How Nebraska licenses assisted living in Omaha

Who licenses assisted living facilities in Omaha, Nebraska?

The Nebraska Department of Health and Human Services (DHHS), through the Licensure Unit of its Division of Public Health in Lincoln, licenses every assisted living building in Omaha and the rest of the state under the Assisted-Living Facility Act, the Health Care Facility Licensure Act and the regulations in 175 NAC 4.

The City of Omaha, Douglas County and the Sarpy County cities do not license care settings. Zoning, building and fire codes apply to the building itself, but the right to operate as assisted living comes from the state license, and that is the record to check first. The Licensure Unit's assisted living staff can be reached at (402) 471-3324 or DHHS.HealthCareFacilities@nebraska.gov, and the unit publishes a statewide roster of every licensed ALF, updated regularly, which is the source for our directory.

The DHHS roster of October 15, 2026 lists 79 licensed assisted-living facilities in the five Omaha-area counties with 5,432 licensed beds, out of 277 ALFs and 13,957 beds statewide; 53 are in Douglas County.

What counts as an assisted-living facility in Nebraska?

Under 175 NAC 4-002, an assisted-living facility is a place where shelter, food and care are provided for pay for more than 24 consecutive hours to four or more people who require or request those services because of age, illness or physical disability; DHHS's own summary puts it simply: anyone providing assisted living services to four or more residents must be licensed.

“Care” in the regulation means supervision and help with personal care (bathing, dressing, grooming), activities of daily living (transfers, walking, toileting, eating, taking medications) and health maintenance activities, which are routine, predictable tasks that can be done by exact direction. DHHS states plainly that an ALF is not a nursing home and cannot provide routine care by licensed nurses. Two arrangements fall outside the definition: casual care at irregular intervals, and buildings where competent residents arrange their own services and no more than 25% of residents receive them. That second exception is why some independent living apartments have no ALF license even when home care aides visit.

How long does a Nebraska assisted living license last, and what does it cost?

Every Nebraska ALF license expires on April 30 each year (175 NAC 4-004.03), and the annual fee is set by bed count: $950 for 1 to 10 beds, $1,450 for 11 to 20, $1,650 for 21 to 50, and $1,950 for 51 or more (175 NAC 4-004.09).

DHHS sends a renewal notice at least 30 days before expiration. Because every license ends on the same date, every ALF on the current roster is licensed through April 30, 2027 unless DHHS acts sooner. A license is issued for one licensee at one premises and cannot be transferred: a sale of the business, a lease of operations or a move ends the license, and the new operator must apply for its own. The licensee must notify DHHS in writing ten days before a facility is sold, leased, discontinued or moved, and must not put more beds into use than the license allows.

Who runs a Nebraska ALF, and what training does the administrator need?

Every ALF must have an administrator who is at least 21, is placed on DHHS's administrator registry within six months of starting, and has completed at least 30 hours of initial training covering resident care, social services, financial management, administration, gerontology and ALF rules, unless he or she is a licensed nursing home administrator or a hospital administrator (175 NAC 4-006.02).

After that, an ALF administrator must complete 12 hours of ongoing training every year. The rule makes the administrator responsible for compliance, for staffing sufficient to meet each resident's service agreement, for designating a substitute during absences, and for reporting and investigating suspected abuse, neglect or misappropriation of resident money. The current roster lists the administrator's name for each facility; our facility pages reproduce it so families can confirm who is in charge before a tour.

How often does Nebraska inspect assisted living in Omaha?

Nebraska inspects every new ALF before licensure, but after that it sets no fixed cycle: DHHS may inspect unannounced at any time, choosing up to 25% of ALFs at random each year and adding focused inspections after complaints, deaths or serious harm, changes of ownership or services, financial instability, or five years without an inspection (175 NAC 4-005.04).

When an inspection finds violations that do not put residents in imminent danger, DHHS may ask the facility for a statement of compliance describing how and when each problem will be fixed; a facility that submits and carries out a good-faith statement avoids discipline. Serious violations lead to disciplinary action under 175 NAC 4-008. DHHS's ALF page says results of all ALF inspections can be viewed through the state's LIS license lookup, one facility at a time, and residents have a right under 175 NAC 4-006.04 to examine the results of the most recent DHHS survey of their facility.