Reading Nebraska's Assisted Living Roster: The Four Flags Omaha Families Should Check

What is the DHHS assisted living roster?

Every assisted-living facility in Nebraska holds a license from the Department of Health and Human Services, and the Licensure Unit in Lincoln publishes a roster of all of them, sorted by town. It is a plain document produced from a database: one block per facility, with the town and county, the facility name and address, phone, licensee, administrator, license number, total licensed beds and a short list of services. The edition used for this site was updated on October 15, 2026.

Statewide the roster counts 277 licensed ALFs with 13,957 beds. In Douglas, Sarpy, Cass, Saunders and Washington counties it lists 79 facilities with 5,432 beds. Families rarely read it, because it looks like a phone book. That is a mistake, because the service column answers several questions that brochures blur.

Flag one: is the building certified for the Medicaid AD Waiver?

The code reads “Aged/Disabled Med Wvr Cer.” It means the facility is enrolled to bill Nebraska Medicaid's Aged and Disabled Waiver for its Supported Residential Living service. In the five counties, 36 of 79 ALFs carry it.

Why it matters: at Nebraska's 2025 assisted living median of $6,350 a month, many residents' savings last only a few years. A resident who spends down in a building without the flag usually has to move to keep receiving services. A resident in a certified building may be able to convert in place, if the facility agrees. That is a question to put in writing before move-in, not after.

Flags two and three: Alzheimer's unit and memory care endorsement

An “Alzheimers Unit” code (42 local ALFs) means the facility represents itself as specializing in dementia care and must meet the dementia-unit rule in 175 NAC 4-006.11E: written admission and discharge criteria before move-in, and direct care staff awake, dressed and available at all times.

“Memory Care Endorsement” (34 local ALFs) is a separate credential created by LB698 in 2016. DHHS awards it to facilities that prove qualifications covering staffing enhancements, training, dedicated programming, cultural competencies, facility requirements and security. 32 buildings hold both. A building that markets memory care but has neither code should be able to explain why.

Flag four: complex nursing interventions

Nebraska forbids ALF staff from performing complex nursing interventions, tasks that require a nurse's judgment to adapt or sequence. Residents who need them can stay only if they, or their representative, and a physician or RN agree, and the care is arranged through home health, hospice or private duty staff. The “Complex Nursing Intervent” code shows buildings that handle that arrangement; 14 local ALFs carry it.

It is not a higher license. It is a sign the building is used to coordinating outside nurses, which matters for a parent with an unstable condition or one likely to enroll in hospice.

How the flags break down by county

Source: Nebraska DHHS Licensure Unit, Assisted Living Facility Roster, updated October 15, 2026. Every row in our assisted living directory shows the same four flags, sortable, so you can list, for example, every waiver-certified ALF in Sarpy County in two clicks.

Licensee and administrator: the two names worth noting

Each roster block names the licensee, the business or organization that holds the license, and the administrator. The licensee tells you who is legally responsible. A limited liability company with the building's street address in its name often belongs to a larger operator; a church-affiliated corporation or a county usually runs its own building. Neither is better by definition, but it helps to know whom you are dealing with when a problem needs to go above the administrator.

The administrator must be at least 21, on DHHS's administrator registry within six months of starting, and trained: 30 hours at the start and 12 hours every year, unless he or she is a licensed nursing home administrator or hospital administrator. If the administrator named on the roster is not the person who greets you on the tour, ask how long the current administrator has been there. Frequent administrator changes are worth a question.

A five-minute routine before every tour

Open the facility's roster entry, which our directory reproduces on each facility page. Note the bed count, so you know whether you are touring a household or a campus. Note the four flags. Note the licensee and administrator. Then write three questions from what you found: if the building is not waiver-certified, what happens when savings run out; if it lists an Alzheimer's unit but no endorsement, what training and overnight staffing it provides; if it is flagged for complex nursing interventions, which home health and hospice agencies it works with. That routine turns a sales tour into an interview, and it takes five minutes.

What the roster cannot tell you

The roster shows no inspection results, prices, vacancies or staffing. Nebraska makes ALF inspection results viewable one facility at a time through its LIS license lookup, and residents have a right to examine the most recent DHHS survey. Ask for it on the first visit, along with the rate schedule, a sample service agreement and the discharge criteria. The roster also lists every license as expiring April 30, because that is when all Nebraska ALF licenses expire; the date says nothing about a particular building.