Long Term Care Nebraska

Studies show Nebraska has the lowest Medicaid nursing home census in the United States. As of 2002, Medicaid covered only 52.8 percent of nursing home residents in Nebraska; as compared to an average of 66.7 percent for the country as a whole. This is important because higher dependency on relatively low Medicaid reimbursements for nursing home care can exacerbate financial, staffing and quality problems.

The state also has the highest market penetrations for private long-term care insurance in the country--over 15 percent. Other states in the Heartland have similarly high rates of long-term care insurance2 and concomitantly high private-pay nursing home censuses. This is important because people who pay privately for nursing home care often pay half again as much as the Medicaid reimbursement rate.

As a solution to its residents long term care needs, the state made great strides in the last few years toward deinstitutionalizing Medicaid long-term care recipients and providing them alternative care in the community. And, home and community based waiver (home care and assisted living) slots were increased as well.

Similar to other states, Nebraska does face many of the same demographic and long-term care challenges that afflict the rest of the country. The state, like the country as a whole, needs to act soon to resolve growing problems and to mitigate future threats.

Statistics revealed the percent of persons age 65 and older who reside in nursing facilities averaged 4.2 percent in the U.S. as a whole in 2001. The comparable figure for Nebraska is 6.5 percent. It ranks number two in the country for percent of people age 65 plus in nursing facilities. And, persons age 85 and older, the age group most likely to need long-term care, will rise from 1.5 percent to 1.9 percent between 2000 and 2020 in the United States.

The percentage of nursing home residents in the state dependent on Medicaid seems to be creeping up as well. As of 2003, 54.4 percent of nursing facility patient days was paid by Medicaid. And, although the state’s Medicaid program has creatively increased cost-effective home and community-based alternatives to expensive nursing home institutionalization, it has already de-institutionalized most of the lowest acuity nursing home patients.

But to cure its challenges towards LTC, the states’ Long-Term Care Partnership establishes a special public/private program that joins private long-term care insurance with Medicaid. This Partnership Policy is a tax qualified long-term care insurance policy that allows residents to retain a greater share of their assets should they need to apply for Medicaid after using their long-term care insurance benefits.

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