Nebraska is home to about 2 million people, and it has a large senior population that accounts for over 16% of the population. It supports its aging population through over 200 nursing homes and skilled nursing facilities, as well as nearly 100 hospitals, including four that provide long-term care. Among its top-ranking hospitals are Nebraska Medical Center and Bryan Medical Center, both of which specialize in senior care.  

Nursing homes in Nebraska provide private and semiprivate rooms, three daily meals, social services, nursing services and most of the medical supplies and equipment residents need. On average, seniors in the state pay $7,194 per month for semiprivate accommodations. Private rooms are a little costlier at $7,931 monthly.   

This guide provides an overview of the cost of nursing home care in Nebraska and how it compares to fees in nearby states and other types of senior care. It outlines the state’s programs and agencies that can help seniors find alternatives to nursing home placement or options for covering costs. The guide also summarizes the rules and regulations that nursing homes in the state must comply with to maintain licensing.   

The Cost of Nursing Home Care in Nebraska

According to the Genworth 2020 Cost of Care Survey, semiprivate rooms in nursing homes in Nebraska cost $7,194 per month, which is about 7% cheaper than the national average of $7,756. While this state is a relatively affordable option for this level of care, several of its bordering states have lower monthly fees. In Iowa, which borders on the east, seniors pay the lowest fees in the region of $6,570 per month. In Kansas, to the south of Nebraska, fees come in at $6,692, and in South Dakota, nursing home care costs $7,011 per month. Wyoming is the only neighboring state with higher care costs, with fees exceeding the national average at $8,258 per month.  

$7194

Nebraska

$7756

The United States

$7011

South Dakota

$6570

Iowa

$6692

Kansas

$8258

Wyoming

Nursing home fees vary depending on factors such as local living costs, amenities and service fee schedules. The most affordable city for nursing home care is Grand Island, where seniors pay approximately $6,608 monthly. In the capital city of Lincoln, fees are closer to the state median at $7,254, and in Omaha, the state’s most populous city, fees are the highest at $8,182 per month. Across state lines, local nursing home fees range widely. Manhattan, Kansas, which is about 70 miles south of Nebraska’s border, is one of the cheapest nearby cities at $5,735 monthly. In Sioux Falls, South Dakota, fees exceed Nebraska’s median at $7,650. Cheyenne, Wyoming, is one of the most expensive nearby cities at $8,547 per month.  

$6608

Grand Island

$7254

Lincoln

$8182

Omaha Area

$7650

Sioux Falls, SD

$8547

Cheyenne, WY

$5735

Manhattan, KS

Nursing home care is the most expensive senior care option in Nebraska, and seniors who need short-term or intermittent skilled nursing services may have more affordable options. Home health care, which features personal care, housekeeping and some nursing services in the individual’s home, is considerably more economical, with monthly fees averaging $4,957 for 44 hours per week of care. In-home care, which includes homemaker services but doesn’t offer nursing care, is a little cheaper at $4,862. Limited skilled nursing services may also be administered in assisted living facilities, where seniors pay $4,188 per month. The most affordable senior care option in Nebraska is adult day care, which costs $1,560 per month.  

$4862

In-Home Care

$4957

Home Health Care

$1560

Adult Day Care

$4188

Assisted Living Facility

$7194

Nursing Home Care

Financial Assistance for Nursing Home Care in Nebraska

Most people do not pay for skilled nursing care entirely out-of-pocket. Rather, they utilize financial assistance programs to help cover the cost of nursing care. Of public financial assistance programs, Medicaid provides the most comprehensive coverage of nursing home care. But, not all seniors are eligible for Medicaid. And because each state operates its own Medicaid program within federal guidelines, eligibility and benefits vary from state to state. Below, we provide more information on Medicaid in Nebraska.

Nebraska’s Medicaid Program

As of September 2020, 266,738 Nebraskans were enrolled in Medicaid and CHIP, which is a 9% increase over the number of enrollees in 2013. The state’s Medicaid program covers nursing home services for eligible seniors, along with some skilled nursing services provided in private homes and assisted living facilities.  

Medicaid coverage for nursing home care is available to seniors who meet income and asset guidelines. Applicants must also meet nursing facility level of care criteria and have a Preadmission Screening and Resident Review, which must be submitted to the Department of Health and Human Services prior to admission. The state mandates that prospective nursing home residents be medically stable, require around-the-clock care and supervision and have health issues that need daily care from a skilled, licensed professional. To have services covered by Medicaid, the nursing home must provide standard rooms, nutrition services, nursing and routine services and most medical supplies and equipment. Statewide, there are approximately 206 licensed nursing homes and skilled nursing facilities serving more than 15,000 people annually.  

Medicaid Eligibility in Nebraska

To be eligible for Medicaid, Nebraska seniors must be at least 65 years old, permanent residents of Nebraska, legal U.S. residents or citizens and require a nursing home level of care. They can have a monthly income of up to $1,073 per month,  including cash gifts, veterans’ benefits, pension payments, disability benefits, Social Security benefits and withdrawals from retirement accounts. Individuals can have up to $4,000 in countable assets. Spouses who are both applying for Medicaid to cover nursing home care can have up to $1,452 in monthly income and $6,000 in countable assets.  

Alternative Financial Assistance Options

  • Medicare: Medicare will cover the cost of one’s care in a skilled nursing facility for the first 20 days of their stay, and a portion of the costs up until day 100. After 100 days, the individual is responsible for all costs. Seniors must also have a “qualifying hospital stay” of at least 3 days prior to their admission to a nursing home in order to qualify for Medicare coverage.
  • Aid and Attendance: 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: 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 Insurance: 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.

Free and Low-Cost Resources for Seniors in Nebraska

Nebraska offers several programs and organizations that provide services for seniors who need skilled nursing care. Some resources help seniors delay or avoid nursing home placement by obtaining the care they need at home, while others help them find solutions for paying for care when nursing home placement is necessary.  

Resource Contact Service 
Nebraska SHIP (800) 234-7119 
(402) 471-2841 
Nebraska SHIP provides advice, assistance and guidance for Medicare-eligible seniors to help them identify ways to cover care services at home or in a nursing home. Through this program, counselors provide free, unbiased information regarding Medicare benefits, Medicare Advantage and Medigap plans, Medicaid and its waivers and long-term care insurance. It can also help seniors understand and organize their medical bills and dispute billing errors and denied insurance claims.   
Aging and Disability Resource Center (844) 843-6364 The statewide ADRC is a referral network that helps seniors connect with local services and supports. It maintains an up-to-date online database of local nonprofit organizations that provide services, financial assistance and care planning. Seniors can also call the toll-free helpline for one-on-one assistance from an agent or visit their local ADRC office
Nebraska Department of Veterans Affairs (402) 471-2458 The statewide Department of Veterans Affairs serves qualifying veterans and their spouses or survivors through information, advocacy and benefits programs. It administers the Aid and Attendance Benefit, which helps cover services in the home or a long-term care facility. The Department can also help veterans determine whether they qualify for health care services through the VA or admission into the state’s veterans’ homes
Legal Aid of Nebraska (800) 527-7249 Legal Aid of Nebraska provides free and low-cost specialized services for older adults. Through the statewide agency, seniors can obtain assistance with drafting wills and advance directives and assigning guardianship and powers of attorney. The firm can also help older adults access public benefits that cover nursing home care in home-based services, including Medicare and Medicaid. 
Long-Term Care Ombudsman (800) 942-7830 Nebraska’s Long-Term Care Ombudsman advocates on behalf of seniors living in nursing homes, ensuring that they understand their rights and receive the services they’re entitled to. The ombudsman can investigate reports of abuse and neglect, help seniors and families develop solutions for issues they face in long-term care communities and mediate interpersonal disputes. The office can also make recommendations for protecting residents’ rights and improving their care and quality of life.  
Community Action of Nebraska (402) 471-3714 Community Action of Nebraska is a nonprofit organization that provides a broad range of services to seniors. Services vary on the local level but generally include free weatherization and emergency energy bill assistance, case management, transportation services and home-delivered meals.  

Nursing Home Laws and Regulations in Nebraska

Licensing Requirements All nursing homes in Nebraska are required to be licensed through the Nebraska Health and Human Services Department. The initial license must be obtained at least 30 days before the facility opens. The facility must renew its license on an annual basis.  
Staffing Requirements While Nebraska doesn’t enforce specific staffing ratios in nursing homes, facilities are required to have enough qualified staff members at any given time to meet residents’ needs for assistance with personal care, daily living activities, supportive services, supervision and medical care.  
Staff Training Requirements Nursing homes must provide initial and ongoing training by an individual who meets knowledge, education and experience qualifications. Training includes an initial orientation that outlines residents’ rights, emergency procedures, job duties and responsibilities and medical emergency directives. Ongoing training varies for nursing assistants, medication aides and food service directors and must be relevant to their job duties. 
Admission Restrictions Nursing homes can only admit residents who have a physician’s written approval. The residents can only live in the facility for as long as it’s able to meet their needs for care, treatment and supervision.  
Care Planning Requirements Nursing homes must develop and implement care plans for each resident to ensure that they provide the degree and quality of care needed. The care plan must include: A comprehensive, interdisciplinary assessment of the resident’s needs Measurable objectives to meet the resident’s needs The services that the resident is to receive and who is to provide them Time-specific and measurable goals for the resident A personalized discharge plan A preliminary care plan must be developed within 24 hours of the resident’s admission, and a comprehensive care plan must be created within seven days of admission. It must be reviewed and revised quarterly or when the resident’s needs change.  
Dietary and Nutritional Services Requirements Facilities are required to provide residents with three nourishing, well-balanced meals daily that meet their nutritional and special dietary needs. Menus must be developed based on the Food and Nutrition Board of the National Research Council and accommodate the food preferences of residents. Those who refuse food must be offered substitutes that are similar in nutritive value. 
Specialized Rehabilitative Services All nursing homes must provide specialized rehabilitative services as ordered by a medical practitioner and outlined in the residents’ care plans. These services must be designed to preserve and improve residents’ abilities to function as independently as possible. If the facility doesn’t have qualified personnel to provide these services, it’s required to contract with a third party that meets its professional standards.   
Medication and Pharmaceutical Services Nursing homes must employ or obtain the services of a state-licensed pharmacist to provide the development, implementation and supervision of pharmaceutical services. They must abide by state guidelines pertaining to acquiring, storing, administering and disposing of prescription drugs. They’re also permitted to buy nonprescription drugs in bulk.  
Activities Requirements  Nursing homes are required to designate a qualified resident activities director who provides daily activities to promote residents’ physical, spiritual, social, emotional and intellectual well-being. Residents should be encouraged, but not forced, to participate in activities.  
Infection Control Requirements  All facilities must maintain practices that promote a healthy environment and avoid sources and transmission of infections and communicable diseases. This includes ensuring that facilities have measures in place for recognizing and controlling infections and preventing cross-contamination. 
Medicaid Coverage Nursing home services in Nebraska are covered under the state’s Medicaid program for those who meet medical eligibility and income and asset requirements. Medicaid also covers nursing services for seniors who live in a private residence or a residential care community.