Nursing Home Payment Project

Medicaid Related Assistance
Medicaid & Long-Term Care

What would you like to do?

What you need to know

      New Payment Rates

New draft payment rates for nursing facilities were sent to Nebraska's nursing facilities on May 28, 2020. These rates will become final with CMS's approval and the end of the 2020 legislative session.

Updates of note in these draft payment rates include an inflation factor of 1.51% and the removal of a deficiency requirement in the quality component.


As providers know, the healthcare marketplace is ever-changing for beneficiaries, providers, and governments alike. To adapt and evolve, the Division of Medicaid & Long-Term Care (MLTC) has been working with stakeholders for more than two years to update the payment methodology for nursing facilities.

Medicaid is committed to continued transparency through this process. As part of our engagement with stakeholders, MLTC created this webpage to keep stakeholders up to date.

On this page you will find presented materials, FAQs, important updates and more. You will also find the most recent payment methodology that has been agreed upon by MLTC and stakeholders.

If you have questions, please send them to

Important Dates

​Project Kickoff​March 2019
​Statewide Listening Tour​August 2019
LeadingAge Spring Conference​March 12, 2020
NHCA Spring ConferenceApril 27-29, 2020​
​Submit State Plan Amendment to CMS​May 2020
​Remove current payment methodology from regulationsJune 2020
Publish Facility Draft Rate Notifications​May 28, 2020
​SFY2021 Rates Webinar with NHCA & LeadingAge Nebraska​June 4, 2020
​Implement new payment methodology​July 2020


March 6, 2020 - Next Steps and Webpage Changes

As the nursing home payment project moves forward, MLTC would like to share a few updates on changes to this webpage and our next steps toward finishing this project.

MLTC recently participated in a webinar alongside the Nebraska Health Care Association (NHCA) and LeadingAge Nebraska to discuss the latest developments in the payment redesign project. Following this webinar, MLTC will be attending both NHCA's and LeadingAge's spring conferences to meet with stakeholders and continue this discussion. In the coming weeks MLTC will continue to refine the details in our payment redesign plans.

We've made a handful of changes to this page to make sure stakeholders have the most up-to-date information on the project. Above we've updated the 'Documents & Links' section by adding the webinar and associated presentation and removing out-of-date items. These out-of-date items are now in an archive below for reference. Finally, we updated the dates in the table above.

February 4, 2020 - Project Update  

On January 17, 2020, MLTC finalized the framework of the new nursing facility rate methodology, which has been under development since March 2019. Key stakeholders, including providers, representatives of Leading Age Nebraska and the Nebraska Health Care Association, and the Health and Human Services Committee of the Nebraska Legislature, agreed on the framework of this new methodology, which will go into effect on July 1, 2020.

Work on this project is now shifting from framework development to refinement of operational details, communication planning, and implementation planning. The new model achieves two of MLTC's main objectives by introducing quality into the payment paradigm for nursing facility per diems and narrowing the rate disparity between facilities providing similar levels of service to Medicaid beneficiaries.  MLTC will be partnering with Leading Age Nebraska and the Nebraska Health Care Association to provide more communication about the new model in the coming weeks.

November 15, 2019 - Working with Feedback

In November, Medicaid has been taking a close look at the feedback stakeholders have sent about the payment redesign project. Medicaid has been adjusting our plans to include additional feedback from stakeholders.

MLTC appreciates those who have sent in feedback, and welcomes additional comments on any of the materials shared about the payment project, including the draft rate notifications in our last update.

October 1, 2019 - Draft Rate Notifications

Throughout this project, MLTC has committed to sharing examples of what payments to nursing homes will look like once the new rate methodology is in place. Our first data modeling of new rates is now available.

August 26, 2019 - Business Plan is released

Over the last four years DHHS has created and released a business plan to inform the public about many of the Department's efforts over the fiscal year.

The fourth business plan, Helping Hands: Helping People Live Better Lives, was released on August 26, 2019. One of the initiatives in the business plan is Medicaid Long-Term Care Redesign (pg. 21).

This initiative lays out the Division of Medicaid & Long Term Care's goal to update the rate methodology. The initiative provides a summary of the listening tour and public presentations that were held in the beginning of August.

Please check out the initiative and all the other efforts being undertaken by the Department.

August 13, 2019 - Nursing Home Listening Tour

As you may know, Nebraska Medicaid is proposing changes to the rate methodology for nursing facilities. MLTC has been in ongoing conversations with the trade associations who represent nursing homes, particularly Nebraska Health Care Association (NeHCA) and Leading Age of Nebraska, around the issues with the current payment methodology for more than two and a half years.

On March 6, 2019, members of the Nebraska Medicaid team publicly presented the proposed rate methodology changes to the Long-Term Care Stakeholder Committee, which includes providers and representatives from NeHCA and Leading Age.

On July 24, 2019, MLTC sent out an open invite to the provider community - any facility administrator who wanted a visit from MLTC would get an in-person visit. Nineteen facilities requested visits, and from August 5-13, 2019, at least one MLTC deputy director visited each facility. Additionally, MLTC held four public presentations for providers to attend. The presentations were held in Scottsbluff, Cozad, Norfolk and Omaha.

Thank you to all the facilities who hosted members of the MLTC team and to all of those who attended and provided feedback at the public presentations.

If you have more questions, please send them to

June 25, 2019 – Nursing Facility Rate Methodology Stakeholder Meeting

Today, MLTC met with more than 20 stakeholders, including providers, associations, consultants, and accountants. At this meeting, MLTC walked through the feedback we received since our presentation on March 6, 2019. The meeting focused on topics that require further, in-depth conversation as MLTC continues to work toward payment modernization for nursing homes. Among those in attendance were providers who had reached out to MLTC since March and several providers recommended from NEHCA and Leading Age.

This meeting was helpful for MLTC in making further decisions and revisions to the methodology. Additionally, this meeting helped form the update provided to all state stakeholders during listening tours in August.

March 6, 2019 - Nursing Facility Rates Reform Public Presentation

On March 6, Nebraska Medicaid shared with the public for the first time DHHS's proposed plan to update Medicaid's payment methodology for nursing homes.  During the Long-Term Care stakeholder meeting, MLTC presented our plan to those in attendance as well as to those attending online. At this meeting, MLTC, invited feedback from stakeholders. 

For the following 3 months, MLTC met with providers to better understand their feedback and suggestions.

To view the March 6, 2019, presentation, please see the Archive section below.


Project Archive

The following documents may not necessarily still apply to the project, but are kept in this section for informational purposes.