Adult Foster Homes in Oregon: Rules, Care Levels, Who Pays

If a discharge planner has suggested an Oregon adult foster home for your mom or dad, know that state law caps these family homes at five adults, with a caregiver on duty 24 hours a day.1 You may be hearing the term for the first time, and it's natural to wonder whether a house with a handful of residents is safe enough. The rules behind these homes are specific, and they give you real questions to ask before you choose one.

In This Guide

• What Is an Adult Foster Home in Oregon?
• Who Lives in the Home and Who's on Duty
• Class 1, 2 and 3: Matching the Home to Your Parent's Needs
• The Dementia Training Every Caregiver Needs
• Who Pays for an Adult Foster Home in Oregon
• If the Home Asks Your Parent to Leave
• How to Vet an Oregon Adult Foster Home
• Frequently Asked Questions

What Is an Adult Foster Home in Oregon?

The word "foster" throws a lot of families, because most of us only know it from child welfare. In Oregon it means something else entirely. Under Oregon Revised Statutes chapter 443, an adult foster home is "any family home or facility in which residential care is provided in a homelike environment for five or fewer adults who are not related to the provider by blood or marriage."1 Every provider must be licensed with the licensing agency before opening or operating one.1

Nationally, homes like this fall under the wider label of board and care homes: small private residences, usually with 20 or fewer residents, where staff provide meals and personal care and nursing care usually isn't provided on site.5 Oregon's version is smaller than that national norm, and it has its own licensing system.

Two state agencies license adult foster homes. The Oregon Department of Human Services (ODHS) licenses its homes, and the Oregon Health Authority licenses the homes under its jurisdiction.1 This guide covers the ODHS homes for older adults and adults with physical disabilities. ODHS's Office of Aging and People with Disabilities writes their rules in Oregon Administrative Rules chapter 411, division 049, which define an adult foster home as one serving adults who are 65 or older or have a physical disability.1

Those division 049 rules are temporary rules, in effect from August 1, 2026 through January 27, 2027, so expect permanent rules to replace them.1 The day-to-day licensing work is done by the Local Licensing Authority, which means the local ODHS offices and the Area Agencies on Aging that contract with ODHS to carry out parts of the licensing process.1

Who Lives in the Home and Who's on Duty

The question most families ask first is simple: will someone be there? Oregon's statute answers it directly. A provider must live in the home or hire a resident manager to live there, and a provider or substitute caregiver must be on duty 24 hours a day.1 The state can grant exceptions only under rules designed to safeguard residents' health, safety and uninterrupted services.1

For homes serving older adults and adults with physical disabilities, ODHS rules require the licensee or administrator to live in the home at least five 24-hour days a week as the primary caregiver.1 Instead of a licensee or administrator living in as primary caregiver, an ODHS-licensed Oregon adult foster home serving these groups may use one of three alternatives: an approved resident manager who lives in and works five days and nights a week, two approved primary caregivers who live in and split the week three and four days, or round-the-clock staffing at least five days a week by approved shift caregivers.1

Nights are where families worry most, so it helps to know the exact wording. The ODHS rule requires "qualified caregivers, including awake caregivers as necessary, sufficient in number to meet the 24-hour needs of each resident."1 That standard is tied to what each resident needs, so ask any home you're considering how it staffs overnight and what happens when a resident needs help at 3 a.m.

Capacity is set with staffing in mind too. When the licensing authority decides a home's maximum capacity, it must ensure a ratio of at least one caregiver per five residents, counting adult day services clients and anyone else in the home who needs care or supervision, except where the rule allows otherwise.1

Class 1, 2 and 3: Matching the Home to Your Parent's Needs

Not every adult foster home can care for every level of need, and that's by design. ODHS licenses each home serving older adults or adults with physical disabilities as Class 1, Class 2 or Class 3, and a home may admit or keep only residents whose impairment levels fall within its class.2 The classes are measured in activities of daily living (ADLs), so get a rough sense of how much help your parent needs before you start touring.

Table source: OAR 411-049-0105, temporary rule effective August 1, 2026 through January 27, 2027.2

Needs change, sometimes quickly after a fall or a hospital stay. When a new or current resident's impairment goes beyond the home's class, the licensee or administrator must request a written variance from the Local Licensing Authority.2 The authority may grant a variance that lets the resident move in or stay, but only if the home proves the rule's criteria by clear and convincing evidence, and one of those criteria is that living there is the resident's own choice.2 If your parent has settled in and wants to stay, say so to the home in writing, so the variance request can show that choice.

The Dementia Training Every Caregiver Needs

If your parent is living with memory loss, you'll want to know who's trained to help. Oregon law requires every caregiver in an ODHS-licensed adult foster home serving older adults and people with physical disabilities, substitute caregivers included, to complete dementia care training before providing direct care.1 ODHS rules require that training to be approved by the Department, and ODHS lists Pre-Service Dementia Care Training among the courses required before licensure.1

The statute, ORS 443.743, sets what the training must cover:1

• How dementia progresses, including memory loss and psychiatric and behavioral symptoms
• Techniques for understanding and managing behavioral symptoms, including reducing the use of antipsychotic medications for nonstandard uses
• Ways to meet the social needs of people with dementia and give them meaningful activities
• Specific aspects of dementia care and safety, such as addressing pain, providing food and fluids, preventing wandering and elopement, and using a person-centered approach

If you're weighing an adult foster home against a memory care community, our guide to memory care in Oregon explains how Oregon's memory care endorsement works.

Who Pays for an Adult Foster Home in Oregon

Money is often the hardest part of this decision, and it's okay if it's the thing keeping you up at night. It helps to ask two separate questions: who pays for your parent's care, and who pays room and board.

On the care side, ODHS pays for nursing facility care and home and community-based care for people who qualify under the Oregon Supplemental Income Program Medical, known as OSIPM.3 Whether OSIPM will pay for your parent's care in a particular adult foster home, and how much, is something to confirm with your local ODHS or Area Agency on Aging office before you sign an agreement, and to ask each provider directly whether it takes residents on OSIPM.

To qualify for OSIPM, Oregon's Medicaid long-term care program, in 2026, an applicant's countable income must be at or below $2,982 a month, which is 300% of the full Supplemental Security Income (SSI) standard for one person, or the applicant must set up a qualifying income cap trust.3 The OSIPM resource limit is $2,000 for one person, and Oregon looks back 60 months at asset transfers.3 Our guide to Medicaid and nursing home care in Oregon walks through these tests, spousal protections and the income cap trust in more depth.

On the room-and-board side, the resident pays. Oregon's rules count an adult foster home licensed by ODHS as a community-based care facility, and under OAR 461-155-0270, effective January 1, 2026, a person living in a community-based care facility must pay room and board, and the room and board standard is $773.00 a month.4 That rule applies to adult foster homes licensed by ODHS; if your parent's home is county-licensed in Multnomah County, ask the county and your caseworker how room and board is handled there.

Some residents also owe toward the cost of their care. An OSIPM recipient who receives long-term care services must apply their adjusted income to the cost of care in the amount ODHS determines, which is called patient liability.4 A person who receives SSI is eligible for OSIPM benefits without having to make that payment.4

If your family is paying privately, ask each home for its monthly rate in writing, what it includes, and whether the rate changes if your parent's needs move up a class. Families comparing an adult foster home with assisted living can see how Oregon handles assisted living costs in our guide on how to pay for assisted living in Oregon, and our national guide, How to Pay for Assisted Living, walks through the main payers beyond Oregon's rules, from private savings to long-term care insurance and VA benefits.

If the Home Asks Your Parent to Leave

No one wants to imagine a move-out notice, but knowing the rules ahead of time can save your family a frantic week. For homes under the state statute, a provider may transfer or discharge a resident only for medical reasons, for the welfare of the resident or other residents, or for nonpayment.1

• Notice: the provider must give the resident and their legal representative, guardian or conservator written notice at least 30 days before the proposed move.1
• Medical emergencies: in a medical emergency, which can include an increase in the resident's level of care needs or behavior that poses an imminent danger to the resident or others, written notice must come as soon as possible under the circumstances.1
• Hearing: the resident has the right to an administrative hearing before an involuntary transfer or discharge. After an emergency or welfare move, the hearing must be held within seven days of the move.1
• Held space: the provider must hold a space for the resident while the administrative order is pending.1

The Residents' Bill of Rights in ORS 443.739 repeats the core promise: a resident has the right not to be moved out without 30 days' advance written notice and an opportunity for a hearing.1 If you receive a notice, keep a copy, note the date, and ask in writing which of the permitted reasons the home is relying on.

How to Vet an Oregon Adult Foster Home

A small home can feel wonderfully personal, and it can be hard to know what to look for beyond whether your parent likes the people. Use the rules above as your checklist when you visit:

1. Ask who licensed the home (ODHS, the Oregon Health Authority, or Multnomah County) and what class the license is.1,2
2. Ask whether your parent's current needs fit that class, and what the home would do if they grew, including whether it has ever requested a variance.2
3. Ask who lives in the home: the licensee, a resident manager, or two primary caregivers, or whether it runs on shift caregivers.1
4. Ask how many residents live there now, how many caregivers work each shift, and who is awake overnight.1
5. Ask whether every caregiver, substitutes included, has finished the Department-approved dementia training.1
6. Ask whether the home takes residents on OSIPM, and get the private-pay rate and any room-and-board charge in writing.4
7. Ask under what circumstances the home has asked a resident to leave, and how it gives notice.1

If something goes wrong after your parent moves in, you don't have to handle it alone. The Oregon Long-Term Care Ombudsman is set up in state law to work separately and independently from any other state agency, and it investigates and resolves complaints made by or for residents about actions that may affect their health, safety, welfare or rights.6 The Oregon Long-Term Care Ombudsman's jurisdiction includes adult foster homes with residents over 60.6

Learn More

Find personalized help working out which adult foster home license class fits your parent, and whether they may qualify for OSIPM, at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.