============================================================================== CERTIFICATE OF NEED INTELLIGENCE BRIEF: NEBRASKA The Rojas Report | conlaws.rojasreport.com/states/nebraska/ ============================================================================== State: Nebraska (NE) Score: 45/100 Tier: Moderate Rank: 23 of 51 jurisdictions ------------------------------------------------------------------------------ SUMMARY ------------------------------------------------------------------------------ In-depth analysis of Nebraska's heavily reformed Certificate of Need (CON) laws, market concentration, and the impact on healthcare competition. ------------------------------------------------------------------------------ SCOPE OF REGULATION ------------------------------------------------------------------------------ * Regulated Services * Nebraska's CON law is narrow, primarily acting as a moratorium on new beds in specific long-term care facilities. * Long-Term Care Beds * Rehabilitation Beds * No review for imaging, ASCs, or general hospital services ------------------------------------------------------------------------------ APPLICATION PROCESS ------------------------------------------------------------------------------ Nebraska has significantly narrowed its CON program, but the remaining regulations for long-term care beds continue to shield incumbents and limit competition in a critical sector. No review for imaging, ASCs, or general hospital services ------------------------------------------------------------------------------ MARKET CONCENTRATION ------------------------------------------------------------------------------ Major metropolitan areas are highly concentrated, dominated by a few large systems. $81.4B in discounted drugs. Zero disclosure requirements. ------------------------------------------------------------------------------ REFORM STATUS ------------------------------------------------------------------------------ Nebraska's CON law is narrow, primarily acting as a moratorium on new beds in specific long-term care facilities. Heavily Reformed, But Not Repealed ------------------------------------------------------------------------------ CASE LAW / DENIALS ------------------------------------------------------------------------------ A classic example of central planning failure. Beatrice Manor was denied a CON for additional nursing home beds in Gage County. The state's rationale was not a lack of quality or financial viability, but simply that the county already had 82 beds per 1,000 elderly residents, exceeding the state's arbitrary optimum of 68.6. This denial protected existing facilities from competition at the direct expense of patient choice and potential access to newer facilities. ============================================================================== Source: The Rojas Report | conlaws.rojasreport.com/states/nebraska/ Data: Cicero Institute, NASHP, FTC, DOJ, CMS, state health departments Generated: April 2026 ==============================================================================