Assisted Living News 2026July3

Kierstin Reed • July 2, 2026

Waiver Provider Handbook and DDA Updates

DDA has released a new AD/TBI Waiver Provider Handbook which details requirements for providers of these services. We have expressed significant concerns regarding some of the requirements in this handbook for providers and continue to work through the details with DDA administration. Below is what we have confirmed so far: 


  • EMAR- ALF providers do not need to use the state mandated case management system for EMAR documentation. They may continue to use their current EMAR system. 
  • Annual Criminal Background Checks- despite this being included in the manual, DDA confirmed that while it is highly suggested that these are done, it is not a current requirement under the waiver. Medicaid will likely be changing this in the near future and it may be included in the new agreements. As a reminder, providers are required to complete background checks for excluded persons, OIG and other requirements outlined in the Nebraska Medicaid application as a provider. Providers face possible sanctions if they bill for services provided by someone who has been excluded from the Medicaid program. 


We continue to work with the department to discuss these concerns and will provide follow up as it becomes available. 

CPR for ALL Direct Care Staff

A new waiver requirement for all HCBS providers has gone into effect on July 1st. There is a 60 day grace period for providers to have all staff trained in CPR, First Aid and one hour of abuse/neglect training. This is a significant departure from what ALF providers have been doing. While it is not a requirement to perform CPR on a waiver resident, it is a Medicaid requirement for all staff to be trained to do so. If you are in need of resources in your area to complete this training, please reach out to LeadingAge Nebraska or DHHS for assistance. 

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