Listen To This Story
Sixteen Nebraska nursing homes have closed in the last four years, according to the Nebraska Health Care Association. For many assisted-living residents, that has meant traveling to find care or going without it. Nebraska's first homecare cooperative is trying to change that.
Cathy Bowers has spent most of her life around elder care. As a Girl Scout, she visited residents at her local care home through an adopted grandparent program. She became a certified nursing assistant, then a licensed practical nurse and then a registered nurse overseeing a unit. Along the way, she kept hearing the same thing from residents.
"These people have worked their whole entire lives for what they have, and now they're forced to give it up to go into a nursing home," Bowers said. "There's just little things, like, if I had someone to cook for me, if I had someone to do these things for me that I'm not able to do anymore, that I could stay home."
She knew the feeling personally. When she was a college student, her grandmother needed help managing her diabetes and wanted to stay home rather than enter a care facility. Bowers made regular visits to administer insulin. It kept her grandmother home longer — until Bowers had a newborn of her own and couldn't care for both.
Bowers eventually stepped back from nursing to raise four children. But the idea of building an in-home care service never left her. When her kids were grown and Arapahoe's Good Samaritan nursing home closed in 2021, the need became impossible to ignore.
Heidi Thomas, an Arapahoe teacher, felt it, too. Her husband needed care, and the closure left few local options. Thomas spoke with the Omaha World-Herald about the closure, which caught the attention of Cindy Houlden, a cooperative development specialist at the Nebraska Cooperative Development Center. Houlden was already exploring whether a homecare cooperative could fill the gap and reached out through the reporter to find community contacts. Thomas became her first connection to Arapahoe.
Houlden said the gap in care in Nebraska was vast, especially in its rural areas.
"The state of Nebraska is becoming what they call a homecare desert or a care desert," Houlden said. "There's not only not a care facility — there's not a doctor's office, there's not a hospital and there aren't care providers either."
Thomas and Houlden had already been meeting about the cooperative idea when Bowers ran into Thomas at a local pharmacy in 2023. Thomas mentioned an upcoming meeting with the Cooperative Development Center and invited Bowers along. Bowers went, listened and walked out thinking she could do it.
The Nebraska Cooperative Development Center, a University of Nebraska-Lincoln extension program, helped connect Bowers with a cooperative attorney, startup funding and a national network of homecare cooperatives called Elevate. But the turning point came in March 2024, when the center sent Bowers to the National Home Care Cooperative Conference in Dulles, Virginia.
"It wasn't just me telling her, hey, this is a great idea," Houlden said. "She met people that were like her, passionate about home care, about caring for others."
Bowers came back from the trip ready to build. Republican River Valley Homecare was incorporated in April 2025 with four worker-owners, including Bowers and Linda Fitzsimmons. In a worker cooperative, all owners hold an equal ownership stake and have an equal say in how the business is run. The people deciding how the cooperative operates are the same people living and working in the community it serves.
The cooperative began accepting clients in January, serving a 120-mile radius around Arapahoe. It also serves people with developmental disabilities and traumatic brain injuries. It offers non-medical services such as meal preparation, housekeeping, grocery shopping, and laundry.
For Bowers, the day-to-day work is a reminder of why she started. It's the small moments of human connection, she said, that can change the tone of someone's entire day.
"You come home and you reflect, and you're like, this is why I'm doing this," Bowers said. "I'm doing this to give clients the ability to stay in their own home."
Houlden said Republican River Valley Homecare's model can be replicated. The worker-owned homecare model isn't new to the United States. In fact, the nation's largest worker-owned business is a homecare cooperative in New York City. Houlden said the Nebraska Cooperative Development Center is ready to help any community in the state facing similar care gaps explore the model.
"We're here to help anyone who wants to explore this model for their community," Houlden said.
Bowers said her goal is to grow, so that anyone in her service area has the ability to stay in their homes longer.
"I want to grow into something where if people want to stay home, that is a possibility for them to age in their own homes, in their own communities, and they have the opportunity to do that, and it's easily accessible to them," Bowers said.