
Percentage Of Short Stay Residents Assessed And Appropriately Given The Pneumococcal Vaccine 81.20 Higher
Percentage Of Short Stay Residents Who Newly Received An Antipsychotic Medication 2.65 Higher
Percentage Of Long Stay Residents Whose Ability To Move Independently Worsened 13.70 Lower
Percentage Of Long Stay Residents Who Received An Antianxiety Or Hypnotic Medication 23.62 Higher
Percentage Of High Risk Long Stay Residents With Pressure Ulcers 8.96 Higher
Percentage Of Long Stay Residents Assessed And Appropriately Given The Seasonal Influenza Vaccine 93.94 Lower
Percentage Of Short Stay Residents Who Made Improvements In Function 74.10 Lower
Percentage Of Short Stay Residents Who Were Assessed And Appropriately Given The Seasonal Influenza Vaccine 75.97 Higher
Percentage Of Short Stay Residents Who Were Rehospitalized After A Nursing Home Admission 22.31 Lower
Percentage Of Short Stay Residents Who Had An Outpatient Emergency Department Visit 11.27 Lower
Number Of Hospitalizations Per 1000 Long-stay Resident Days 1.83 Higher
Number Of Outpatient Emergency Department Visits Per 1000 Long-stay Resident Days 1.05 Lower

FAQs About Nursing Homes in Alabama

How Many Nursing Homes in Alabama

There are 225 skilled nursing facilities registered with CMS in Alabama with a total of 26,530 beds. Average occupancy was 78.29% in August 2023.

Alabama has 48 homes that are rated as having one star on the CMS 5-Star Rating System. Approximately 23.15 percent of the total number of available skilled nursing beds in Alabama are in one-star facilities. In Alabama, occupancy is higher in skilled nursing facilities where the CMS 5-Star Rating is higher than one-star.

How to Report a Nursing Homes in Alabama

If you run into an issue at a Alabama nursing home, there are a few steps you can take to make sure the issue is reported. First, speak with the immediate staff. If the problem is not solved, speak with a director or administrator, doctor, or any other employee of a high level.

As required by Medicare and Medicaid, reports and complaints must go through a grievance procedure. Per the Center for Medicare & Medicaid Services, a grievance is “an expression of dissatisfaction (other than an organization determination) with any aspect of the operations, activities, or behavior of a Medicare health plan, or its providers, regardless of whether remedial action is requested”. All grievances must be filed in writing or verbally within 60 days of the event prompting the grievance.

To report a Alabama nursing home for quality of care, go through a grievance procedure through your Medicare or Medicaid plan. You can also go through the Beneficiary and Family Centered Care-Quality Improvement Organizations (BFCC-QIO). These groups serve to help with complaints made regarding the quality of care by Medicare providers. You can also choose to go through both Medicare and a BFCC-QIO.

Worst Nursing Homes in the Largest Alabama Cities

All of the following nursing homes have been given a Weighted Health Inspection Score by the Centers for Medicare and Medicaid Services. Every year, nursing homes in Alabama go through an unannounced inspection performed by independent state examiners. These examiners look at factors such as cleanliness, hazards, and safety to perform the inspection. Points are given to nursing homes based on their deficiency in a certain category. Thus, a higher Weighted All Cycles Score means more problems and lower quality of care.

The list below ranks the homes with the highest (worst) weighted scores. The score is shown next to the facility name. The list also shows the two most recent deficiencies for each of the nursing homes.

Worst Nursing Homes in Birmingham

  • Birmingham Nursing and Rehabilitation Ctr LLC (411)
    • Provide appropriate pressure ulcer care and prevent new ulcers from developing. (2023-03-13)
    • Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. (2023-03-13)
  • Oak Knoll Health and Rehabilitation, LLC (185.833)
    • Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. (2023-05-19)
    • Administer the facility in a manner that enables it to use its resources effectively and efficiently. (2023-05-19)
  • Diversicare of Riverchase (52)
    • Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. (2023-06-02)
    • Provide appropriate pressure ulcer care and prevent new ulcers from developing. (2023-06-02)
  • North Hill Nursing and Rehabilitation Ctr, LLC (47)
    • Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. (2022-10-07)
    • Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. (2022-10-07)
  • Cherry Hill Rehabilitation and Healthcare Center (37.333)
    • Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements. (2023-01-25)
    • Create arrangements with other facilities to receive patients. (2023-01-25)
  • Elite Nursing and Rehabilitation Care Center (36.667)
    • Respond appropriately to all alleged violations. (2022-03-25)
    • Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. (2022-03-25)
  • East Glen (34)
    • Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident?s advance directives. (2023-06-10)
    • Provide properly protected cooking facilities. (2023-04-26)
  • Fair Haven (34)
    • Provide appropriate treatment and care according to orders, resident?s preferences and goals. (2022-09-08)
    • Ensure staff are vaccinated for COVID-19 (2022-04-18)
  • Galleria Woods Skilled Nursing Facility (32)
    • Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. (2022-01-12)
    • Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. (2022-01-12)
  • Brookdale University Park Snf (al) (30)
    • Have corridors or aisles that are unobstructed and are at least 8 feet in width. (2020-01-10)
    • Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements. (2020-01-10)

Worst Nursing Homes in Huntsville

  • Signature Healthcare of Whitesburg Gardens (272.833)
    • PASARR screening for Mental disorders or Intellectual Disabilities (2023-03-23)
    • Provide safe and appropriate respiratory care for a resident when needed. (2023-03-23)
  • Meadowview Healthcare and Rehab (103.667)
    • Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. (2022-10-07)
    • Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. (2022-10-07)
  • Huntsville Post-Acute and Rehabilitation Center (66.667)
    • Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. (2023-03-15)
    • Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. (2023-03-15)
  • Windsor House (63.333)
    • Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. (2022-09-29)
    • Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. (2022-09-29)
  • Huntsville Health Care Center (60.167)
    • Have an alternate power supply for its alarm system. (2023-07-14)
    • Ensure precautions for handling oxygen cylinders and equipment are correctly followed. (2023-06-19)
  • Ahc Millenium (32)
    • Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment. (2021-05-27)
    • Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months. (2021-05-27)
  • Mrc Creekside (24.667)
    • Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. (2023-02-09)
    • Provide and implement an infection prevention and control program. (2023-02-09)
  • Focused Care at Huntsville (20)
    • Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. (2023-04-07)
    • Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. (2023-04-07)
  • Diversicare of Big Springs (19.333)
    • Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. (2023-06-13)
    • Provide care and assistance to perform activities of daily living for any resident who is unable. (2023-06-13)
  • Huntsville Health and Rehabilitation, LLC (19.333)
    • Have properly located and lighted "Exit" signs. (2022-02-23)
    • Keep aisles, corridors, and exits free of obstruction in case of emergency. (2022-02-23)

Worst Nursing Homes in Mobile

  • Azalea Health and Rehab LLC (120)
    • Use approved construction type or materials. (2023-09-01)
    • Protect each resident from the wrongful use of the resident's belongings or money. (2022-11-27)
  • Gulf Coast Health and Rehabilitation, LLC (30.667)
    • Ensure proper usage of power strips and extension cords. (2020-02-19)
    • Provide appropriate pressure ulcer care and prevent new ulcers from developing. (2020-02-13)
  • Lynwood Nursing Home (28.667)
    • Allow resident to participate in the development and implementation of his or her person-centered plan of care. (2022-03-17)
    • Provide appropriate treatment and care according to orders, resident?s preferences and goals. (2022-03-17)
  • Twin Oaks Rehabilitation and Healthcare Center (21.333)
    • Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. (2021-09-03)
    • Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. (2019-11-25)
  • Kensington Health and Rehabilitation (20)
    • Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. (2022-03-17)
    • Ensure medication error rates are not 5 percent or greater. (2022-03-17)
  • Knollwood Healthcare (19.333)
    • Provide and implement an infection prevention and control program. (2021-08-12)
    • Use approved construction type or materials. (2021-07-28)
  • Ashland Place Health and Rehabilitation, LLC (18.667)
    • Install corridor and hallway doors that block smoke. (2020-03-04)
    • Have corridors or aisles that are unobstructed and are at least 8 feet in width. (2020-03-04)
  • Allen Health and Rehabilitation (16.667)
    • Inspect, test, and maintain automatic sprinkler systems. (2020-03-31)
    • Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. (2020-03-20)
  • Crowne Health Care of Mobile (14.667)
    • Install an approved automatic sprinkler system. (2019-10-30)
    • Have corridors or aisles that are unobstructed and are at least 8 feet in width. (2019-10-30)
  • Springhill Senior Residence (10)
    • Have approved installation, maintenance and testing program for fire alarm systems. (2020-02-28)
    • Meet other general requirements. (2020-02-28)

Worst Nursing Homes in Montgomery

  • Montgomery Health and Rehab, LLC (78)
    • Inspect, test, and maintain automatic sprinkler systems. (2023-02-23)
    • Provide properly protected cooking facilities. (2023-02-23)
  • Montgomery Children's Specialty Center (74.667)
    • Ensure each resident receives an accurate assessment. (2023-06-29)
    • Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. (2023-06-29)
  • Montgomery General Elderly Care (60)
    • Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. (2023-01-31)
    • Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. (2023-01-31)
  • Father Purcell Memorial Exceptional Children's Ctr (51.667)
    • Provide a written emergency evacuation plan. (2023-01-24)
    • Inspect, test, and maintain automatic sprinkler systems. (2023-01-20)
  • Montgomery General Hospital (39.333)
    • Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. (2022-05-12)
    • Ensure each resident receives an accurate assessment. (2022-05-12)
  • Diversicare of Montgomery (33.333)
    • Create arrangements with other facilities to receive patients. (2023-05-18)
    • Address subsistence needs for staff and patients. (2023-05-18)
  • Hillview Terrace (25.333)
    • Install an approved automatic sprinkler system. (2020-04-13)
    • Install a two-hour-resistant firewall separation. (2020-04-13)
  • Crowne Health Care of Montgomery (16)
    • Keep aisles, corridors, and exits free of obstruction in case of emergency. (2023-05-24)
    • Develop and maintain an Emergency Preparedness Program (EP). (2023-05-24)
  • Montgomery Nursing and Rehabilitation Center (15.333)
    • Properly select, install, inspect, or maintain portable fire extinguishes. (2022-09-07)
    • Install proper backup exit lighting. (2022-09-07)
  • Capitol Hill Healthcare Center (6)
    • Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. (2021-05-06)
    • Keep aisles, corridors, and exits free of obstruction in case of emergency. (2019-04-02)

Worst Nursing Homes in Tuscaloosa

  • Heritage Health Care and Rehab Inc (18)
    • Provide and implement an infection prevention and control program. (2022-09-01)
    • Install corridor and hallway doors that block smoke. (2022-03-10)

Worst Skilled Nursing Homes in Other States

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