Provider Resources

Medicaid & Long-Term Care

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What you need to know

​​​​​​The State Unit on Aging oversees a number of service providers. This page contains information, guidance, online resources, and other tools for these service providers. Public resources can be found on the Resources for You page.

Sections on this page

    Helpful Links


    Forms and Guidance Documents

    These documents should help service providers serve older Nebraskans and Nebraskans with disabilities.

    COVID-19 specific service provider documents can be found here:

    ADRC Contact + Census ComparisonADRC Contact + Census Comparison.xlsx
    Budget Request and Revision TemplateBudget Request and Revision Template.xlsx
    Care Management AssessmentCare Management Assessment.pdf
    Caregiver Assessment (with Gender Identity)Caregiver Assessment (with Gender Identity).docx
    Caregiver AssessmentCaregiver Assessment.docx
    COVID-19 Services + ReportingCOVID-19 Services + Reporting.pdf
    Current AAA and ADRC MapCurrent AAA and ADRC Map.pdf
    Form C FY 2020Form C FY 2020.xlsx
    Forms A and E FY 2020Forms A and E FY 2020.xlsx
    Frequently Asked QuestionsFrequently Asked Questions.pdf
    FY 2021 Senior Volunteer Budget NarrativeFY 2021 Senior Volunteer Budget Narrative.docx
    FY 2021 Senior Volunteer Program Annual Plan InstructionsFY 2021 Senior Volunteer Program Annual Plan Instructions.docx
    FY 2021 Senior Volunteer Program App for FundingFY 2021 Senior Volunteer Program App for Funding.xlsx
    FY 2021 Senior Volunteer Program Reservation TableFY 2021 Senior Volunteer Program Reservation Table.docx
    HDM Service Type Flow ChartHDM Service Type Flow Chart.pdf
    Major Disaster Declaration PPTMajor Disaster Declaration PPT.pdf
    NAPIS to OAAPS CrosswalkNAPIS to OAAPS Crosswalk.pdf
    New Service FormNew Service Form.docx
    NRA-NSI NAMIS to PeerPlace ConversionNRA-NSI NAMIS to PeerPlace Conversion.pdf
    NSIP Eligibility Flow ChartNSIP Eligibility  Flow Chart.pdf
    NSIP Meal Form FFY2020NSIP Meal Form FFY2020.xlsx
    NSIP Meal Form InstructionsNSIP Meal Form Instructions.pdf
    NSIP Report FFY2020NSIP Report FFY2020.xlsx
    PeerPlace Transition GuidePeerPlace Transition Guide.pdf
    Program Reference Guide SFY 20-23Program Reference Guide SFY 20-23.pdf
    Reservation Table By CountyReservation Table By County.pdf
    Senior Center Manual TemplateSenior Center Manual Template.docx
    Service and Funding Tracking PPTService and Funding Tracking PPT.pdf
    SFY 21 ADRC Funding DescriptionSFY 21 ADRC Funding Description.pdf
    SUA-20-IM-09 Time Study Excel TemplateSUA-20-IM-09 Time Study Excel Template.xlsx
    1 - 30Next

    Active Program Instructions

    SFY 20SUA-20-PI-48 FY21 Plan Updates + Reservation Table 3-3-20
    SFY 20SUA-20-PI-47 Senior Volunteer Program (SVP) Plan and Application
    SFY 20SUA-20-PI-46 Reservation Table FY2020 Revised PI-Table
    SFY 20SUA-20-PI-44 Guidance for Title III-C2 Home-Delivered Meal Nutrition Services
    SFY 20SUA-20-PI-43 Peer Place Transition Guide
    SFY 20SUA-20-PI-42 Care Management Assessment
    SFY 20SUA-20-PI-41 PeerPlace Software Offline Checkout Procedures
    SFY 20SUA-20-PI-40 AAA Partners - Security Request Guidelines
    SFY 20SUA-20-PI-39 Menu Planning
    SFY 20SUA-20-PI-38 Title III-B Minimum Percentages
    SFY 20SUA-20-PI-37 Federal Fund Cash Advances
    SFY 20SUA-20-PI-34 FY 19 Reservation Table
    SFY 20SUA-20-PI-33 Financial Reporting Requirements
    SFY 20SUA-20-PI-32 NSIP Billing Form
    SFY 20SUA-20-PI-31 2015-2020 Dietary Guidelines
    SFY 20SUA-20-PI-30 Nebraska Sales and Use Tax Regulations
    SFY 20SUA-20-PI-29 Title III-D Evidence-Based Programs
    SFY 20SUA-20-PI-28 Congregate Meal Site Voluntary Contribution
    SFY 20SUA-20-PI-27 Senior Center List Updates
    SFY 20SUA-20-PI-26 Home Delivered Meals Assessment
    SFY 20SUA-20-PI-25 Hood Extinguishing Systems
    SFY 20SUA-20-PI-24 OAA Nutrition Program Regulations
    SFY 20SUA-20-PI-23 Home Delivered Meals Instructions
    SFY 20SUA-20-PI-22 Senior Center and Nutrition Site Days of Operation
    SFY 20SUA-20-PI-21 Home Delivered Meal Operations
    SFY 20SUA-20-PI-20 Senior Volunteer Program Application
    SFY 20SUA-20-PI-19 Care Management Sliding Fee Scale
    SFY 20SUA-20-PI-18 SHIIP Units in NAMIS
    SFY 20SUA-20-PI-17 Care Management Basic Assessment
    SFY 20SUA-20-PI-16 Care Management Unit Recertification
    1 - 30Next

    Active Information Memoranda

    SFY 20SUA-20-IM-18 SCSEP Combined State Plan Public Comment
    SFY 20SUA-20-IM-17 Comprehensive Caregiver Assessment
    SFY 20SUA-20-IM-16 PeerPlace Anonymous Client Guidance
    SFY 20SUA-20-IM-15 PeerPlace Internal Software Consent-Permission Policy
    SFY 20SUA-20-IM-14 PeerPlace Client Notes and Case Notes
    SFY 20SUA-20-IM-13 PeerPlace Care Management Fee Statement Terms
    SFY 20SUA-20-IM-12 Locally Grown Produce and Title III-C1 and C2
    SFY 20SUA-20-IM-11 Service Participant Validation
    SFY 20SUA-20-IM-10 Indirect Costs vs. Area Plan Administration Costs
    SFY 20SUA-20-IM-09 Time Study Guidance
    SFY 20SUA-20-IM-09 Time Study Excel Template
    SFY 20SUA-20-IM-08 Title III-E Caregivers Defined
    SFY 20SUA-20-IM-07 Comprehensive Caregiver Assessment
    SFY 20SUA-20-IM-06 Care Management Changes in NAMIS
    SFY 20SUA-20-IM-05 ADL and IADL Reporting
    SFY 20SUA-20-IM-04 Merging Clients in NAMIS
    SFY 20SUA-20-IM-03 NAMIS Contribution Letter Requirements
    SFY 20SUA-20-IM-02 Printing Labels from NAMIS
    SFY 20SUA-20-IM-01 Senior Centers and Webinars
    SFY 19SUA-19-IM-04 Home Modifications

    Monitoring Tools

    Monitoring Tools (Word documents) need to be completed and returned three weeks before the scheduled monitoring date. Depending on computer security settings, you may need to click on the View menu, and select Edit Document ​to complete the forms.

    Review Forms (PDFs) will be used by the SUA to evaluate files.

    State Fiscal Year 2020 monitoring will take place between July 1, 2019 through June 30, 2020.

    ADRC Monitoring Tool
    Care Management File Review Form
    Care Management Monitoring Tool
    Case Management File Review Form
    Disaster Plan Evaluation Tool
    Governance Monitoring Tool
    Health Program Monitoring Tool
    Legal NE4A Monitoring Tool
    Legal Non-NE4A Monitoring Tool
    Nutrition Monitoring Tool
    SCSEP Monitoring Tool
    Senior Volunteer File Review Form
    Senior Volunteer Program Monitoring Tool
    Title III-B Monitoring Tool
    Title III-E Monitoring Tool


    State Unit on Aging
    Medicaid & Long-Term Care / Department of Health & Human Services
    Phone Number
    (402) 471-2307
    Fax Number
    (402) 742-8388
    Mailing Address
    P.O. Box 95026, Lincoln, Nebraska 68509-5026