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Diagnosed with Bulbar induced ALS and RA. Looking for possible assisted living arrangement or home nurse checks.

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I think at this point he needs more care than an AL can provide. They don't do skilled nursing. I think someone stopping in is not enough. My friends husband was wheelchair bound with oxygen. He could do nothing for himself. I just read what Bulbar means and pretty much it means brother is getting weaker. He probably needs 24/7 care. It maybe time for Skilled Nursing Care. Who has been helping him?

You may need to make a trip where he is to see what his situation is. As suggested, start with his County Office of Aging.
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Does he by any chance have any Blue Cross coverage?  I can't say for certain but I do remember seeing something in a recent communication from them about providing medicine checks for those with BC coverage.    It's possible I may have seen it elsewhere as well, but I would contact his medical insurer and ask it it's covered under his policy. 

Another option is to contact an ALS organization and ask for options from them.   Or contact the VA if he's a Veteran and is enrolled, but if not, get information on the closest VA at which he could be enrolled.
 
Yet another potential option is to contact the county in which he lives, explain the situation and ask what assistance might be available, not just through the county but what they might recommend.

Does your brother live alone?   Does he have any assistance at home now?
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This is a forum for caregivers and not a place to get referrals.

Someone may have experience in the area your brother lives but, you should contact the Counsel on Aging for his area and they can help you with resources for what is available.
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