VALENTINE, Neb. — Nebraska is facing a growing nursing home shortage — a crisis hitting especially hard in rural areas like the Sandhills. According to the Nebraska Health Care Association, 16 nursing homes have closed across the state in the past four years. Cherry and Keya Paha Counties currently have no nursing facilities, while Brown and Rock Counties each have just one.

During a recent Cherry County Board of Commissioners meeting, Commissioner Nina Nelson asked State Sen. Tanya Storer what could be done to address the shortage.

Storer said the issue is complex, extending beyond funding and staffing challenges. She explained that Nebraska’s “Certificate of Need” law — in place for about 50 years — restricts the creation of new nursing home and rehabilitation beds.

To add beds, a facility must either purchase unused capacity from another provider or qualify for a narrow exception to the law. That means any new nursing home would first need approval, in the form of a “certificate of need,” from the Nebraska Department of Health and Human Services, or would have to buy bed rights from another facility.

“And often times they don’t want to sell the bed space,” Storer said. “I think it’s a really bad policy because it takes away the ability for a local community to make decisions.”

The law was originally designed to prevent overbuilding and duplication of medical facilities, with the goal of controlling health care costs.

Last legislative session, Sen. Merv Riepe of Ralston — a former hospital administrator — introduced Legislative Bill 437, which would have repealed the Certificate of Need Act.

“There was wide support to get it passed, but the Speaker didn’t like it, so it was never brought up,” Storer told commissioners.

According to the Nebraska Examiner, representatives from Madonna Rehabilitation Hospital and Bryan Medical Center argued that repealing the law could drive up costs by worsening the nursing shortage and forcing hospitals to rely more heavily on contract staff. Supporters of the current law say the real issue is Medicaid reimbursement rates, which they argue need to be increased to help rural nursing homes stay open.

Storer said she’s hopeful lawmakers will revisit the issue next session.

“Every community deserves the chance to make the decision for yourself,” she said, referring to the lack of control local leaders face when their nursing home closes.