Omaha Senior AdvisorWhat does waiver certification mean for an Omaha assisted living facility?
A waiver-certified ALF is enrolled to bill Nebraska Medicaid's AD Waiver for Supported Residential Living services for eligible residents, and the DHHS roster marks it “Aged/Disabled Med Wvr Cer”; a building without that mark accepts only private pay, insurance and similar sources.
36 of the 79 licensed ALFs in the five Omaha-area counties (46%) are marked on the DHHS roster of October 15, 2026 as certified for the Medicaid Aged and Disabled Waiver. Certified buildings must meet extra standards for waiver residents, including a private room with a toilet and sink, lockable doors and a lease within the service agreement.
Why does certification matter for a long stay?
Because at Nebraska's 2025 median of $6,350 a month, many residents' savings run out within a few years, and a resident who spends down to Medicaid's $4,000 resource limit in a private-pay-only building usually has to move to a certified one to keep receiving services.
A second move is hard on anyone and especially on someone with dementia. Choosing a certified building at the start keeps that path open, even if the family plans to pay privately for years.
Does a waiver-certified ALF guarantee a Medicaid apartment?
No. Certification lets the facility bill the waiver; it does not require the facility to accept any particular number of waiver residents, and some certified buildings limit waiver apartments or have waiting lists.
Ask in writing how many waiver residents the building serves, whether a private-pay resident who becomes eligible can convert in place, and what room-and-board charge applies after conversion.
Are private-pay-only ALFs worse?
Not necessarily. Many private-pay-only buildings are newer or smaller and offer amenities or staffing the waiver rate does not support, and a family with enough resources for the expected length of stay, or long-term care insurance, may never need the waiver.
The point is to choose with eyes open. Run the numbers on how long savings will last, and if the answer is shorter than the likely stay, give certified buildings priority.
How do we find waiver-certified ALFs near a parent?
Open the assisted living roster in our directory, filter by county or city, and sort by the “Medicaid AD Waiver certified” column, which reproduces the DHHS roster flag for every licensed ALF in the five counties.
Each facility's own page also lists the nearest waiver-certified alternatives.
At a glance
| Waiver-certified ALF | Private-pay-only ALF | |
|---|---|---|
| Medicaid | Can bill AD Waiver services | Cannot |
| Rooms for waiver residents | Private room with toilet and sink | No waiver standard applies |
| Spend-down | A resident may convert in place, if the facility agrees | A resident usually must move |
| Roster flag | Aged/Disabled Med Wvr Cer | No flag |
Sources include 175 NAC 4 (assisted-living facilities), the Nebraska Revised Statutes cited above, Nebraska DHHS program and licensure pages, CMS, CareScout and VA rate tables; see our editorial standards.
