At a glance
A 20-bed Nebraska facility needs about $950,000 before opening
For a founder-scale facility, the constraint is not the $100 online LLC filing. It is securing a building that passes Nebraska bed-capacity, life-safety, accessibility and inspection requirements while funding staff before occupancy stabilizes.
Statewide planning model, 2026 USD: budget about $950,000 for a Typical launch, with a defensible planning range of $645,000 to $1.51 million depending mainly on building conversion work and liquidity. The Base operating case is 17 occupied beds at $5,800 realized monthly revenue per resident, producing $98,600 monthly revenue and $11,801 monthly normalized passive-basis cash operating profit before D&A. A working owner who personally fills the administrator role has a modeled pre-tax business cash benefit of $18,601 per month before maintenance capex. Sustainable break-even is about 14.4 occupied beds, or 72% of licensed capacity. The final address dominates uncertainty because building compliance can move cost and timing far more than filing fees.
Official ruleNebraska requires an assisted living facility license for four or more residents receiving assisted-living services. DHHS defines the service around shelter, food and assistance for 24 hours or longer; routine RN/LPN nursing is outside this base configuration. See the Nebraska DHHS Assisted Living Facilities guidance. That regulatory boundary is why this model excludes memory-care specialization and routine skilled-nursing revenue.
Startup scope
Where the $950,000 goes before the first resident moves in
The Typical case leases and adapts an existing roughly 8,500-square-foot building rather than developing from the ground up. Room dimensions, fixtures, dining space, accessibility and fire protection can still turn a cheap building into an expensive conversion.
| Use of funds | Lean | Typical | Premium |
|---|---|---|---|
| Facility and launch infrastructure | |||
| Site deposit + first month | $20,000 | $25,000 | $40,000 |
| Design, code, legal + licensing consulting | $25,000 | $35,000 | $55,000 |
| Renovation, accessibility + life-safety build-out | $180,000 | $300,000 | $550,000 |
| Resident rooms, common areas, kitchen + laundry equipment | $95,000 | $140,000 | $220,000 |
| Call system, IT, access/security + admin technology | $25,000 | $35,000 | $55,000 |
| Facility subtotal | $345,000 | $535,000 | $920,000 |
| Pre-opening and launch risk | |||
| Licenses, inspections, background/admin training + local permit allowance | $10,000 | $12,000 | $15,000 |
| Insurance deposits | $15,000 | $18,000 | $28,000 |
| Pre-opening payroll, recruiting + training | $55,000 | $75,000 | $110,000 |
| Branding, referral development + launch marketing | $18,000 | $25,000 | $40,000 |
| Opening food, linens, cleaning + care supplies | $15,000 | $20,000 | $30,000 |
| Pre-opening subtotal | $113,000 | $150,000 | $223,000 |
| Liquidity and uncertainty | |||
| Initial net working capital, excluding opening supplies | $10,000 | $15,000 | $25,000 |
| Opening operating-cash reserve | $145,000 | $185,000 | $260,000 |
| Contingency | $32,000 | $65,000 | $82,000 |
| Total project cost / founder cash required | $645,000 | $950,000 | $1,510,000 |
Startup scope – Nebraska statewide model, 2026 USD, total project cost
The $12,000 Typical regulatory line includes the $1,450 Nebraska ALF license fee for 11 – 20 beds, the State Fire Marshal's $50 inspection fee for 50 or fewer beds, the $100 online LLC filing, background/training costs and a modeled local-permit allowance. Local fees require address-specific quotes. The relevant official pages are the DHHS licensure page, State Fire Marshal fee schedule, and Secretary of State fee information.
Licensing and launch
Nebraska licensure makes the site – not the LLC – the critical path
Entity formation and an EIN can be completed early, but they do not authorize resident care. The operator still needs a qualifying site, trained administration and staff, physical-plant and fire compliance, and DHHS licensing/inspection clearance.
| Gate / requirement | Authority | Status | Fee / cost basis | Timing | Dependency / inspection |
|---|---|---|---|---|---|
| Nebraska LLC Certificate of Organization | Secretary of State | Required for modeled entity | $100 online; $110 in-office | File early | Official forms and fees |
| Employer Identification Number | IRS | Required with employees | $0 direct from IRS | After entity formation | IRS EIN guidance |
| Assisted Living Facility license, 11 – 20 beds | Nebraska DHHS | Mandatory | $1,450 initial / renewal | Agency SLA not published | Application, documentation and onsite inspection when required; official licensing page |
| Bed-capacity / physical-plant compliance | Nebraska DHHS + applicable code authorities | Mandatory | Design + construction scope; local quote required | Before final approval | Rooms, toilets, bathing, dining and code compliance; Title 175 regulations |
| Fire / life-safety inspection | Nebraska State Fire Marshal or delegated authority | Mandatory | $50 for facility with 50 or fewer beds; reinspection can add cost | Near completion | Health care facility inspection program |
| Administrator qualification / registry | Nebraska DHHS | Mandatory | Training/provider cost varies | Registry within 6 months of working | 30 hours initial training unless qualified route; annual continuing training; DHHS FAQ |
| Medication-aide qualification for staff who provide medications | Nebraska DHHS | Conditional by duty | Course/exam provider pricing; quote required | Before assigned medication duties | 40-hour course + state-approved exam; medication aide requirements |
| Zoning, building, occupancy, signage and local fire approvals | City / county | Varies by address | Varies by city/county; local quote required | Critical path can be months | Confirm use before lease; design/building inspections and certificate of occupancy may apply |
| Workers' compensation + unemployment insurance account | Workers' Compensation Court / NDOL | Employer requirement | Insurance quote; 2026 new non-construction UI rate 1.25% | Before / with hiring | Workers' compensation guidance and NDOL rate table |
Nebraska does not apply its Certificate of Need program to assisted-living beds; DHHS limits that program to rehabilitation and nursing-home beds. ALF licensure and local land-use/building approvals still apply. See the DHHS facilities and services page.
Local variation and address checks
Large-metro example
Omaha's official portal says to confirm use/zoning before committing to a site and obtain required permits and a Certificate of Occupancy. It is an address-level example, not a statewide benchmark. Official location guide.
Capital-market example
Lincoln's guidance requires zoning review and can involve special permits or zoning changes; occupancy also depends on a Certificate of Occupancy. Official zoning guidance.
Regional-market example
Grand Island separates planning, building permits and inspections, reinforcing the need to recheck the selected jurisdiction. Official planning and building portal.
Physical capacity
A 20-bed license works only if the building passes the bed-capacity math
Capacity is not simply the number of bedrooms a broker's flyer lists. Nebraska's Title 175 rules connect licensed capacity to resident-room size, toilet and bathing fixtures, dining area, building code, fire code, accessibility and other physical-plant requirements. DHHS also uses a bed-capacity worksheet for new facilities and capacity increases.
Bedroom envelope
For an existing/new facility pathway, Title 175 specifies at least 80 square feet for a single bedroom and 60 square feet per occupant for a multiple-occupancy room; new construction has larger room standards. This model uses private rooms and does not assume that every existing bedroom automatically qualifies.
Fixture bottleneck
The regulation specifies toilet and bathing ratios that differ by existing facility, new facility and new-construction status. One deficient bathroom can constrain licensed capacity even when bedroom square footage appears sufficient.
Dining and common space
Dining-area requirements are stated per resident and vary by project status. The model's roughly 8,500-square-foot site assumption is therefore a planning envelope, not proof that a particular 8,500-square-foot building can license 20 beds.
High confidenceThe physical-plant requirements are direct regulatory evidence in Nebraska Title 175. The DHHS assisted-living FAQ specifically notes the bed-capacity worksheet for new facilities and capacity increases. The practical implication is straightforward: perform a code-and-capacity test before converting a lease proposal into a signed fixed obligation.
Operating economics
At 85% occupancy, the statewide Base model produces about $98,600 a month
Revenue is built from occupied resident-months. Base uses 17 of 20 beds at $5,800 realized monthly revenue. That 2026 rate is modeled, not an observed statewide average: Genworth reported a 2024 Nebraska median of $61,416 annually, or $5,118 monthly. The premium reflects private rooms and care-level add-ons and must be validated locally.
Base revenue = 17 occupied residents × $5,800 realized monthly revenue = $98,600/month = $1,183,200/year
Base realized rate is modeled as roughly $5,250 for accommodation/basic care plus $550 weighted care and medication-assistance add-ons. Discounts, credits and collection leakage are reflected separately in variable costs; sales/use tax collected, if any on ancillary taxable items, is excluded from revenue.
| Metric | Downside | Base | Upside |
|---|---|---|---|
| Occupied residents / utilization | 14 / 70% | 17 / 85% | 19 / 95% |
| Realized revenue per occupied resident / month | $5,300 | $5,800 | $6,200 |
| Monthly net operating revenue | $74,200 | $98,600 | $117,800 |
| Annual net operating revenue | $890,400 | $1,183,200 | $1,413,600 |
| Variable operating costs / month | $17,353 | $21,699 | $26,687 |
| Fixed + step-fixed operating costs / month | $61,500 | $65,100 | $70,100 |
| Normalized passive-basis cash operating profit / month | – $4,653 | $11,801 | $21,013 |
| Cash operating margin before D&A | – 6.3% | 12.0% | 17.8% |
| Working-owner pre-tax business cash benefit / month | $2,147 | $18,601 | $28,213 |
Published benchmarkThe price anchor is Genworth's 2024 Nebraska Cost of Care release, which reports a $61,416 annual median for assisted living communities. No comparable Nebraska occupancy series was found, so Base 85% is benchmarked to NIC's Q1 2025 assisted-living occupancy of 85.8% across its tracked U.S. markets. Occupancy is therefore moderate-to-low confidence for Nebraska and must be tested.
Occupancy ramp – Nebraska statewide Base model, 20-bed capacity, 2026 planning case
Cost structure and owner economics
Care labor determines whether ownership is a job or an investment
Base is manager-operated: administrator replacement labor is an operating cost, so avoided payroll is not passive return. Direct-care coverage retains a fixed core even below full occupancy, then steps up with census and acuity.
| Cost line | Base / month | Behavior / basis |
|---|---|---|
| Variable and resident-driven | ||
| Variable direct-care payroll | $9,000 | Steps with occupancy / acuity |
| Food + resident consumables | $11,220 | $660 per occupied resident-month |
| Collection, payment + discount leakage | $1,479 | 1.5% of net revenue |
| Variable subtotal | $21,699 | 22.0% of Base revenue |
| Fixed and step-fixed | ||
| Baseline direct-care payroll coverage | $21,000 | Minimum coverage before occupancy step-up |
| Administrator replacement payroll, fully loaded | $6,800 | Fixed owner-replacement labor |
| Food service payroll | $5,500 | Step-fixed |
| Housekeeping + laundry payroll | $3,800 | Step-fixed |
| Activities + transportation payroll | $3,000 | Step-fixed |
| Facility rent / CAM planning allowance | $10,500 | Fixed; local quote required |
| Utilities | $3,700 | Mostly fixed |
| Insurance | $3,200 | Quote required |
| Maintenance, waste, software, telecom, marketing, professional, transport, recurring training + miscellaneous | $7,600 | Fixed / step-fixed planning basket |
| Fixed + step-fixed subtotal | $65,100 | 66.0% of Base revenue |
| Total cash operating cost | $86,799 | 88.0% of Base revenue |
Labor is modeled above statutory minimums. Nebraska's 2026 minimum wage is $15.00 per hour. BLS's May 2023 Nebraska occupational data reported mean wages of $15.85 for home health and personal care aides and $18.49 for nursing assistants. Because those figures predate the model year, Base uses a $19.00 direct-care cash wage plus roughly 18% payroll/benefit/workers' compensation burden rather than mechanically inflating a stale mean. The BLS Nebraska wage table is the benchmark; actual recruiting quotes are required.
Revenue minus all modeled cash operating costs, including $6,800/month fully loaded administrator replacement labor. No D&A is modeled, so this is normalized cash operating profit before D&A – not EBIT or EBITDA.
Passive-basis profit plus the $6,800/month administrator labor the owner personally supplies. That add-back is imputed compensation for work, not an owner draw and not passive return on capital.
Below operating profit, the Base plan reserves $2,500 per month for maintenance capex after stabilization. With no debt modeled, potential pre-tax owner cash after that reserve is about $9,301 per month passive or $16,101 per month for a working owner. Income tax is intentionally not converted into a fake business expense or a personalized effective rate; founders should model entity and owner tax separately. If debt is actually committed, principal, interest, covenants and draw timing need a new cash schedule rather than a generic loan assumption.
Unit economics and break-even
Break-even is about 14.4 occupied beds in the sustainable Base case
The natural unit is one occupied resident-month. Because the owner's modeled role is facility administration rather than direct resident-care production, administrator replacement labor stays in fixed cost; it is not deducted twice in unit contribution. Food/consumables, variable direct-care labor and collection leakage are the unit-level costs.
| Metric / formula | Base result | Decision meaning |
|---|---|---|
| Revenue per occupied resident-month | $5,800 | Realized net operating revenue |
| Food + resident consumables | – $660 | Resident-driven cost |
| Variable direct-care labor | – $529 | $9,000 ÷ 17 occupied residents |
| Collection / payment leakage | – $87 | 1.5% of revenue |
| Passive/economic contribution per resident-month | $4,524 | 78.0% contribution margin |
| Cash-survival break-even before owner compensation | 12.9 beds | Fixed non-owner cash cost of $58,300 ÷ 78.0% margin |
| Sustainable working-owner / passive break-even | 14.4 beds | Includes $6,800 administrator replacement compensation |
| Break-even monthly revenue | $83,469 | $65,100 fixed cost ÷ 77.99% contribution margin |
Sustainable break-even capacity – Nebraska statewide Base model, 20 beds, 2026 USD
The distinction between cash survival and sustainable ownership matters. At roughly 12.9 residents, the business can cover non-owner operating cash costs while the owner supplies the administrator role without receiving its modeled market compensation. At roughly 14.4 residents, the business also supports the $6,800 monthly administrator replacement value. Calling the lower number “break-even” without naming the missing owner compensation would overstate the economics.
About 9.8 years on the passive-owner basis. Starts with the full $950,000 Typical project capital, applies the eight-month occupancy ramp, then $9,301/month stabilized cash after maintenance capex. Pre-tax; no debt.
About 5.7 years when the owner's avoided $6,800/month administrator replacement labor is counted as part of the owner's business cash benefit. This combines labor value and investment return and therefore is not a passive-return metric.
These are monthly cumulative cash schedules. Months 1 – 8 use the displayed occupancy ramp; maintenance capex begins in month 9. Because the opening reserve is funded at month 0, ramp losses are not counted again as new equity. Under the Downside case, passive project payback is not reached within a 15-year modeling horizon because stabilized cash operating profit is negative before maintenance capex.
State demand and sensitivity
Nebraska demand is real, but one empty wing can erase the margin
Nebraska has a substantial older population and licensed ALF supply, but neither proves a specific 20-bed building will fill. Address diligence must still test referrals, household economics, nearby alternatives, workforce and competitor quality.
Reported government dataThe DHHS roster reports 277 licensed assisted-living facilities and 13,957 beds as of August 14, 2026. Census QuickFacts reports a July 1, 2025 population estimate of 2,018,006 and 18.3% age 65 or older.
Occupancy sensitivity
At Base unit economics, each occupied resident-month contributes about $4,524 after resident-driven costs. Two fewer occupied beds reduce annual contribution by roughly $108,600 before any staffing de-escalation. Early-warning KPI: occupied beds and qualified lead-to-move-in conversion.
Price sensitivity
A $200 monthly change in realized rate across 17 residents moves annual revenue by about $40,800; after the 1.5% leakage assumption, the contribution impact is about $40,200. Early-warning KPI: realized rate after discounts and care-level mix.
Labor sensitivity
A $1/hour increase across roughly 16,000 annual direct-care hours, with 18% burden, raises annual labor cost by about $19,000. Early-warning KPI: filled shifts, agency hours, overtime and caregiver turnover.
Risk interaction matters more than any single percentage. A weak admission month can leave payroll largely unchanged because baseline coverage cannot fall one-for-one with census. A high-acuity resident can require more labor without immediately supporting a matching care-level increase. Conversely, an operator with durable hospital/home-health referral relationships and disciplined pricing can move from 70% to 85% occupancy without proportionally increasing fixed rent, insurance or administration. Primary operating KPIs are utilization, realized rate and labor hours per resident.
Method and evidence
What is known statewide – and what still needs an address-level quote
Research was reviewed August 28, 2026. Nebraska fees, rules and facility counts are high-confidence. Conversion cost, care-compatible rent, insurance, recruiting wages, resident pricing and occupancy remain model-dependent because no official statewide series describes this exact 20-bed private-pay format.
| Source / publisher | Geography / period | Evidence type | How used |
|---|---|---|---|
| Nebraska DHHS – Assisted Living Facilities | Nebraska / current | Official fee or rule | License threshold/fee and inspections; paired with Title 175 for staffing and physical-plant rules |
| Nebraska DHHS – ALF roster | Nebraska / Aug. 14, 2026 | Reported government data | 277 facilities and 13,957 licensed beds |
| Nebraska State Fire Marshal | Nebraska / current | Official fee or rule | Fire inspection scope and fee cross-check |
| Nebraska Secretary of State | Nebraska / current | Official fee or rule | LLC legal form and filing fee |
| Nebraska DOL + BLS OEWS | Nebraska / 2026 rule + May 2023 wages | Official rule + government data | $15.00 wage floor and care-worker wage benchmark; age disclosed |
| Genworth / CareScout Cost of Care | Nebraska / 2024 | Published benchmark | $61,416 annual Nebraska assisted-living median price anchor |
| National Investment Center | U.S. tracked markets / Q1 2025 | Published benchmark | 85.8% assisted-living occupancy context; not a Nebraska observation |
| U.S. Census Bureau – QuickFacts | Nebraska / 2025 estimate | Reported government data | Population and age-65-plus demand proxy |
| Nebraska Department of Revenue | Nebraska / current | Official tax rule | Long-term lodging / facility transaction-tax treatment; ancillary sales flagged for review |
| Nebraska Workers' Compensation Court + NDOL | Nebraska / current | Official employer rule | Workers' compensation requirement and employer-cost treatment |
Evidence labels: official Nebraska rules/data are high confidence; authoritative but older or non-state benchmarks are moderate; modeled assumptions are low/model-dependent. Rent, build-out, staffing, insurance, marketing, occupancy and 2026 realized resident rate require validation. “Local quote required” means replace the allowance after the address and scope are known.
This planning model is not legal, tax, clinical or architectural advice. Before committing capital, confirm the address with DHHS, fire and local authorities, a health-care architect, insurer and counsel. Next, obtain a site-specific bed-capacity/code review and current wage, insurance and competitor-rate quotes.