Author: A. Ant, CADC-II, Licensing & Accreditation Expert
Disclaimer: This content is provided for general informational purposes only and should not be construed as legal, regulatory, or licensing advice. Requirements change frequently. Consult qualified professionals for guidance specific to your situation.
Every residential treatment license in Nebraska runs out on the same day. Under 175 NAC 18-004.01, “A mental health substance use treatment center license expires annually on September 30.” A center that lets the date pass gets a short second chance in the general facility chapter: 175 NAC 1-003.04 says “A licensee can request reinstatement of an expired license within 90 days of the expiration date,” by letter carrying the information an initial application would, plus the fee. The catch sits in the next line. “The facility or service may not operate during this time.” In Nebraska, a missed renewal doesn’t mean a late fee. It means the doors are closed until DHHS acts on the reinstatement.
The fee for coming back is the ordinary license fee. Section 71-434(4) tells DHHS to collect the regular amount “for reinstatement of a license that has lapsed or has been suspended or revoked,” which under 175 NAC 18-004.02 is $250, $275 or $300 depending on licensed beds. Reinstatement applications also need the same lawful presence documents (Neb. Rev. Stat. 4-108 to 4-111) as a first application.
How Nebraska Disciplines a Facility License
Each step below is taken from the Health Care Facility Licensure Act on the Nebraska Legislature’s site and from 175 NAC 1 on the Secretary of State’s rules site. Where we say what a step means in practice, that is our reading.
Enforcement belongs to one office. Section 71-448 gives the power to the Division of Public Health of the Nebraska Department of Health and Human Services, the same Licensure Unit that issues the license, and the statutes lay out a sequence with short clocks.
| Stage | What the statute provides | Section |
|---|---|---|
| Inspection report | Sent to the facility within 10 working days after the inspection ends | 71-440 |
| Minor problems | DHHS may ask for a statement of compliance within 10 working days instead of taking formal action | 71-443 |
| Emergency | Temporary suspension or limitation of the license and an order to move residents, with a hearing within 10 days and a limit of 90 days | 71-446 |
| Sanctions | Fine of up to $10,000 per violation, a ban or limit on admissions, probation up to 2 years, suspension up to 3 years, or revocation | 71-449 |
| Notice | By certified mail, and final 15 days after mailing unless the licensee asks in writing for an informal conference or a hearing | 71-451, 71-452 |
| Informal conference | Held within 30 days of the request, report within 20 working days, DHHS decision within 10 working days, then 5 working days to ask for a hearing | 71-453 |
| Hearing and appeal | Decision final 30 days after mailing unless appealed under the Administrative Procedure Act | 71-454, 71-455 |
The 15-day window is the one that costs centers the most. It runs from the date DHHS mails the notice, not from when someone opens it, so a notice that sits in a mailbox over a holiday weekend loses days before anyone reads it. The informal conference can be with DHHS or with a peer review organization, and in our experience it is the cheaper way to reach a negotiated outcome. Asking for a hearing keeps the full record for court if it comes to that.
What Gets a Center Cited
Section 71-448 lists the grounds. The ones we’d expect in a residential addiction or mental health setting are violations of the rules, conduct or practices detrimental to residents, refusing DHHS access, retaliation, a report that the center’s accreditation was sanctioned or withdrawn, and “Failure to file a report of suspected abuse or neglect as required by sections 28-372 and 28-711.”
That last ground connects to a notice rule many operators haven’t read, because it sits in 175 NAC 1 and not in the treatment center chapter. 175 NAC 1-005.01(G), part of the general chapter in its January 20, 2025 version, requires every facility licensed under the Act to notify DHHS electronically, in writing or by fax within 24 hours when it has reason to believe abuse, neglect or exploitation of a resident occurred, when a resident dies at the facility from suicide, a violent act, drowning or the use of restraint or seclusion, when a resident who needs supervision leaves without staff knowing, after a fire, and after a natural disaster or accident that harms the physical plant in a way that directly affects a resident. The notice has to describe the steps taken to keep residents safe. Separately, 28-372 makes owners, operators and employees of DHHS-licensed facilities tell law enforcement or DHHS when they have reasonable cause to believe a vulnerable adult has been abused, neglected or exploited, with a written report within 48 hours if DHHS asks, and 28-711 covers suspected child abuse. In our reading, a missed 24-hour notice is a rule violation in its own right, and surveyors reviewing an incident will look for it.
The Five Routes Back in 71-456
Nebraska spells out reinstatement by how the license was lost. Section 71-456 sets these paths:
- A license that lapsed for nonpayment of fees can be reinstated with payment of the fee.
- A suspended license is eligible at the end of the suspension, after an inspection and payment of the renewal fee.
- A license on probation comes off probation at the end of the term, with an inspection if DHHS thinks one is warranted.
- A licensee may petition the director for reinstatement before a suspension or probation period ends.
- A revoked license “is not eligible for relicensure until two years after the date of such revocation,” and the way back is a new initial application.
The statute and the rule overlap on expired licenses. The statute lets a lapsed license come back on payment of the fee without naming a deadline, while 175 NAC 1-003.04 sets the 90-day window described above. Our reading is that the 90 days is the practical limit, and that a center outside it should plan on a fresh initial application, inspection included. Ask the Licensure Unit before assuming otherwise.
Revocation Follows the People
A revocation reaches past the license itself. Under 71-449 the licensee “may not apply for a license for a minimum of two years after the effective date of the revocation,” and 71-447 lets DHHS deny an application from an applicant who had a license revoked within the two years before applying. Selling the building doesn’t wipe the slate. Nebraska licenses can’t be transferred (71-435), so a buyer applies as a new licensee, and the application under 71-433 names the owner and every person in control. In our view, a new entity with the same people behind it should expect DHHS to connect the dots.
Running a facility without a license is its own problem, and in our reading that covers the months after a revocation or an expiration nobody reinstated. Section 71-458 makes it a Class I misdemeanor, and every day after a first conviction counts as a separate offense.
Accreditation Trouble Is License Trouble
A center licensed on the strength of accreditation that DHHS accepted owes DHHS a report. Section 71-438(2) requires notice when that accreditation “has been sanctioned, modified, terminated, or withdrawn,” and under 71-448(4) an accreditor’s report of that kind can itself support discipline against any licensed facility. The practical hit can come faster than any DHHS action. Seclusion, locked units and mechanical or chemical restraint are reserved by 175 NAC 18-006.05 for centers holding Joint Commission, CARF or Council on Accreditation status, which means a center that loses its accreditor also loses those tools the same day. Restraint policies, locked doors and staff training all need to come back into line with what a non-accredited center may do, namely hands-on restraint and time-out, each governed by a policy a physician has signed off on.
Psychiatric Hospitals Under the Same Act
A Nebraska hospital with psychiatric beds is licensed as a hospital (175 NAC 9) by the same DHHS Licensure Unit through its acute care facilities office. Because 71-448 applies to any “license issued under the Health Care Facility Licensure Act,” our reading is that the sanctions, notice periods and reinstatement paths above apply to them as well. More on that setting is in Nebraska Mental Health Inpatient Licensing.
Writing a Response DHHS Will Accept
When DHHS asks for a statement of compliance, the 10 working days go quickly. From what we’ve seen in surveys, the statements that close cleanly take each citation by its rule number, say what changed, name who owns the fix and when it was done, and attach proof such as the corrected policy, sign-in sheets from the retraining or the results of a record review. If an incident is behind the citation, attach the 24-hour notice and any abuse report that went with it. Keep records long enough to prove your history: 175 NAC 18 sets two years, while the January 2025 general chapter (175 NAC 1-008.03) requires “a minimum of 7 years beginning with each service date,” and we’d follow the longer one.
Questions about reinstatement go to the Office of Developmental Disabilities & Behavioral Health Facilities at dhhs.ddbhfacilities@nebraska.gov, phone (402) 471-9607. Letters, including a reinstatement request, should be addressed to the Licensure Unit with Attn: MHSU at PO Box 94669, Lincoln NE 68509-4669. For the requirements behind a first license, see Nebraska Drug and Alcohol Inpatient Treatment Licensing, Nebraska Drug and Alcohol Outpatient Treatment Licensing plus the state summary, Nebraska Behavioral Health Licensing.
Frequently Asked Questions
What happens if a Nebraska treatment center license is not renewed by September 30?
The license expires. Under 175 NAC 1-003.04 the licensee can request reinstatement by letter within 90 days of expiration, with initial application information and the fee, but the facility may not operate while that request is pending.
How soon can a Nebraska facility reapply after its license is revoked?
Not for at least two years. Neb. Rev. Stat. 71-449 bars applying for a minimum of two years after the revocation takes effect, 71-456 makes a revoked license ineligible for relicensure until two years after revocation, and the return is through a new initial application.
How long does a Nebraska facility have to contest disciplinary action?
Fifteen days from the date DHHS mails the notice. Under 71-451 and 71-452 the action turns final when that period ends unless DHHS has received a written request for an informal conference or a hearing.
Holding a DHHS notice with a 15-day clock running? We can help you sort out the response.
Sources
- Nebraska Secretary of State, Title 175 (175 NAC 1 and 175 NAC 18): Health Care Facilities rules (checked October 19, 2026)
- Nebraska DHHS, Licensure Unit: Mental Health Substance Use Treatment Centers (checked October 19, 2026)
- Nebraska DHHS, Licensure Unit: Hospital Licensing (checked October 19, 2026)
- Neb. Rev. Stat. 71-433: License application contents (checked October 19, 2026)
- Neb. Rev. Stat. 71-434: License and reinstatement fees (checked October 19, 2026)
- Neb. Rev. Stat. 71-435: License not transferable (checked October 19, 2026)
- Neb. Rev. Stat. 71-438: Accreditation and notice of sanctions (checked October 19, 2026)
- Neb. Rev. Stat. 71-440: Inspection report (checked October 19, 2026)
- Neb. Rev. Stat. 71-443: Review of inspection findings, statement of compliance (checked October 19, 2026)
- Neb. Rev. Stat. 71-446: Temporary suspension or limitation (checked October 19, 2026)
- Neb. Rev. Stat. 71-447: Denial or refusal to renew (checked October 19, 2026)
- Neb. Rev. Stat. 71-448: Grounds for disciplinary action (checked October 19, 2026)
- Neb. Rev. Stat. 71-449: Sanctions (checked October 19, 2026)
- Neb. Rev. Stat. 71-451 and 71-452: Notice and request for conference or hearing (checked October 19, 2026)
- Neb. Rev. Stat. 71-453: Informal conference (checked October 19, 2026)
- Neb. Rev. Stat. 71-454 and 71-455: Hearing decision and appeal (checked October 19, 2026)
- Neb. Rev. Stat. 71-456: Reinstatement (checked October 19, 2026)
- Neb. Rev. Stat. 71-458: Operating without a license, penalty (checked October 19, 2026)
- Neb. Rev. Stat. 28-372: Reporting suspected adult abuse (checked October 19, 2026)
- Neb. Rev. Stat. 28-711: Reporting suspected child abuse (checked October 19, 2026)
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