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.

    View COVID-19 specific service provider documents

    ADRC Request for Information.pdfADRC Request for InformationADRC
    Area Plan - Budget Workbook.xlsxArea Plan - Budget WorkbookArea Plan/Budget
    Budget Request and Revision Template.xlsxBudget Request and Revision TemplateFiscal
    Care Management Assessment.pdfCare Management AssessmentCare Management
    Caregiver Assessment (with Gender Identity).docxCaregiver Assessment (with Gender Identity)III-E
    Caregiver Assessment.docxCaregiver AssessmentIII-E
    Caregiver Case Management File Review Checklist.docxCaregiver Case Management File Review ChecklistIII-E
    COVID-19 Services + Reporting.pdfCOVID-19 Services + ReportingData Collection
    Current AAA and ADRC Map.pdfCurrent AAA and ADRC MapSUA, ADRC
    Form C FY 2021 Instructions.pdfForm C FY 2021 InstructionsCare Management, Fiscal
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    Active Program Instructions

    SFY 23SUA-23-PI-03 Non-SUA Funding ProgramsData Collection, Fiscal
    SFY 23SUA-23-PI-02 Care Management Slidfing Fee Scale 2023Care Management
    SFY 23SUA-23-PI-01 SFY24-27 Area Plan InstructionsArea Plan/Budget
    SFY 23SUA-22-PI-11-Caregiver Case Management QA Review FormIII-E
    SFY 23SUA-22-PI-10 Care Management Unit Rates FY23Care Management, Fiscal, Rates
    SFY 23SUA-22-PI-09 ADRC APO Budget + Service NarrativesFiscal
    SFY 23SUA-22-PI-06 Aging Services Regulations Chapter 5 - RevisedRegulations
    SFY 22SUA-22-PI-05 FY23 Senior Volunteer Program Application and Instructions with AttachmentsSVP
    SFY 22SUA-22-PI-04 FY23 Area Plan Update + Reservation Table + Budget Template REVISEDBudget, Fiscal
    SFY 22SUA-22-PI-03 2020-2025 Dietary Guidelines for AmericansNutrition
    1 - 10Next

    Active Information Memoranda

    SFY 23SUA-23-IM-04 - SVP Request for InformationSVP
    SFY 23SUA-23-IM-03 - ADRC Request for InformationADRC
    SFY 23SUA-23-IM-02 - SVP Competetive Grant InformationSVP
    SFY 23SUA-23-IM-01 - ADRC Competetive Grant InformationADRC
    SFY 22SUA-22-IM-03 - Care Management Care PlansCare Management, Data Collection
    SFY 22SUA-22-IM-02 FY21 ARPA Award ProposalFiscal
    SFY 22SUA-22-IM-01 - Units of Information ServicesData Collection, III-B
    SFY 20SUA-20-IM-17 Comprehensive Caregiver AssessmentIII-E, Data Collection
    SFY 20SUA-20-IM-16 PeerPlace Anonymous Client GuidanceData Collection, PeerPlace
    SFY 20SUA-20-IM-15 PeerPlace Internal Software Consent-Permission PolicyPeerPlace
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    Monitoring Tools

    Monitoring Tools (Word documents) need to be completed and returned 3-4 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 2023 monitoring will take place between July 1, 2022 through June 30, 2023​​.

    ADRC Monitoring Tool
    Care Management File Review Form
    Care Management Monitoring Tool
    Case Management File Review Form
    Disaster Plan Evaluation Tool
    Disaster Plan Review AAA
    Financial Site Visit Review Form
    Fiscal Monitoring Tool
    Governance Data
    Governance Monitoring Tool
    Legal Contracting Attorney Legal Aid Contracts Monitoring Tool
    Legal Elder Access Line Monitoring Tool
    LTCO Monitoring Tool
    Senior Volunteer File Review Form
    Senior Volunteer Program Monitoring Tool
    Title III-B Monitoring Tool
    Title III-C1 & C2 (Nutrition) Monitoring Tool
    Title III-D (Health) 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