Long Term Care Facilities
Applications/Licensure Requirements

Any person intending to establish, operate, or maintain a long term care facility must first obtain a license from the Department. An applicant for an initial or renewal license must demonstrate that the facility meets the care, treatment and operational and physical plant standards contained in 175 Nebraska Administrative Code (NAC) 12 Sections 006 and 007.

A license is issued only for the premises and persons named in the application and is not transferable or assignable.

Initial Licensure

The applicant must demonstrate that the facility meets the care, treatment, operational and physical plant standards contained in 175 NAC 12 Sections 006 and 007. The application is not complete until the Department receives documents specified in 175 NAC 12 Section 003.01B.

The Department will review the completed application and inspect the facility. The Department will then determine if the applicant meets the standards contained in 175 NAC 12 and the Health Care Facility Licensure Act.

An applicant must:

1. Submit a written application to the Department which includes:

    175 NAC 12 Section 003.01B.

2. Pass an on-site inspection as specified in 175 NAC 12 Section 005.01 – Initial Inspection.

Upon receipt of a completed application, contact will be made to schedule an initial inspection date. A Long Term Care Facility cannot operate until the inspection has been completed and the Department determines a license can be issued.

All application materials must be submitted to:

Department of Health and Human Services
    Regulation and Licensure
Licensing & Regulatory Affairs
Long Term Care Facilities
P O Box 94986
Lincoln, NE 68509-4986

All Long Term Care licenses expire March 31st of each year.

Renewal Licensure

Long Term Care licenses expire on March 31st of each year.

Renewal process: Notice of renewal is sent to the licensee’s preferred mailing address not later than 30 days prior to the expiration date. To renew a license the following must be submitted:

1. A completed written application ( 175 Nebraska Administrative Code (NAC) 12 Section 003.02A)
2. Required licensure fee specified in 175 NAC 12 Section 004.10
3. List of names and addresses of all persons in control of the facility. The list must include all individual owners, partners, limited liability company members, parent companies and members of boards of directors owning or managing the operations and any other persons with financial interests or investments in the facility. In the case of publicly held corporations, the individual owners listed must include any stockholders who own 5% or more of the company’s stock
4. Current Certificate of Occupancy issued by the Nebraska State Fire Marshal or delegated authority dated within the 12 months prior to the license expiration date.

Final notice: If a renewal application is not postmarked or received by April 1st, the long term care facility will receive a final notice.

If a renewal is not received by May1st the license will be placed on lapsed status. (See 175 NAC 12 Section 003.02B.) During lapsed status the facility may not operate until the license has been reinstated.

Refusal to renew: The Department can refuse to renew a license. (See 175 NAC 12)

Forms

Initial License Application
Renewal License Application