Nursing Homes in Nebraska
Nursing homes provide a safe and comfortable environment for seniors who have long-term medical conditions, as well as those recuperating from illness or surgery. Staff is a combination of therapists, registered and licensed nurses and certified nursing assistants who provide round-the-clock medical and nonmedical care for people with varying medical conditions. Nursing homes also offer opportunities for seniors to engage socially with peers. Residents typically reside in private or semiprivate rooms maintained by housekeeping staff, and meals are chef-prepared.
Adults aged 65+ comprise 16.4% of Nebraska's 2 million residents. Approximately 20% of them will need long-term care support for around 5 years, and 35% of those seniors will spend at least 12 months in one of Nebraska's 190 nursing homes. Currently, 9,571 seniors receive nursing home care in Nebraska, which is around 3% of its elderly residents.
In this guide, seniors and their families will find a discussion about how and if Medicaid can pay for nursing home care and other financial assistance options, such as Medicare. It also has links to nonprofits that can assist families and includes a summary of Nebraska's nursing home laws and regulations.
Popular Cities in Nebraska
Cost of Nebraska Nursing Homes
The average cost of nursing homes in Nebraska is $197 per day. This is higher than the national average which is $228 per day.
Can You Use Medicaid to Pay for Nursing Home Care in Nebraska?
Nebraska's Medicaid program will pay 100% of nursing home care costs for seniors who satisfy qualifying criteria. Data published by Medicaid.gov shows that 387,459 Nebraskans were enrolled in Medicaid and CHIP as of December 2022. Those residing in nursing homes are entitled to a wide range of services, including medical and nonmedical care, equipment and supplies, dietary services and room and board. Medicaid also pays for services that restore human functions, such as occupational and physical therapies.
Nebraskans requiring nursing home levels of care that don't wish to enter an institution may be eligible for the Aged and Disabled Waiver. It will cover their medical and nonmedical costs for care at home or in the community. This includes assistive technology devices, home modifications, light housekeeping and personal care services. However, unlike Medicaid, which is an entitlement program that approved applicants can access almost immediately, the waiver may have a waiting list.
Eligibility for Medicaid in Nebraska
A single person can't have an annual income greater than $14,580 and assets of $4,000 to be eligible for Medicaid in Nebraska. These figures are also the same if one person from a two-person household applies. Seniors must contribute all of their income toward nursing home care in Nebraska. However, they are allowed a personal needs allowance of $60 per month to cover necessary expenses, such as haircuts and clothing, as well as what they need to pay their Medicare premiums. If one person moves into a nursing home from a two-person household, the remaining spouse may be entitled to a spousal income allowance and may retain assets of up to $148,620.
| Income Limits* | Asset Limits | |
|---|---|---|
| Single Person | $14,580 | $4,000 |
| Two-Person Household | $14,580 (for the applicant) | $4,000 (applicant)$148,620 (non-applicant spouse) |
*Per year
In addition to satisfying the financial requirements, applicants must also satisfy other qualifying criteria. These are:
- Being a U.S. citizen or legal resident
- Residing in Nebraska
- Being aged 65 or older
- Requiring a nursing home level of medical care
Applying for Medicaid in Nebraska
Seniors and their families have several ways they can apply for Medicaid in Nebraska, each targeted at people with different preferences for communicating. They are:
- Online: The speediest option is to complete an online application at ACCESS Nebraska.
- In-person: People who prefer face-to-face contact should make an appointment at their nearest Area Agency on Aging office to speak to a Medicaid advisor.
- By phone: Those who prefer the phone can call the Nebraska Department of Health and Human Services at (855) 632-7633.
- By mail: This is the slowest method but may suit seniors more comfortable using mail. Applicants must download and print a copy of the Medicaid application form. The senior can then mail a completed copy to their nearest Department of Health and Human Services office.
What Information You Will Need
Nebraska Medicaid will require documents that prove the applicant's qualifying status. These may include:
- Proof of income, such as 60 months of bank statements
- Proof of assets, such as investment account statements
- Social Security number
- Health insurance policy numbers for the entire household
- Proof of legal residency if not a U.S. citizen
- Birth certificate
Additional Medicaid Support & Resources in Nebraska
Seniors and families who want more information about Medicaid or need help with matters related to it can access several resources that don't charge for their services. The following table includes three of them, with contact details and a short explanation of how they might help.
| Contact | Service | |
|---|---|---|
| Legal Aid of Nebraska | (800) 527-7249 | Legal Aid of Nebraska is a nonprofit law firm whose attorneys and paralegals can help older adults. They advocate for seniors who have been denied Medicaid, as well as other state and federal benefits, including SSI and SSDI. |
| Medicaid.gov | (855) 632-7633 | Medicaid.gov is a federal government website for all things Medicaid. It's a useful source of information, as it's updated routinely, and it includes links for seniors who are ready to apply. They can also check their eligibility status and apply for a new Medicaid card. |
| American Council on Aging | Online Only | Experts in Nebraska Medicaid maintain and update the information on the American Council on Aging's website. It can be a good resource for those who prefer to do their own research. The site also includes helpful tools, such as a spend down calculator and a Medicaid eligibility test.. |
Can You Use Medicare to Pay for Nursing Home Care in Nebraska?
Medicare provides limited coverage for short-term stays in a skilled nursing facility following a hospital stay, but seniors must meet a number of specific requirements. This benefit is available to beneficiaries who have been hospitalized for at least three days, excluding the date of discharge, so it's most valuable for those who are recovering from an injury, illness, or surgery.
Once seniors meet the hospitalization requirement, Medicare will pay for up to 100 days of skilled nursing per benefit period. The first 20 days are covered in full. Starting on day 21, beneficiaries must pay a daily coinsurance rate. After day 100, seniors are responsible for the entire cost.
What Does Medicare Cover?
Medicare covers a number of specific services, including:
- Meals
- A semiprivate room
- Medications
- Skilled nursing
- Physical therapy
- Occupational therapy
- Speech therapy
- Audiologist care
- Medical supplies
- Medical social services
- Nutritional counseling
- Ambulance transportation
What Isn't Covered by Medicare?
Medicare does not cover long-term custodial care that addresses seniors' day-to-day needs. This includes help with daily activities, such as bathing, dressing and using medical equipment.
For more information about Medicare and when it covers Nursing Home Care, read our Guide to Nursing Homes.
Medicare Support & Resources in Nebraska
Seniors who wish to know more about Medicare and how it may help them cover their nursing home costs for a limited period can check out the links in the following table. There are also links to other nonprofits that can help with age-related matters, such as home-delivered meals and legal representation.
| Contact | Service | |
|---|---|---|
| Nebraska Aging and Disability Resource Center | (844) 843-6364 | Aging and Disability Resource Centers manage the state's SHIP program, which provides seniors with impartial information and advice about Medicare, including supplementary programs, such as Medigap. It also manages the Senior Medicare Patrol program, which identifies Medicare fraud and raises awareness of health care scams. |
| Nebraska Department of Health and Human Services | (402) 471-3121 | The department manages many programs that aid Nebraska's older residents, including its Medicaid program and ACCESSNebraska. It also manages an array of long-term care services for those who need skilled nursing care but can remain at home, such as Meals on Wheels and wheelchair-accessible transportation. |
| State Unit on Aging | (402) 471-3121 | The unit's purpose is to help older Nebraskans age in place. It can provide them with some financial support to make living at home possible and advise them about Medicare plans and how to choose the right one. |
| Area Agencies on Aging | (844) 843-6364 | Nebraska's eight Area Agencies on Aging help seniors and their families learn more about Medicare and choose the appropriate plan for their needs and budgets. The agencies also support caregivers and help seniors with legal issues that involve civil law. |
Other Financial Assistance Options for Nursing Home Care in Nebraska
While Medicaid and Medicare are two of the most common programs used to pay for Nursing Home Care, there are other financial assistance options available, depending on your unique situation.
| How to Apply | How It Works | |
|---|---|---|
| Aid and Attendance | Learn more and apply online at va.gov. | Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for skilled nursing care. |
| Reverse Mortgages | Learn more about your options and how to apply at ftc.gov. | If you own a home, you may be able to use a reverse mortgage to help pay for nursing care. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. This type of funding can be especially useful for married couples when only one partner needs nursing care, as the other residents of the home may continue living there. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan. |
| Long-Term Care (LTC) Insurance | Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov. | Seniors who already have long-term care insurance may be covered for skilled nursing care. Most policies cover at least a portion of the cost of nursing home care, but it depends on the specific policy terms. Note that older adults who are already in need of skilled nursing care will not be eligible to sign up for a LTC insurance policy. |
Nursing Home Laws and Regulations in Nebraska
| Licensing Requirements | The Nebraska Health and Human Services Department licenses and regulates the state's nursing homes. Facilities must be licensed at least 30 days before they open and reapply annually. The department makes unannounced inspections to ensure nursing homes are abiding by laws. |
| Staffing Requirements | Nebraska doesn't dictate staff-to-resident ratios in nursing homes but does require at least one Registered Nurse or Licensed Practical Nurse to be on-site for a minimum of 8 hours per day and on call 24/7. Each resident must receive at least 2.8 hours of direct care daily. |
| Staff Training Requirements | Certified Nursing Assistants must complete a state-approved program with a minimum of 75 hours of instruction. They must also receive 12 hours of refresher training annually. Registered Nurses and Licensed Practical Nurses are required to graduate from an approved nursing education program. |
| Admission Restrictions | Nebraska's nursing homes can only accept individuals who have the written approval of a licensed physician. Seniors are entitled to remain in the facility if it provides the type of care they need. Those with a history of violence may be refused admittance. |
| Care Planning Requirements | A comprehensive assessment of the resident's physical, mental and psychological functioning is required within 14 days of admission, with a care plan written within 21 days. The plan must be reviewed and revised as necessary every 3 months, or sooner if there's a change. |
| Dietary and Nutritional Services Requirements | Menus must be developed by a registered dietitian or nutritionist and meet the sustenance needs of each resident. Menus are required to be written and updated quarterly. Food must be prepared, stored and served safely. |
| Specialized Rehabilitative Services | Physical, occupational and speech therapies must be available to help residents regain their mobility, functional skills and ability to speak and swallow. There should also be respiratory therapies and psychological services, including counseling and psychotherapy. |
| Medication and Pharmaceutical Services | There must be policies and procedures for storing, administering and monitoring medications. Nursing homes must provide all the medications that residents have been prescribed, including over-the-counter drugs. A regular review of each resident's medication plan is required. |
| Activities Requirements | There must be a qualified activities director who ensures the nursing home's social calendar satisfies specific needs. These typically include activities focused on emotional, spiritual, physical and intellectual well-being. |
| Infection Control Requirements | All staff must wash their hands with soap and water or use an alcohol-based hand sanitizer before and after providing care to residents. They must use PPE equipment as necessary, such as gowns and gloves. Cleaning staff must regularly disinfect surfaces and equipment. |
| Medicaid Coverage | Nebraska's Medicaid program covers the costs of all services a senior can receive in a nursing home, such as medical care, room and board and transportation for medical purposes (such as to a hospital). |
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