Nebraska is a landlocked state that doesn’t offer beaches like the coastal states or the warm winters people can find in the south, but people in this state are happy. According to a Gallup poll, Nebraska ranks 6th in the nation for well-being. Gallup measures well-being through an analysis of five interrelated elements: financial security, social relationships, physical health, relationship with community and sense of purpose. These factors, coupled with a lower overall cost of living when compared to more urban states, have attracted a growing number of retirees to the state – many of whom ultimately opt for assisted living facilities.
Paying For Assisted Living in Nebraska
The monthly median cost of assisted living in Nebraska is $3,844, which is slightly below the national average of $4,000. According to Genworth’s 2018 Cost of Care Survey, Nebraska has a lower average cost than all but two of its neighboring states.
The costs of assisted living in the only two major metropolitan areas in Nebraska (Lincoln and Omaha) drive up the median cost in the state. Both areas exceed $4,000 per month in average monthly costs and Lincoln is extremely expensive at $5,429, while the rest of the state costs $3,239 on average.
The state median cost of assisted living is less expensive than most other types of long-term care except adult day health care and independent living. It’s considerably cheaper than nursing home care, in particular.
Financial Assistance for Assisted Living in Nebraska
The Aged and Disabled Waiver
While Nebraska’s Medicaid program doesn’t cover the cost of living at an assisted living facility, there is a program that helps to cover the cost of care, called the Aged and Disabled Waiver. For Nebraska seniors who reside in an assisted living community, this waiver can help offset costs for medical and care related services, as well as home and vehicle modifications. The waiver does not, however, cover expenses for room & board.
Who Is Eligible?
Applicants need to meet certain asset limits and functionality requirements. There is a $2,000 resource cap for individuals and a $3,000 cap for couples. With respect to income limits, Nebraska follows a “standard of need” model, which allows people to deduct their housing costs (such as rent), or a portion thereof, from their income before income is considered in eligibility. For individuals, the standard of need is $520/month and $821/month for a married couple.
To be eligible, you also must meet the qualifications of needing a nursing home level of care.
How to Apply
To get more details about eligibility requirements and start an application, contact your local area agency on aging or apply for Medicaid by using the online application or by calling (855) 632-7633.
More Ways to Finance Assisted Living
Some additional ways to finance assisted living costs include:
- Veterans Benefits: Veterans can take advantage of several different pension programs to help cover the cost of assisted living. For more information, see the article on benefits.va.gov.
- Life Insurance Policies: Even if a spouse or loved one hasn’t died, certain types of life insurance policies can be used to pay for assisted living. More information is available at longtermcare.acl.gov
- Long-Term Care Insurance: Long-term care insurance is a type of insurance policy that pays for long-term care when it becomes necessary, including the cost of assisted living. For more information on the benefits and drawbacks of this financing method, visit longtermcare.acl.gov.
- Reverse Mortgages: Reverse mortgages allow seniors to access the equity from a home that they own, and these funds can be used to pay for assisted living. The U.S. Department of Housing and Urban Development offers a federally insured reverse mortgage program.
Free Assisted Living Resources in Nebraska
Nonprofit and governmental organizations found across Nebraska may offer free assistance for the elderly and their families in the process of seeking long-term care. These organizations can provide an excellent starting point in understanding your rights and options.
Aging and Disability Resource Center
Nebraska’s Aging and Disability Resource Center provides information, referral services, and assistance for older adults in accessing community services and long-term care options. The effort is coordinated by the state’s Department of Health and Human Services.
Long-Term Care Ombudsman Program
Like many states, Nebraska maintains a Long-Term Care Ombudsman program. The Ombudsman is tasked with:
- Educating communities, residents, and families on the rights of residents and issues of aging, long-term care and a variety of other relevant topics
- Investigating complaints by community residents and making sure their rights are being upheld
- Empowering individuals to resolve concerns and complaints on their own behalf when possible
- Advocating for residents and their families, and empowering them to advocate for themselves
- Advocating for systemic changes if there are significant concerns and problematic trends
Area Agencies on Aging
Area Agencies on Aging (AAA) is a network of hundreds of nonprofit organizations across America that provide federally funded services to adults over 60 in their local areas.
Nebraska has many Area Agencies on Aging that offer comprehensive information on various kinds of programs and community supports for seniors. The State Unit on Aging provides federal and state funds to help support the programs in these agencies:
|Area Agency on Agin||Address||Phone Number|
Bluffs Business Center. 1517 Broadway, Suite 122. Scottsbluff, NE 69361
119 W Norfork Ave. Norfolk, NE 68701
115 North Vine, North Platte, NE 69101
4623 2nd Ave, Suite 4. Kearney, NE 68847
115 North Vine. North Platte, NE 69101
2727 W. 2nd Street, Suite 440. Hastings, NE 68901
1901 Court Street. Beatrice, NE 68301
4223 Center Street. Omaha, NE 68105
As in most states, Nebraska has VA centers to help veterans and their spouses with financing options for various kinds of care. These offices can provide guidance on your eligibility and direct you to the best support options for you.
|VA Center||Address||Phone Number|
Lincoln Vet Center
3119 O Street, Suite A, Lincoln, NE 68510
402-476-9736 or 402-476-9736
Omaha Vet Center
3047 S 72nd Street, Omaha, NE 68124
Social Security Offices
Nebraska’s Social Security offices offer another great resource for seniors looking for assistance. By contacting or visiting a Social Security office, you can get a better understanding of your or your loved one’s social security benefits and what types of assistance may be available to help pay for assisted living expenses. Below is a list of Social Security Offices in Nebraska.
|Social Security Office||Address||Phone Number|
115 N Webb Rd. Grand Island, NE 68803
1-877-407-3441 or TTY: 1-308-385-6453
100 Centennial Mall N Room 240. Lincoln, Nebraska 68508
1-866-593-2880 or TTY: 1-800-325-0778
605 Iron Horse Dr Suite 1. Norfolk, Nebraska 68701
1-855-207-7082 or TTY: 1-800-325-0778
300 E 3rd St Room 204. North Platte, Nebraska 69101
1-866-830-0668 or TTY: 1-308-534-0441
604 N 109th Ct Old Mill Centre. Omaha, Nebraska 68154
1-866-716-8299 or TTY: 1-800-325-0778
415 Valley View Dr. Scottsbluff, Nebraska 69361
1-800-297-4291 or TTY: 1-800-325-0778
Assisted Living Laws and Regulations in Nebraska
Assisted Living Service Plans
A service agreement in a Nebraska assisted living facility outlines the services that will be provided to meet the resident’s needs as identified during an intake assessment. The agreement also outlines what care services are provided by facility staff versus other sources, including how often, when, and by whom they will be delivered.
Assisted Living Admission Requirements
Assisted living communities in Nebraska cannot accept any resident who is not capable of directing their own self-care. Individuals who need complex nursing care or who have unstable medical conditions cannot be admitted into assisted living facilities unless they have arranged for care through a licensed home health agency or licensed hospice agency.
Assisted Living Scope of Care
The scope of care offered in assisted living facilities in Nebraska generally covers the following:
- Assistance with personal care
- Activities of daily living and instrumental activities of daily living
- Medication administration, either by self or qualified staff
- Health maintenance activities, defined as non-complex nursing interventions
For residents requiring more complex care, care can be arranged through a licensed home health or hospice agency.
Beyond these necessities, facilities may also provide supportive services, including:
- Financial assistance or management
- Behavioral management
- Case management
- Spiritual services
- Salon services such as a beauty or barber shop
Assisted Living Medicaid Policy
The costs for assisted living are not directly covered by the state’s Medicaid program, but Nebraska does offer three different waivers to help offset the cost of care. One of the waivers, the Aged and Disabled Waiver, can help to cover the cost of care in an assisted living. However, the cost of room and board in the facility isn’t covered.
Assisted Living Facility Requirements
A resident unit in an assisted living community in Nebraska may be a bedroom or apartment. In apartments, there must be a private bathroom and kitchen area in addition to the sleeping area.
For older facilities (constructed prior to April 2007), a maximum of four residents are allowed per unit, with at least one toilet and sink fixture per six licensed beds. There must be one bathing facility for every 16 residents.
For more recent facilities, a maximum of two residents are allowed per unit, with one toilet and sink fixture per four licensed beds, and at least one bathing facility for every 8 residents. For any new construction after 2015, there needs to be a toilet room adjoining each residents bedroom.
Medication Management Regulations
There are three ways for residents to receive medications in an assisted living facility:
- If capable of doing so, residents can self-administer with or without staff supervision.
- Licensed healthcare professionals can administer medications, so long as their scope of practice includes medication administration.
- Trained medication aides that have demonstrated minimum competency standards can administer medications if they are appropriately directed and monitored.
A registered nurse must oversee medication aide training and review and document medication administration policies and procedures at least once per year.
Direct care staff, also referred to as nursing assistants, assist residents with personal care, while trained medication aides are responsible for administering medications. The facility must have a registered nurse on staff to both review medication administration policies and procedures and to preside over medication aide training.
Nebraska has no minimum ratio for staff-to-residents in assisted living facilities, but the facilities are expected to maintain a sufficient number of staff with the required training and skills needed to meet residents’ specified needs. Resident service agreements stipulate that someone must be awake at all times to meet needs as required.
Staff Training Requirements
Assisted living facility administrators must complete requisite initial training within the first 6 months of their employment in that role. Requisite training consists of at least 30 hours covering the following topics:
- Resident care and services
- Social services
- Financial management
- Rules, regulations, and standards relating to assisted living facility operations
Beyond this requirements, administrators must also complete 12 hours of ongoing training relating to care provision and management of populations served.
Direct care staff members are required to complete orientations and ongoing training in topics appropriate to their specific job duties, and they must meet the physical and mental special care needs of current residents. Direct care staff, like administrators, must complete at least 12 hours of continuing education per year.
Background Checks for Assisted Living
Assisted living facilities must conduct criminal background and sex offender registry checks for all direct care staff. Providers must also contact the nurse aide registry, the adult central registry of abuse and neglect, and the child central registry of abuse and neglect to ensure potential employees are not listed for abuse, neglect or misappropriation of resident property. Anyone found to have adverse findings on the nurse aide registry may not be employed as direct care staff, but the facility can make decisions on an individual basis for any other findings.
Requirements for Reporting Abuse
There is an online complaint form available through the Nebraska Department of Health and Human Services to conveniently and anonymously register concerns about a community.
Adult Protective Services, a specific division within Health and Human Services, is tasked with handling reports of elder abuse. The toll-free, 24-hour hotline for this division is 1-800-652-1999.