How to start a home care agency in Oregon

Oregon requires a In-Home Care Agency license (classified Limited, Basic, Intermediate or Comprehensive) from Oregon Health Authority, Public Health Division (Health Care Regulation and Quality Improvement / health facility licensing) to operate a home care agency. Fee: Initial license fee by class: Limited $2,000; Basic $2,250; Intermediate $2,500; Comprehensive $3,000; plus $1,250 per subunit (ORS 443.315(4)). Change of ownership outside the renewal date: $350 plus $350 per subunit.

License required

Yes

License

In-Home Care Agency license (classified Limited, Basic, Intermediate or Comprehensive)

Issuing agency

Oregon Health Authority, Public Health Division (Health Care Regulation and Quality Improvement / health facility licensing)

Fee

Initial license fee by class: Limited $2,000; Basic $2,250; Intermediate $2,500; Comprehensive $3,000; plus $1,250 per subunit (ORS 443.315(4)). Change of ownership outside the renewal date: $350 plus $350 per subunit.

Renewal

Every year · Annual renewal: Limited or Basic $1,000; Intermediate $1,250; Comprehensive $1,500; plus $1,000 per subunit.

Accreditation

Optional. OHA may accept federal certification or accreditation from an approved body in place of the biennial on-site inspection if the agency shares the documentation and lets OHA join the exit interview.

Survey and inspection

On-site inspection before services begin and every two years after that (ORS 443.315(7)).

Regulation

ORS 443.305 to 443.350 (incl. 443.315); OAR chapter 333, division 536

1. Choose the license classification that matches the services to be offered
2. Apply to the Oregon Health Authority in the form it requires, with the class fee
3. Pass an OHA on-site inspection before any services are provided
4. Renew every year with the renewal fee and proof of continued compliance; on-site inspections recur every two years

Staffing

• Agency must keep administrative and professional oversight of service quality

Training

• Agency must ensure caregivers meet any training requirements OHA sets under ORS 443.011

Program

Oregon Health Plan (OHP), Oregon Health Authority (OHA)

Enrollment portal

Oregon MMIS Provider Portal (or-medicaid.gov)

Application fee

Under the federal rule (42 CFR 455.460), institutional providers pay the CMS application fee when they first enroll, re-enroll or revalidate. The fee is $750 for calendar year 2026. Individual physicians and non-physician practitioners do not pay it. A fee already paid to Medicare or to another state's Medicaid program counts. OHA's enrollment page does not list a separate state fee.

Fingerprinting

Under federal rules (42 CFR 455.434 and 455.450), the state places provider types in 'limited', 'moderate' or 'high' risk levels. High-risk providers, and anyone who owns 5% or more of one, must submit fingerprints for a criminal background check. The OHA enrollment and revalidation pages do not describe a separate state fingerprint process.

Site visit

Under federal rule (42 CFR 455.432), the state must visit moderate- and high-risk providers before and after enrollment. Every enrolled provider must allow unannounced on-site inspections. The OHA enrollment and revalidation pages do not describe a separate state site visit process.

Revalidation

OHA rescreens every actively enrolled provider at least once every 5 years. It mails a notice to the provider's mail-to address. The provider returns the listed forms (for organizations OHA 3972, 3974 and 3975; for payable individuals OHA 3972 and 3975; for other individuals OHP 3113 and OHA 3975) by the due date, ideally online through the MMIS Provider Portal. If the forms are not returned, participation can end under OAR 410-120-1260. A revalidation received within 30 days after inactivation is treated as a revalidation; after that it is treated as a re-enrollment.

Full Oregon Medicaid enrollment guide →

CON program

Yes

Program

Certificate of Need

Agency

Oregon Health Authority, Public Health Division (Certificate of Need Program)

Services covered

• new hospitals
• new skilled nursing or intermediate care services or facilities (long-term care), including rebuilds and bed relocations through expedited review

Oregon certificate of need details →

Model

hybrid

State vendor

Direct Care Innovations (OR PTC DCI) for ODHS in-home workers; none for home health agencies

Services in scope

• personal care (homecare and personal support workers)
• home health

Alternate EVV allowed

Yes

Program

https://www.oregon.gov/odhs/providers-partners/orptc/pages/default.aspx

Oregon EVV requirements →

State minimum wage

$15.55 an hour

Effective

2026-07-01

Scheduled increases

Adjusted each July 1 by CPI (US DOL); the July 2027 rates were not yet published in the sources reviewed.

Direct-care wage floor

Homecare and personal support workers paid through ODHS earn a base rate set by collective bargaining: $21.25/hour at step 1 for 2026, plus add-ons (CPR/first aid, enhanced and exceptional pay).

HCBS 80/20 rule

Federal baseline: 42 CFR 441.302(k) requires the state to show that each provider spends at least 80% of Medicaid payments for homemaker, home health aide and personal care services under 1915(c) waivers on direct care worker pay and benefits. Compliance starts 2030-07-09 (for managed care, the first rating period starting on or after that date); annual payment-adequacy reporting under 441.311(e) starts 2028-07-09. A state may set a lower share for state-defined small providers and exempt providers facing hardship, each only through a public notice-and-comment process. The eCFR text has not changed since 2024-07-09. No state-published 80/20 implementation step (small-provider criteria, hardship exemption or reporting guidance) was found for this state in the official sources reviewed.

Personal care / in-home supportive care organizations — active organization NPIs (NPPES)

251 (as of Sep 13, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

1,264,858 (as of Jun 1, 2026)

All Oregon Home care Medicaid rates, ranked →

• OR Adults' HCBS Waiver (1915(c))
• OR Aged and Physically Disabled Waiver (1915(c))
• OR Behavioral (ICF/IDD) Model Waiver (1915(c))
• OR Children's Extraordinary Needs Waiver (1915(c))
• OR Children's HCBS Waiver (1915(c))
• OR Medically Fragile (Hospital) Model Waiver (1915(c))
• OR Medically Involved Children's Waiver (MICW) (1915(c))
• Oregon Project Independence - Medicaid (1115)

Oregon waivers and waiting lists →