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Census 2025 estimates · CMS September 2026 · CDC 2020

Senior housing development in Nebraska

Nebraska had 156,913 residents aged 75 and older in July 2025, +18.4% since April 2020 (US +23.4%), and 41,154 aged 85 and older (+1.4%). Its 180 certified nursing homes hold 13,715 beds, 333.3 for every 1,000 people 85 and older, more than the US ratio of 222.6. Certificate of need for nursing home beds: yes plus moratorium; for assisted living: not listed.

Age 75+ (2025)
156,913
Growth since 2020
+18.4%
Nursing beds per 1,000 aged 85+
333.3
Assisted living beds per 1,000 aged 75+
73.3

Demand: the older population

Age groupApril 2020July 2025ChangeUS change
75 and older132,579156,913+18.4%+23.4%
85 and older40,58641,154+1.4%+11.3%

Nationally, the Census Bureau's 2023 projections have the 75+ population growing 21% from 2025 to 2030 and the 85+ population 59% from 2025 to 2035. The bureau publishes those projections for the US only, not by state.

Supply: licensed beds

SettingBedsPer 1,000 aged 75+Per 1,000 aged 85+Source
Nursing homes (Medicare or Medicaid certified)13,71587.4333.3CMS, September 2026
Residential care / assisted living11,50073.3279.4CDC survey, 2020

US: 222.6 nursing beds and 170.1 assisted living beds per 1,000 aged 85+. Assisted living beds are CDC's 2020 survey estimate, its latest with state detail, set against 2025 population, so the ratio understates any supply added since.

Certificate of need

Nursing home beds
Yes plus moratorium
Assisted living
Not listed
Notes
Moratorium on LTC beds. 2026 LB437 enacted it extends CON validity "from one year to three years"

From NCSL's certificate of need table (updated April 29, 2025, covering January 2025) with later changes checked on state sites on October 24, 2026. "Not listed" means NCSL does not name assisted living, not that it is exempt. Confirm with the state health planning agency before relying on it. HUD requires a state CON for nursing home beds where the state has one (Handbook 4232.1, 2.5.EE).

Counties

The 25 counties with the most residents aged 75+, with certified nursing home beds per 1,000 aged 85+.

CountyAge 75+Since 2020Share of populationAge 85+Nursing homesBeds per 1,000 aged 85+
Douglas County38,501+24.6%6.3%9,47824311.4
Lancaster County23,811+30.9%7.1%5,59114275.6
Sarpy County12,396+33.7%6%2,9165166.7
Hall County4,625+12.7%7.3%1,2916319.9
Buffalo County4,092+24.3%8%1,1545262.6
Scotts Bluff County3,781+16.5%10.6%1,13900
Dodge County3,316+0.6%8.7%8903279.8
Lincoln County3,236+10.7%9.7%8454426
Platte County3,098+18.0%8.7%8162275.7
Madison County3,044+10.3%8.4%1,0005360
Adams County2,752+11.6%8.9%6812270.2
Cass County2,379+28.6%8.6%5412317.9
Gage County2,299+3.4%10.6%6783323
Washington County1,999+32.1%9.4%5032314.1
Saunders County1,980+14.4%8.4%4683517.1
Dawson County1,821+10.6%7.4%4452294.4
Seward County1,658+17.0%9.2%4752341.1
Otoe County1,609+14.8%9.7%4343513.8
York County1,386+6.9%9.5%3902428.2
Dakota County1,354+22.5%6.2%2613716.5
Custer County1,220+7.1%11.6%3762260.6
Saline County1,213+15.2%8.1%3772254.6
Holt County1,109+8.2%11%3303560.6
Knox County1,086+8.0%13%3513461.5
Red Willow County1,063+1.2%10.3%3361297.6

Fastest growth in the 75+ population

  1. Sarpy County: +33.7% (12,396)
  2. Lancaster County: +30.9% (23,811)
  3. Cass County: +28.6% (2,379)
  4. Douglas County: +24.6% (38,501)
  5. Buffalo County: +24.3% (4,092)
  6. Platte County: +18.0% (3,098)
  7. Scotts Bluff County: +16.5% (3,781)
  8. Hall County: +12.7% (4,625)
  9. Adams County: +11.6% (2,752)
  10. Lincoln County: +10.7% (3,236)

Counties with at least 2,000 residents aged 75+.

Fewest nursing beds per 1,000 aged 85+

  1. Scotts Bluff County: 0 (0 beds, 1,139 aged 85+)
  2. Sarpy County: 166.7 (486 beds, 2,916 aged 85+)
  3. Buffalo County: 262.6 (303 beds, 1,154 aged 85+)
  4. Lancaster County: 275.6 (1,541 beds, 5,591 aged 85+)
  5. Douglas County: 311.4 (2,951 beds, 9,478 aged 85+)
  6. Hall County: 319.9 (413 beds, 1,291 aged 85+)
  7. Madison County: 360 (360 beds, 1,000 aged 85+)

Counties with at least 1,000 residents aged 85+.

HUD Section 232 construction in Nebraska

Since fiscal 2001 HUD has insured 10 new construction or substantial rehabilitation loans on care facilities in Nebraska (9 assisted living, 0 nursing homes), $107.6 million of original principal, 2 of them since fiscal 2016.

  • FY2022: Salt Creek Assisted Living, LINCOLN, assisted living, $25.7 million
  • FY2017: Knolls Assisted Living, LINCOLN, assisted living, $19.9 million

Planning a building in Nebraska? Model the budget, lease-up and a HUD 232 construction loan.

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Sources: Census Bureau Vintage 2025 county population estimates; CMS Nursing Home Provider Information (September 2026); CDC/NCHS National Post-acute and Long-term Care Study (2020); HUD Office of Healthcare Programs endorsement database (data run 07/08/2026); NCSL. Absorption is operated by Janover Capital LLC and is not affiliated with any of them. Methodology.