How much will I get paid as an Adult Care Home operator?

A lot depends on the population you serve: Developmental Disabilities, Aging and People with Disabilities, or Mental Health and Addictions.  There are two payment options: private pay and Medicaid. 

Private Pay

  • The resident has a contract with you to pay a certain amount of money each month in return for specific care and services. Private pay rates are negotiable, and based on the services you provide, and what other private pay homes charge.


Aging and People with Disabilities

  • Rates for homes serving older adults and adults with disabilities (not developmental disabilities or mental health and addictions) currently range from $1932 to $2985 per month, plus the resident's contribution of a $654 room & board payment. An electronic assessment of care needs completed by the resident’s Medicaid case manager calculates the total amount to be paid by Medicaid for a resident’s care.

Developmental Disabilities

  • For Developmental Disability homes, the standard Medicaid rate is between $2000 and $3000 a month, plus the resident's contribution of a $654 room & board payment. A standardized calculation tool is used to determine payment.

Mental Health and Addictions

  • Mental Health homes may receive between $1500 and $2500 a month, plus the resident's contribution of a $654 room & board payment.

How do I get residents for my home?

It is the operator’s responsibility to market their own home and/or to inform programs that help place residents that they have a vacancy.

Homes serving older adults and adults with disabilities may promote free of charge on the county's Adult Care Options website.

Can I buy someone else’s licensed home, and take over the business?

No. A new license is required independent from that of the currently licensed operator.

Before an operator closes their home, all residents are given 30 days notice to move. However, if the residents choose to stay and be cared for by the new operator, they may if that new operator can meet the care needs and license requirements.

Who licenses Adult Care Homes in Multnomah County?

The Adult Care Home Program
Multnomah County Aging, Disability and Veterans Services
209 SW 4th Ave., Suite 650
Portland OR, 97204

Does Multnomah County have the same rules for Adult Care Homes as the rest of the state?

No. Multnomah County has exempt status, which means:

  •  different administrative rules than rest of state
  •  different licensing requirements than rest of state

Multnomah County licenses homes for People with Intellectual/Developmental Disabilities, Seniors and People with Disabilities, and Mental Health and Addictions. The rest of the state has different work units for licensing.

What is a Room and Board home?

A room and board home provides a private or shared room, meals and snacks, medication management, laundry service, but no hands-on care to older adults or adults with disabilities. 

The maximum capacity of the home is not limited to five people, but is determined by the physical characteristics of the home and fire safety requirements.

Medicaid does not pay for room and board homes. 

Learn more: Room and Board License Application Process

What do I need to know to start a business?

If you are thinking of applying for a license to run an adult care home, you will also want to research what it takes to start a business and to be an employer. Making a business plan before starting the licensing application process will help you be a successful business owner and employer.  The Oregon Secretary of State's office has two great resources to help you get started: