Omaha Senior AdvisorWhich Nebraska counties does Omaha Senior Advisor cover?
We cover five Nebraska counties of the Omaha metro: Douglas (Omaha and Elkhorn), Sarpy (Bellevue, Papillion, La Vista and Gretna), Cass (Plattsmouth), Saunders (Wahoo and Ashland) and Washington (Blair).
| County | Population | 65+ | 85+ | Median age | Licensed ALFs | Nursing homes |
|---|---|---|---|---|---|---|
| Douglas County | 606,460 | 93,667 | 9,478 | 35.7 | 53 | 24 |
| Sarpy County | 208,303 | 30,358 | 2,916 | 36.2 | 16 | 6 |
| Cass County | 27,657 | 5,836 | 541 | 43.2 | 3 | 3 |
| Saunders County | 23,702 | 4,918 | 468 | 41.6 | 3 | 3 |
| Washington County | 21,302 | 4,663 | 503 | 43.1 | 4 | 2 |
U.S. Census Bureau, Vintage 2025 county population estimates by age (July 1, 2025); Nebraska DHHS rosters, October 15, 2026.
Why these five counties?
They are the Nebraska counties of the Omaha metropolitan area, they follow the same state licensing and Medicaid rules, and four of them (all but Saunders) share the Eastern Nebraska Office on Aging; Saunders County is served by Aging Partners in Lincoln.
Pottawattamie County, Iowa, including Council Bluffs, is part of the same metro but follows Iowa law, so we do not list its facilities; see what changes across the Missouri River. Dodge County (Fremont) shares ENOA but is outside our directory.
Which county has the oldest population?
Washington County: 21.9% of its residents were 65 or older in 2025 Census estimates, with a median age of 43.1, compared with 15.4% in Douglas County and 14.6% in Sarpy County.
Cass and Saunders counties are close behind. Those three rural counties have only a handful of licensed buildings each, so families there often weigh a local home against options in Omaha, Elkhorn, Papillion or Bellevue.
Where is most of the region's licensed senior care?
Overwhelmingly in Douglas County: Omaha and Elkhorn hold 53 of the 79 licensed ALFs and 24 of the 38 nursing homes, with Sarpy County second.
Each county page lists every licensed facility or links to the city pages that do, along with straight-line distances from the county seat to the nearest hospitals and to downtown Omaha.
How many older adults live in the five counties?
Census Bureau estimates put 139,442 residents aged 65 and older in the five counties on July 1, 2025, including 13,906 aged 85 and older, the group most likely to need help with daily activities.
Douglas County holds most of them in absolute numbers, while the rural counties have higher shares. That is why the same roster can feel crowded in West Omaha and thin in Cass County.
At a glance
| Shared across all five counties | Different county to county | |
|---|---|---|
| Rules | Nebraska DHHS licensing and Medicaid rules | How many licensed facilities exist locally |
| Hotlines | APS (800) 652-1999, DHHS (402) 471-0316, ombudsman (800) 942-7830 | The Area Agency on Aging (ENOA or Aging Partners) |
| PACE | Immanuel Pathways serves select ZIP codes in each | Whether a given address is covered |
| Costs | The same Nebraska CareScout medians | Actual local quotes |
