Medicaid Reimbursement

$ 1

2017 was reimbursed based off of 2015’s costs estimates. The deficit was $25 per patient per day.

$ 1

This year nursing homes will be paid $36 per patient per day less than the cost of care.

LB468 putting off managed care.

Managed care would only divert more funds from a nursing home to administrative costs. This would mean that any headway in other bills that may be made could be undone. Managed care leads to less timely payments as well which would negatively impact our facilities.

LB403 Stopping the Negative inflation factor

The last two years DHHS has used the inflation factor as a deflation factor instead of its intended use. LB403 would not allow DHHS to make the factor less than 0%. Last year it was -2.65%, and this year they gave us a -7.17%.

LB404 Give nursing homes their own bucket

DHHS has used the inflation factor to match their budget instead of following the appropriations committee and using it for actual inflation. LB404 would give more transparency to where the money is going and give nursing homes their own bucket.

Customers reviews


The increased money needed for agency staffing combined with the decreasing money received from the State of Nebraska is putting a huge toll on our operating budget. I am very concerned as to what the future holds for our small-town nursing home.
Kathy Engel
With all of the nursing homes that have closed and those that are in financial trouble I would think the state would realize that cut backs such as those proposed would cause a catastrophe in the nursing home business in the state of Nebraska.
Ron Vaca
Board Member St Joseph's Villa

About Us

Rural Health Development is a provider of management services for rural nursing homes in Nebraska. The nursing facilities in Nebraska are facing a “perfect storm” that will have drastic results for the communities in Nebraska, which includes the closings of many small, rural nursing homes.


Our mission is to inform the public of the current severe Nursing Home Crisis and the culmination of events that has led to it. We need to discuss possible solutions to overcome the financial crisis that small, rural nursing homes in Nebraska are finding themselves in. Ultimately this will lead many nursing to close and will displace residents further from their homes.

“A conversation to avert the current nursing home crisis. It is a perfect storm”

Medicaid Reductions

The last two years medicaid has adjusted its rates "based off of inflation" by -2.65% and -7.19%. This ~10% decrease has greatly impacted nursing homes.

Occupancy is down

The average occupancy rate has been reduced over these last few years and is below the national standard of 95%. Nebraska nursing homes average an occupancy rate of 85%

cost of staffing

In rural areas staffing can be extremely difficult and most facilities rely on pooled labor which costs 50% more than regular workers.

over estimation for medicaid

The cost calculation over estimates the number of days people on Medicaid will require nursing home care, which reduces the total amount of funding available.

The Impact

Private Pay has to make up for the cost.

Private pay residents are having to make up the cost difference. A private pay resident may have to pay upwards of $225/day while the Medicaid funding only pays $130/day. Private pay residents are essentially paying for the State’s lack of support.

Nursing Homes are having to close

Nursing Homes are having to shut down or be subsidized by cities/counties. The former causing residents to be moved out of their currently facility into a new one, causing a disruption in care and often putting seniors further away from family members and friends. The latter is not a sustainable activity for small rural communities.

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The rise in pool labor causes the money from nursing home jobs to be spent elsewhere instead of locally, where it was supporting the community’s businesses and local services. This drain on small communities will only increase if a facility closes and employs no local people, and also no longer works with local businesses to help keep the building running.

Difficult for staff

With the lack of funding and the need to used pooled labor it becomes difficult for all of the full-time and part-time staff at the facilities.

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