Assisted-Living Facilities
Applications/Licensure Requirements

Any person intending to establish, operate, or maintain an assisted-living facility must first obtain a license from the Department. A facility must not hold itself out as an assisted living facility or as providing health care services unless licensed under the Health Care Facility Licensure Act. An applicant for an initial or renewal license must demonstrate that the Assisted-Living Facility meets the care, treatment, and operational and physical plant standards contained in 175 Nebraska Administrative Code (NAC) 4 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 first stage consists of the applicant’s submission of affirmative evidence of the ability to comply with the operational and physical plant standards contained in 175 NAC 4 Sections 006 and 007. The application is not complete until the Department receives documents specified in 175 NAC 4 Section 003.01B.

The second stage consists of the Department’s review of the completed application together with an inspection of the assisted-living facility. The Department determines whether or not the applicant for an initial license meets the standards contained in 175 NAC 4 and the Health Care Facility Licensure Act.

An applicant must:

1. Submit a written application to the Department which includes 175 NAC 4 Section 003.01B.
2. Pass an on-site inspection as specified in 175 NAC 4 Section 005.01-005.02E.

Upon receipt of a completed application, contact will be made to schedule an initial inspection date. An Assisted-Living Facility cannot operate until the inspection has been completed and a license can be issued.

All Assisted-Living Facility licenses expire April 30th of each year.

All application materials must be submitted to:

Nebraska Department of Health and Human Services
    Regulation and Licensure
Medical and Assisted-Living Facilities
PO Box 94986
Lincoln, NE 68509-4986

Renewal Licensure

All Assisted-Living Facility licenses expire April 30th of each year.

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

1. A completed written application with the information required by 175 NAC 4 Section 003.02A).
2. Required licensure fee specified in 175 NAC 4 Section 004.09
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 May 1, the Assisted-Living Facility will be sent a final notice.

If a renewal is not received by June 1, the license will be placed in lapsed status. 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. (175 NAC 4 Section 008)

Forms

Initial License Application
Renewal License Application