In nursing home desert, Butte fights to bring Senior care back home

BUTTE, Neb. — As nursing homes continue to close across Nebraska, families in rural communities are increasingly forced to make painful decisions about how — and where — their loved ones will age.

Over the past four years, 16 nursing homes have closed statewide, leaving two dozen counties without a single facility. In Boyd County, the closure of its only nursing home earlier this year threatened to leave residents with no local option at all.

For Britanie Brewster, the loss was deeply personal.

From her home in Butte, Brewster can see the window where her grandfather once sat inside the nursing home, watching her come and go.

“My grandpa would sit at this window and watch me,” Brewster said. “If I was mowing my lawn, he would call me. If I got too far and he couldn’t see me, he would call me.”

Her grandfather lived at the facility in Butte, a village of fewer than 300 people in north-central Nebraska. Brewster said she even delayed installing garage doors so he could continue watching her from his window.

That connection was abruptly broken earlier this year when the nursing home — the only one in the county — announced it would close. Families were given 60 days to find alternative care.

“We did not want it to close,” Brewster said. “So when my dad called and asked what we do, we hit the ground running.”

Community members worked to secure financing and explored options to buy the building, hoping to keep residents and staff in place. Brewster said those plans fell apart when the out-of-state company that owned the facility refused to sell it.

“They didn’t want to sell it if we were going to open it as a nursing home,” she said.

Even after the village eventually convinced the company to sell the building, another obstacle emerged: Nebraska’s Certificate of Need law, which limits the number of licensed nursing home beds in the state.

Under the law, a new facility cannot open unless nearby facilities meet certain occupancy thresholds. Brewster said that requirement makes it nearly impossible for rural communities to reopen closed homes.

“The only facility in Nebraska that’s open and at 90 percent occupancy is in Omaha,” Brewster said.

She says the owners of the Butte facility were also unwilling to sell their licensed beds.

“What we see is a lot of major corporations that are out-of-state or just large — they’re taking those beds and abandoning them,” Brewster said. “Once they’re abandoned, they’re lost to the state. They don’t come back.”

With no local options, Brewster’s family made the difficult decision to move her grandfather to a nursing home two hours away.

“I told him I would get him home,” she said. “He just had to give me time.”

One week after the move, her grandfather died.

“He was my best friend,” Brewster said. “He taught me everything. He helped me run a lawn mowing business. He always made sure I was taken care of.”

In the days after his death, Brewster questioned whether she could continue fighting to reopen the facility. She said her mother urged her to keep going.

“She told me, ‘You have to fight harder now,’” Brewster said.

Brewster took that fight to Lincoln, meeting with lawmakers and testifying before the Health and Human Services Committee in support of repealing the Certificate of Need Act. While the bill advanced out of committee, it never reached the Legislature’s floor. Opponents cited staffing shortages and argued the state should focus on preventing closures by increasing Medicaid reimbursement rates.

“You’re putting our elderly in positions where they’re forced to leave their families, their farms and their communities,” Brewster said.

Butte is not alone. Over the past four years, 16 nursing homes have closed across Nebraska, a trend that has accelerated concerns about access to elder care as the state’s population ages.

“You can’t tell me 14,000 nursing home beds are going to take care of 77,000 residents over 85,” Brewster said. “We haven’t even reached the majority of our baby boomers yet.”

For Butte, a closure elsewhere in the state provided an unexpected opportunity. When Hillcrest Care Center in Laurel shut down, its 36 licensed beds were transferred to Boyd County.

Volunteers have since spent weeks cleaning and renovating the building. While full nursing home services will take longer to reopen, the connected assisted living facility, now called Ponca Creek Living, is set to open in the coming days.

“We’ve had over 40 volunteers helping,” said administrator Anita Mathine. “We’ve repainted and cleaned the entire place.”

Mathine said the facility is critical not just for Butte, but for the surrounding area.

“It’s very important for the whole county,” she said.

The facility was once the county’s largest employer, and residents say its return means families can once again keep loved ones close to home.

“There are 24 counties that don’t have a nursing home,” Brewster said. "That’s why this is so critical, not just for here because in Butte we got our beds. We will make this work, but the rest of the state doesn’t.

Though her grandfather is no longer there to watch from the window, Brewster said she believes his spirit remains part of the fight.

“We have an army up there,” she said. “And they’re making sure we get this done.”