Home to almost 2 million people, approximately 16.2% of Nebraska’s population comprises people aged 65 and over. On average, Nebraska’s climate is more comfortable than in many other states, and locals enjoy around 223 sunny days each year. The lower-than-average overall cost of living can help to offset the state’s high taxes. 

This guide provides information about assisted living in Nebraska. It covers various options for long-term care and how much they cost, how to pay for senior care, regulation of assisted living communities, and legal resources for older adults.

Nebraska Assisted Living: Types Of Senior Housing Options

Located in the Midwest, Nebraska covers more than 77,000 square miles. The Cornhusker State is known for its rural beauty, with rich agricultural lands, rolling prairies, hills, and unusual natural features. Several historic trails meander through the state, and cities and towns largely retain a small-town ambiance. Senior housing is available in various locations, many of which offer a laid-back way of life for retirees. There are options suitable for diverse needs and preferences.

Assisted Living Facilities (ALFs)

When a loved one can no longer live independently, an assisted living provider can be a good option.  Assisted living residences are for residents who would like to, and can, maintain some independence but need help with meals, housekeeping, and some of the activities of daily living (ADLs), such as showering, getting dressed, or personal hygiene.

Assisted living facilities in Nebraska are designed for older adults who need assistance with their daily living activities. The Nebraska Division of Public Health, Department of Health and Human Services, Department of Licensure and Regulation licenses assisted living communities across the state.   

In Nebraska, any establishment that provides assisted living care for four or more individuals who aren’t relatives of the owner must have a license to operate.

Independent Living Communities

Independent living communities are a good housing option for seniors who can still live independently but want to downsize. Each resident or couple lives in a private unit, and most communities offer social programs so residents can meet their neighbors. Housekeeping, chores, and some meals may be provided, although these may incur an additional cost. Unlike the care given in an assisted living community, assistance with activities of daily living and medication management aren’t available in these communities. 

Nursing Homes

Nursing homes offer the highest level of care of all senior living options. These communities provide around-the-clock supervision and skilled nursing care, and available medical help. Generally, people in nursing homes have complex medical issues or need more residential care than is offered in an assisted living facility. Nebraska has skilled nursing facilities (SNF) for people who require 24-hour care and intermediate care facilities (ICF) for people who don’t need as much medical care. The average cost of nursing home care in the state is $7,483 for a semi-private room and $8,289 for a private room.

Continuing Care Retirement Communities (CCRCs)

Many seniors prefer to choose a community that will continue to meet their needs in the future. Continuing care retirement communities have independent living, assisted living, and nursing home facilities on the same property or owned by the same community. This model allows seniors to stay near their friends in familiar surroundings, even as their needs change. The care provided in the assisted living section of a CCRC is the same as in an assisted living community. The difference is that residents can easily move to a skilled nursing room if required. Often, CCRCs are bigger than ACHs, as they encompass more care options. 

Supportive Housing

Supportive Housing is a residential facility designed for older adults or persons with disabilities who are unable to live independently.  These individuals need help with toileting, bathing, dressing, medication management and administration, assistance with meals and housekeeping, and other activities of daily living.  These individuals do not need regular nursing care.  There are several housing options available that range from living in a facility to residents living in their own home or apartment, with community-based support services.

Adult Day Care

In homes where the primary caregiver works during the day, older adults may be able to attend an adult day care program instead of staying at home alone. In Nebraska, adult day services provide supervision and services based on individual needs, which may include:

• Nursing care.
• Medication administration.
• Therapeutic activities.
• Social services.
• Social activities.
• Help with personal care and daily living activities.

Adult day care services aren’t provided 24/7, whereas assisted living services are. Adult day care is not an option for people who need around-the-clock supervision, monitoring, care, or assistance in a residential or institutional environment, such as assisted living communities or nursing homes. In Nebraska, adult day health care costs an average of $1,690 per month.

In-Home Care

There are two types of in-home care available in Nebraska: homemaker services and home healthcare. Homemaker services generally provide personal care and may also help with errands, chores, and housekeeping. Home healthcare can deliver these services and offer medical care such as skilled nursing and medication management. Unlike assisted living care, in-home care is provided to people in their homes, making it a good choice for those who prefer to age in place. However, it doesn’t give seniors access to social and recreational programming for assisted living communities. The average cost of homemaker services is $5,148 and the average cost for home health aides is $5,339 per month.

Largest Providers Of Assisted Living In Nebraska

There are over 200 assisted living communities throughout Nebraska, with over 11,000 licensed beds for residents.  Several companies control or manage multiple communities in the state.  CountryHouse has 7 communities, The Heritage has six communities and Bickford manages four facilities in the state.

Quality and Safety of Assisted Living Facilities in Nebraska

Under the Nebraska Administrative Code, Title 473, Chapter 6, assisted living communities must have a license from the Department of Licensure and Regulation. Communities must adhere to standards related to health, safety, and quality. Communities comply by having robust emergency procedures in place, following fire safety and food hygiene regulations, having documented operational procedures, obeying building layout and amenities requirements, adhering to staffing requirements, and training employees.  

Community staff must also pass criminal background checks. Before hiring staff, communities must check against the sex offender registry, nurse aide registry, adult central registry of abuse and neglect, and the central child registry of abuse and neglect. They cannot hire anyone in a direct care position who has a negative result on the nurse aide registry. Discretion is allowed in cases of adverse findings on other registries or criminal background checks. Still, communities must clearly document their reasons for employing an individual. Where results indicate abuse, theft from residents, or exploitation, communities must also show that their hiring decision won’t pose any risk to residents.    

Administrators must hold a valid hospital or nursing home license or complete 30 hours of initial training followed by 12 hours of ongoing training. Direct care staff must complete orientation training and at least 12 hours of job-specific training each year. Staff members who provide care to residents with dementia must have additional training. Only licensed health care professionals or trained medication aides can administer medications.

While there are no set staffing ratios, assisted living communities must have sufficiently trained staff available at all times to provide resident care. And at least one staff member must be on-site and awake at all times.

Cost Of Assisted Living Care In Nebraska

The average cost of assisted living care in Nebraska is $4,076 per month. This is $424 lower than the national average of $4,500 per month.  The cost of living in Nebraska is 10.9% lower than the national average with healthcare costs nearly 32% higher and housing costs 26.9% less than the national average. The exact price of care differs depending on where in the state you’re located. Costs in the state range from $2,906 in Grand Island to $4,715 in Lincoln. 

How Costs Compare In Nearby States

If you live close to Nebraska’s borders, you may find assisted living in a neighboring state is an affordable option.  Two of Nebraska’s neighbors have a higher average cost for assisted living.  Colorado and Kansas have an average cost of $4,750 and $4,580, while South Dakota and Missouri have lower average monthly costs at $3,350 and $3,000.

Paying For Assisted Living Care In Nebraska

The average cost of assisted living in Nebraska is around $48,000 per year, so you or a family member may be wondering how to pay for care. A range of options is available to fund senior housing in the state. 

Private Funds

Selling a home is a common way for seniors to raise funds for assisted living care. Income from pensions and Social Security may also pay for some care. Other examples of private funds include your retirement accounts, mutual funds, and other investments. 

Long-Term Care Insurance

Long-term care insurance covers personal care, residential care, and other long-term support and services. Each plan is different; however, most offer a daily amount based on the policy that pays for assistance with activities of daily living. Most people buy a policy in their 50s or 60s and access it when required. If you or your family member has a policy, read it carefully to see what care it covers. 

Nebraska Optional State Supplement

Nebraska has an optional state supplement for SSI beneficiaries, which enhances a recipient’s monthly SSI payment. The supplement is available for anyone who is aged, disabled, or blind and meets financial eligibility criteria, except for individuals who live in public institutions and don’t receive Medicaid funding. Nebraska calculates the supplement by deducting the federal SSI payment and other countable income from a set state standard amount; any amount remaining after deductions is the state supplement. Recipients may use their additional income to pay for assisted living costs.

Programs For Veterans

Nebraska has four Veterans Homes around the state, in Kearney, Bellevue, Norfolk, and Scottsbluff. These homes provide skilled nursing care to residents of Nebraska who served in the military. The state’s Department of Military and Veterans Affairs also has offices where team members can help people obtain benefits and services. This includes the Aid and Attendance Benefit, which can help qualified veterans fund personal care. 

Elderlife Financial can help you understand how to pay for assisted living.

What Is Included With Assisted Living Care In Nebraska?

The services provided in assisted living communities generally come under three broad categories: personal care, medical care, and amenities. 

Most people move to assisted living communities because they look for easy access to personal care. These services assist with activities of daily living, such as bathing, dressing, walking, and toileting. Communities also provide supervision and can deliver care for unforeseen needs or in cases of emergencies.  

In Nebraska, ACHs must provide care and services in the resident’s care plan. This can include coordinating medical care and appointments. Communities may also deliver health services, with 55% of communities providing skilled nursing. Many have healthcare specialists and on-site services, with 71% of communities offering dental care. In addition, 80% of ACHs have hospice services.

ACHs may provide specialized care for people diagnosed with Alzheimer’s disease or other forms of dementia. These special care units have additional security measures to ensure residents don’t wander, a common symptom of Alzheimer’s disease. Typically, they also offer programs designed to improve cognitive function and routines that help lower stress.

Mental health issues are a growing consideration for communities, and services to address these concerns are becoming more common. In Nebraska, 79% of communities conduct depression screening, and 61% offer mental health counseling. Social work programs are also found in 48% of ACHs. Social workers can provide counseling, conduct assessments, and help ensure residents have access to all the resources they need.

Amenities refer to other features and services of the community. ACHs offer three meals a day and coordinate activity programs to help residents stay active and connected with their families and the community. Nebraska facilities must also provide transportation and laundry services and may offer housekeeping services. 

Wellness Resources in Nebraska

Nebraska has more than 110 hospitals, with a total of over 7,000 beds. There are approximately 5,000 physicians in the state, most of whom accept Medicare. Nebraska is home to several high-performing hospitals, including Nebraska Medicine in Omaha, Bryan Medical Center in the state capital of Lincoln, CHI Health Good Samaritan in Kearney, and CHI Health St. Francis in Grand Island. Many state clinics, health centers, and pharmacies further support resident health.   

Mental Health Resources

Nebraska Department of Health and Human Services, Division of Behavioral Health Services, operates programs to support and maintain mental health. Available 24/7, the toll-free 211 Nebraska hotline provides free, confidential information about local services. Alternatively, individuals can use the live chat service during business hours, complete an online contact form, or contact via the mobile app. The nonprofit Mental Health Association of Nebraska (MHA-NE) provides peer-to-peer support for people experiencing mental health challenges. The National Alliance of Mental Health (NAMI) has a branch in Omaha. 

Veterans can access programs, information, and counseling via the Nebraska Department of Veterans Affairs. The national 24-hour Veterans Crisis Line and Roger, which is part of Stop Soldier Suicide, provide crisis intervention for former members of the U.S. Armed Forces.

The Transition Into Assisted Living In Nebraska

The decision to move into an assisted living community can be difficult. Generally, you’ll notice changes in your loved one that suggest they need some assistance. Signs that this environment could be beneficial include increased isolation, loss of mobility, noticeable weight loss or gain, and signs that they’re neglecting household chores. 

Your older family member may be the one to start talking about assisted living. For many seniors, the idea of moving into a home where cooking, laundry, and other chores are taken care of is appealing. For seniors who realize they need help with daily tasks, the addition of personal care may come as a relief. In Nebraska, 12% of residents need help with eating. Other commonly used services include bed transfer (18%), toileting (24%), and walking (55%). Caregivers in ACHs help 34% of residents to dress, and 69% of residents need help bathing. 

If you think your family member would benefit from assisted living, start talking about it openly. Highlight the positives of a move, such as social activities, cooked meals, and easily accessible assistance. Some ACHs provide respite care, which may allow your family member to have a trial run. Remember, this should be a conversation, not a lecture. Stay open to their opinion. If they’re not ready to transition to assisted living, talk about the care they need to stay at home. 

Nebraska Assisted Living Oversight

The Department of Licensure and Regulation of the Nebraska Division of Public Health is responsible for overseeing Nebraska’s assisted living communities. To ensure regulatory and legal compliance, the department can make on-the-spot visits to any community and random sampling visits throughout the year. Nebraska’s Long-Term Care Ombudsman program investigates complaints against assisted living facilities, nursing homes, and other senior residential care providers. Ombudsmen also educate older adults about their rights related to long-term care and help people resolve issues concerning quality of care. 

Individuals can contact the Medicaid and Long-Term Care team of DHHS for assistance related to funding, social service, and medical support.  

Legal Resources

The term “elder law” is often associated with estate planning, trusts, and help obtaining benefits through Medicare or Medicaid. Unfortunately, the field has grown to include cases involving elder abuse, elder neglect, and exploitation. Skilled attorneys can help older adults affected by these issues.

In Nebraska, Adult Protective Services operates a hotline for reporting abuse against older adults. The State Unit on Aging, Long-Term Care Ombudsman, Office of the Attorney General, and local Area Agencies on Aging can also help people facing elder abuse, fraud, or exploitation. The Senior Medicare Patrol, administered by Nebraska SHIP, provides help related to Medicare scams, fraud, and abuse.

Nebraska’s eight Area Agencies on Aging can help older adults access free or affordable legal services. Agencies partner with Legal Aid of Nebraska to offer the Legal Assistance program. People aged 60 and over can call the Legal Aid of Nebraska’s ElderAccessLine for free civil legal advice and assistance in areas including public benefits, health insurance, debt, consumer matters, wills, powers of attorney, and advance directives.