Measure to repeal health care certificate of need requirements scaled back, advanced

Lawmakers narrowed a bill Jan. 26 that would impact the development of nursing home facilities in Nebraska before giving the proposal first-round approval.

LB437, as introduced last session by Ralston Sen. Merv Riepe, would repeal the Nebraska Health Care Certificate of Need Act. The act requires providers to demonstrate a need for their projects before opening new facilities, expanding existing facilities, increasing bed capacity or purchasing advanced technology.

Riepe said the certificate of need was established to attempt to control costs and prevent needless duplication of services, but has become a “roadblock” for health care expansion in the state.

A Health and Human Services Committee amendment would narrow the scope of the certificate of need repeal to long-term care beds only.

Riepe, however, offered an amendment to the committee amendment to replace both its contents and those of the underlying bill. His amendment instead would extend the timeline for compliance with certificate of need requirements.

Currently, applicants have one year to demonstrate certificate of need compliance with the option to appeal to the state Department of Health and Human Services for a one-year extension. Riepe’s amendment would extend that timeline to three years, while retaining the possible one-year extension.

Riepe said a situation in Butte, Nebraska, highlighted the current system’s shortcomings that LB437 as amended would address.

A nursing home in the small community was slated for closure by its out-of-state owners, he said, and the community could not complete the certificate of need process before the facility’s closure date.

“This amendment removes an arbitrary constraint and reduces an unnecessary bureaucratic hurdle for those who have stepped forward to provide needed care in their community,” Riepe said.

Niobrara Sen. Barry DeKay supported the bill and Riepe’s amendment, saying it would assist rural communities that are trying to reopen closed nursing homes or assisted living facilities and keep their loved ones nearby.

He said the closing of the Butte facility represented the potential loss of approximately 50 local jobs, or about 4% of the county’s employment opportunities. While Butte was able to obtain a new certificate of need, DeKay said, other communities may not be so lucky.

Also speaking in support was Sen. Tanya Storer of Whitman. She said the extended timeline would help groups in Cherry and Boyd counties who are trying to raise funds to reopen or open new “very much needed” facilities in their communities.

The 2021 closure of a nursing home in Valentine meant that residents had to be moved up to 90 miles away to receive appropriate care, she said, which “sent shock waves” through the community.

A group is working to build a new nursing home in Valentine, she said, but under existing rules they have a maximum of two years after qualifying for a certificate of need to complete the project, if they receive an extension.

Storer said it is unrealistic to expect communities to pull together funding for a multimillion-dollar project, go through the permitting process, acquire property, get plans in place and be fully staffed and up and running in two years.

“This is going to make a big difference for people working very hard to reestablish care in their communities out in [rural] Nebraska,” she said.

Following the 42-0 adoption of the Riepe amendment, senators adopted the committee amendment 39-0. They then advanced LB437 to select file on a 41-0 vote.