Memory Care in Nebraska

Table of Contents

Memory Care in Nebraska

Table of Contents

• The Cost of Memory Care in Nebraska
• Nebraska Medicaid Programs for Memory Care
• Can You Use Medicare to Pay for Memory Care in Nebraska?
• More Ways to Pay for Memory Care in Nebraska
• Memory Care Laws and Regulations in Nebraska
• Free and Low-Cost Resources for Seniors in Nebraska
• Nebraska COVID-19 Rules for Memory Care Facilities

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When figuring out how to pay for memory care, you first need to understand how much it will cost for your loved one to move to a quality community. As costs continue to rise, it's vital to have the latest details when planning for elderly care costs. In order to shed light on the impact of inflation on senior living costs, MemoryCare.com has gathered cost information from its network of over 75,000 senior living communities. These prices are based on the cost of Memory Care in Nebraska and 4 other cities in Nebraska.

How Inflation Has Impacted the Cost of Memory Care in Nebraska

Inflation has increased the cost of memory care by 10.4% across the United States from 2022 to 2023, making thorough planning essential for seniors requiring care. Expenses in Nebraska rose 7.2%, slightly less than the U.S. average, but this is still a greater increase than some surrounding states, such as Kansas, where memory care rates jumped by only $107‬. Prices in South Dakota fell 0.8%, while Iowa and Colorado experienced substantial increases of 10% and 11.7%, respectively.

Memory care costs are expected to continue rising into 2024. The Nebraska average may hit $6,914, while Iowa's could rise to $6,299.

Memory Care Costs in Nebraska's Top Cities

Although inflation has affected the cost of care in most cities throughout Nebraska, prices vary significantly depending on where seniors live. At $5,998, Omaha has comparable memory care rates to the state norm, while Lincoln's $5,273 average is considerably cheaper. Elkhorn is relatively expensive at $6,995, and Grand Island is one of the most costly areas overall, with memory care costing $1,173 more than the state average.

The Cost of Other Types of Senior Living

Memory care requires staff with specialized knowledge and training, and seniors with dementia typically need more daily assistance, resulting in higher costs than other types of care. It averages $5,997, much steeper than the $5,043 cost of assisted living. Independent living, in comparison, requires minimal staffing and averages just $3,040. However, families should typically choose the level of care, services and amenities that match their loved one's needs before comparing expenses.

Although Medicaid doesn't cover the cost of memory care in Nebraska, seniors may be able to get some financial assistance through the state's Aged and Disabled Waiver Program. Medicaid does ensure that low-income seniors are able to cover some of their health care costs.

• Who is eligible: Seniors must be 65 years or older and reside in the state of Nebraska. They must also meet certain financial and medical criteria in order to qualify. 
• How to apply: Applicants can apply online through Access Nebraska or in person at their local Department of Health and Human Services Office.

Aged and Disabled Waiver Program

The Aged and Disabled Waiver Program helps seniors cover the costs of care in an assisted living or memory care facility. The program is provided on a sliding scale, with benefits depending on the senior's income and care requirements. Some of the services that may be covered include personal assistance with the tasks of daily living, housekeeping, nonmedical transport, recreational activities, health monitoring and medication reminders. Unfortunately, the waiver does not cover the costs of room and board. 

• Who is eligible: Applicants are required to be 65 or older and meet the medical requirements of the program. They must meet the income guidelines of Medicaid and be U.S. citizens or legal residents.
• How to apply: Seniors can apply for this waiver at their local Area Agency on Aging or by contacting the Department of Health and Human Services at 800-358-8802.

Medicaid Eligibility for Seniors in Nebraska

Medicaid benefits are available to seniors who have limited financial resources available and may be unable to afford the health care they require. In Nebraska, single applicants are limited to an income level of $13,596 per year and married couples may not earn more than $18,312 on an annual basis. Assets may not exceed $4,000 for individuals and $6,000 for dual applicants. 

2022 Medicaid Income Limits for Seniors in Nebraska

To qualify for the long-term care benefits offered by Medicaid, seniors must meet certain other criteria:

• Reside in the state of Nebraska
• Be a U.S. Citizen or Legal Resident
• Meet certain medical requirements

A list of items that may be required at the time of application include:

• Social Security number
• Proof of current address
• Proof of monthly and annual income
• Current expenses
• Proof of U.S. citizenship or legal resident status
• A list of assets and proof of ownership of the assets
• Power of attorney
• Information regarding current insurance policies

How to Get Help Applying for Medicaid in Nebraska

Seniors and their family members who require help completing the Medicaid application form may contact one of the agencies or departments listed in the table below.

Unfortunately, Medicare does not generally cover the cost of Memory Care. Most Memory Care Facilities are considered to be "social settings," so Medicare does not cover the cost incurred in these facilities. The only exception to that is if you are receiving memory care services in a Nursing Home. While this situation is much less common, Medicare would sometimes cover the cost, depending on a number of circumstances.

That being said, Medicare does still cover qualified doctor visits, medications, etc., as it would if you were still at home, but it will not cover the cost of care received at the Memory Care Facility.

In addition to the state programs mentioned above, those looking for resources to finance memory care may consider:

• Long-Term Care Insurance: Depending on the policy details, long-term care insurance may be used to pay for memory care services. It's best to sign up for a policy early, as coverage will likely be denied if one already has long-term care needs. More information about the intricacies of long-term care insurance can be found at longtermcare.acl.gov.
• Reverse Mortgages: Reverse mortgages allow some homeowners to take out a loan as an advance from the eventual sale of their primary residence. This can be a good way to fund memory care in the short-term, but the loans will need to be paid back after the sale of the home. The most commonly used type of reverse mortgages for seniors is the Home Equity Conversion Mortgage, which is the only reverse mortgage insured by the federal government.
• Veterans Benefits: The Department of Veterans Affairs offers several programs that veterans and their spouses may use to cover health care needs such as memory care. More information about these programs can be found on the VA website.

Memory Care Regulation

Assisted living facilities (ALFs) that offer memory care services are licensed and regulated through the Nebraska Department of Health and Human Services, Licensure Unit. ALFs provide shelter, meals and care for a minimum of four residents, and may contain an Alzheimer’s special care unit (ASCU), which is a secure, segregated area for residents with Alzheimer’s disease, dementia or a related cognitive disorder. ASCUs may also be freestanding facilities that specialize solely in memory care.

As part the initial licensing process, and each subsequent renewal, ALFs must file a written document with the DHHS that includes:

• A description of the services offered and the staff that provides them
• A breakdown of the facility’s charges
• The facility’s move-out requirements
• The facility’s resident services agreement or updates to the agreement
• Whether Medicaid is accepted and any related policies or limitations

ALFs that are marketed as offering memory care must file a separate statement that details the facility’s:

• Philosophy and mission
• Admission, transfer and discharge criteria
• Resident assessment practices and policies
• Staffing guidelines
• Physical features and activities that support dementia care
• Policies regarding family involvement

To receive and maintain a license in Nebraska, ALFs must pass initial and periodic inspections to ensure compliance with state regulations. The DHHS randomly inspects up to 25% of all ALFs each year, and may make an unscheduled inspection when an accident, resident injury or death or other concerning incident occurs, or if a complaint is filed against a facility. All ALFs are inspected at least once every five years.

Facility Scope of Care

ALFs and ASCUs must provide services that promote the well-being, safety and health of seniors in a residential setting. At minimum, the scope of care should include admission and continued-stay assessments, accommodations, three daily meals, 24-hour access to staff and support with activities of daily living (ADLs). Facilities may also provide:

• Case management
• Personal care
• Transportation
• Housekeeping and laundry services
• Beauty and barber services
• Behavioral management
• Spiritual activities
• Up to 10 hours per week of nursing services, for a duration of no more than 21 days

Residents or their legal representatives may also arrange for care services through a licensed hospice or home health agency, or from private duty personnel, if they assume responsibility.

Admissions Requirements

ALFs in Nebraska may accept residents with a range of care requirements and conditions, but must follow state regulations regarding who may be admitted. The following table offers details about the conditions that determine if a person may or may not receive care in an assisted living setting:

Residents Who May Be Admitted

Seniors and adults with:

• Physical, developmental or intellectual disabilities
• Stable chronic illnesses
• Mental health conditions
• Alzheimer’s disease and other forms of dementia
• Controlled behavioral issues

Residents Who May NOT Be Admitted

Individuals who:

• Require complex, ongoing nursing care
• Have unstable or unpredictable conditions
• May pose a danger to other residents or compromise facility operations

Care Plan Requirements

An ALF must evaluate each new resident to determine their care needs. A care plan or resident services agreement must be then drawn up that outlines the services the facility will provide to meet the person’s needs, and details the cost of these services. This plan must be reassessed and updated as the resident’s condition and care needs change.

Medication Management Requirements

Each resident entering or living in an ALF or ASCU must provide the facility with an annually updated list of all prescription drugs, biologicals, supplements and devices used or taken. The dosage, reported use and instructions for use must be included.

Facilities responsible for providing access to or administering medications may accomplish this in one of three ways:

• Residents deemed capable of doing so may self-administer medications with or without supervision
• A licensed health care professional may administer medications
• A trained, competent medication aide may administer medications with appropriate direction and monitoring

Facility Requirements

ALFs and ASCUs must meet the state fire codes and standards to ensure resident safety. Each facility is inspected by the Nebraska State Fire Marshal and the specific requirements for fire alarms, sprinkler systems and fire drills are determined by the evacuation capabilities of its residents.

Resident accommodations in an ALF or ASCU may consist of a single bedroom or an apartment. If apartments are provided, they must feature separate sleeping and kitchen areas, and a private bathroom containing a sink, toilet and tub or shower.

ALFs built before 2007 may house four residents per unit, while a maximum of two residents are allowed per unit in facilities constructed after that date. Older facilities must have a sink and toilet for every six residents, and a bathing room for every 16 residents. Newer facilities must provide one sink and toilet for every four resident beds, and one bath or shower for every eight residents. With new construction, a toilet room with a handwashing sink is required for each bedroom, and a minimum of one bath or shower room to serve every eight bedrooms.

Staffing Requirements

ALFs and ASCUs in Nebraska are required to employ an administrator who is responsible for the facility’s overall day-to-day operations, as well as a substitute to act in the administrator’s absence. Facilities must have sufficient direct care staff on duty to provide adequate personal care to residents, and trained medication aides to administer medications. Each ALF must also appoint a registered nurse to review the facility’s medication administration policy and procedures annually, and oversee medication aide training.

Administrators must complete 30 hours of relevant training during the first six months of their employment, while an orientation and training related to their duties is required for direct care staff. All staff must complete a minimum of 12 hours of ongoing training per year.

The administrator and care staff of an ASCU or memory care facility must receive training in the Alzheimer’s disease process, and the facility’s dementia care and supervision philosophy. Skills training in providing care for those unable to perform personal care, who may wander or have behavior issues is also required. All staff must receive a minimum of four hours of dementia care continuing education annually.

Medicaid Policy

Nebraska’s state Medicaid plan does not pay for care in ALFs and ASCUs as an entitlement. However, the state offers the Medicaid Aged and Disabled waiver to help cover the cost of provided services, certain assistive technology and some supplies in these care settings. Nebraskans who qualify for the waiver are responsible for paying the room and board portion of their facility fees. The A & D waiver is also subject to an enrollment cap, and depending on availability, eligible applicants may be placed on a waiting list before being accepted into the program.

Reporting Abuse

Nebraska residents have several available options to report an incident of abuse or neglect in an ALF or ASCU. If the incident occurred in a facility that receives Medicaid payments, concerned individuals may file a complaint with the Medicaid Fraud and Patient Abuse Unit of the Nebraska Attorney General’s office. Alternatively, they may report the incident to the DHHS Licensure Unit, or call 800-942-7830 to contact the local Long-Term Care Ombudsman.

In Nebraska, there is an abundance of resources designed to assist seniors throughout their retirement. MemoryCare.com has compiled information on a range of local organizations, programs, and agencies, categorizing them based on the care services they offer for easy browsing.

Area Agency on Aging

The Area Agency on Aging in is a crucial asset for retired individuals, providing advice on financial assistance, home-based care, and planning for extended care. It also connects seniors and their caregivers with local resources.

Cash Assistance Programs

Financial assistance initiatives exist in Nebraska to help seniors with low income sustain their home living. These initiatives provide tax reductions, discounts on crucial services, and aid for home temperature regulation costs.

Food Assistance Programs

In Nebraska, numerous community programs focus on enhancing the health of seniors via proper diet. These initiatives provide meal delivery, shared meals, and food bank services, guaranteeing that older citizens can obtain reasonably priced, healthy food.

Free Used Medical Equipment

In Nebraska, several organizations are tackling the high cost of new medical devices. They collect lightly used equipment such as wheelchairs, ramps, and walkers, distributing them to local elderly and those requiring assistance.

Home Repair and Modifications

In Nebraska, a variety of programs exist to support seniors and those with disabilities in funding home improvements and repairs. These initiatives, providing grants or loans, feature different eligibility criteria tailored for retired individuals.

Legal Resources

In Nebraska, there are several organizations offering cost-effective or free legal aid to senior citizens. They provide advice on issues such as estate planning, living wills, and power of attorney. Some also champion the rights of the elderly in long-term care establishments.

Medicaid Resources

Grasping Medicaid complexities, particularly for the elderly, can be daunting. A wealth of resources in Nebraska provide insights into Medicaid options, waiver programs, and qualification criteria, aiding seniors in obtaining suitable health care benefits.

Senior Centers

In Nebraska, elderly individuals find a community hub in senior centers, offering a range of recreational pursuits, events, and essential resources. These centers also provide health programs, dietary advice, and support for issues related to senior living.

Senior Engagement

In Nebraska, numerous initiatives are in place to keep seniors involved and energetic. These encompass health programs, opportunities for volunteer work, and supportive communities, all designed to promote social participation and improve the quality of life.

Social Security Offices

In Nebraska, Social Security offices are crucial resources for the elderly and those with disabilities. They provide advice on retirement perks, disability benefits, and additional security income.

Tax Assistance

In Nebraska, a variety of tax assistance options exist for seniors and people with disabilities. These encompass possible medical cost exemptions, property tax cuts, and other tax alleviation measures.

Utility & Energy Bill Assistance

In Nebraska, there are establishments ready to assist seniors with limited income facing challenges with home upkeep expenses, such as energy and utility bills. Emergency financial support might be available for individuals threatened with utility disconnection due to outstanding payments.

Veteran's Services

In Nebraska, retired military personnel can find essential support through local veteran services. These organizations help veterans access their deserved benefits and offer advice on a variety of issues.

Note: The following information was compiled and most recently updated on 2/8/2022. Since COVID-19 is a rapidly evolving crisis, be sure to contact your Memory Care Facility or local Area Agency on Aging for the most up-to-date information.