How to start a hospice in Oregon

Oregon requires a Hospice program license from Oregon Health Authority, Public Health Division, Health Care Regulation and Quality Improvement to operate a hospice. Fee: $1,140.

License required

Yes

License

Hospice program license

Issuing agency

Oregon Health Authority, Public Health Division, Health Care Regulation and Quality Improvement

Fee

$1,140

Fee details

$1,140 to obtain or renew a hospice program license (ORS 443.860(3)); incomplete applications or wrong fees are returned.

Renewal

$1,140 renewal fee.

Accreditation

OHA may accept federal certification or accreditation by an OHA-approved accrediting organization as evidence of compliance if it meets CMS hospice standards, OHA is invited to the exit interview and gets requested documents.

Survey and inspection

OHA must inspect each licensed hospice program in person at least once every three years.

Medicare certification

Medicare certification is separate from the state license (state survey or CMS-approved accreditor). CMS imposed a nationwide 6-month moratorium on new Medicare hospice enrollments (including new practice locations) effective 2026-05-13, extendable in 6-month increments; applications received by the Medicare contractor before that date are still processed, accreditation cannot be used for deemed-status entry during the moratorium, and a hospice undergoing a non-exempt ownership change within 36 months of enrollment must re-enroll as new and is therefore blocked. The federal notice leaves Medicaid/CHIP hospice moratoria to each state.

Regulation

ORS 443.850-443.869 (license and fee at ORS 443.860); OAR chapter 333, division 35

1. Submit a complete application on the OHA form with the $1,140 fee
2. OHA confirms completeness, verifies the hospice primarily provides hospice services and assesses capacity to meet CMS conditions of participation
3. Pass the initial survey (OHA may accept CMS certification or a recent approved accreditation survey instead)
4. Receive the license; renew with the fee

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 →

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.

Hospice agencies (community based) — active organization NPIs (NPPES)

123 (as of Sep 13, 2026)

Medicare-certified hospices (CMS Care Compare)

66 (as of Aug 19, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

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

All Oregon Hospice Medicaid rates, ranked →