Oregon assisted living facility license: ODHS steps, fees and rules

Two licenses under one rule: ALF or RCF

Oregon handles assisted living in one rulebook, OAR chapter 411, division 54, which covers two facility types. Both serve “six or more seniors and adult individuals with disabilities” and both offer supportive services “available on a 24-hour basis”.⁠¹ They differ in the living units:

• An assisted living facility (ALF) consists of “fully, self-contained, individual living units”.⁠¹
• A residential care facility (RCF) consists of “shared or individual living units”.⁠¹

The choice drives your building budget, because each type has its own construction standard (see the building section below). Each facility is licensed as “a separate and distinct facility”. You do not need separate licenses for contiguous buildings of the same license type that the same licensee runs as one integrated unit, but each building needs its own staffing plan.⁠¹

The rule has two more variants. An intensive intervention community (IIC) is an RCF endorsed to house fewer than six residents with co-occurring mental, emotional or behavioral disturbances.⁠¹ A conversion facility is a nursing facility that has converted to an RCF through the conversion process.⁠¹ Neither one is a starting point for a new founder: IIC applicants need a history of an unencumbered ODHS license or a specialized living contract with ODHS.⁠¹

Where the license starts and stops

The prohibition is broad. Without a license, you may not operate a facility, “use the term residential care or assisted living facility,” or hold yourself out as providing those services.⁠¹ Violating ORS 443.400 to 443.455 is a Class B misdemeanor.⁠²

There is one carve-out. A building where six or more people live does not need a license if the facility neither offers nor provides help with activities of daily living or health services. Your staff and written materials may not suggest that such care is available, and tenants must not expect it. When the classification of a facility’s operations is disputed, the ODHS Director decides whether a license is required.⁠¹ Independent-living buildings use this route. If outside home care agencies serve the tenants, those agencies hold their own licenses; see the in-home care agency guide and the home health agency guide.

Below six residents, the model is different. Care in a family home for five or fewer adults not related to the provider is an adult foster home under ORS 443.705, with its own license and rules; see the Oregon adult foster home guide.⁠²

Oregon does not require a certificate of need for an ALF or RCF. ORS 442.315 requires one only for new hospitals and new skilled nursing or intermediate care services or facilities.⁠⁶

Before you buy land or file for a building permit

OAR 411-054-0012 front-loads the state’s review, so it happens before construction rather than after. If you are building, or buying an existing building that is not already a licensed facility, the sequence starts like this:⁠¹

1. Talk to ODHS first

   The rule says the applicant “must communicate with the Department before submitting a letter of intent.”⁠¹ The Community-Based Care licensing page asks prospective providers to contact the unit through its contacts page.⁠⁵

2. Submit a letter of intent before applying for a building permit

   It must identify the applicant, the city and street address, and the intended type (RCF, ALF, IIC or memory care). It must also give the number of units and maximum capacity, whether you can serve an underserved population, whether you will serve residents through the state medical assistance program (Medicaid), and your operations in Oregon or other states that show you can serve this population.⁠¹

3. Attach an independent market analysis by a third-party professional

   It must describe the population you intend to serve, the area’s demographics and regional economy, and the number of potential residents. It must also cover nearby amenities, existing and proposed competing facilities, and the occupancy rates and waiting lists of competing developments.⁠¹ A market analysis is not required for a change of owner of an existing licensed building or for a conversion facility.⁠¹

4. Show your compliance history

   You must demonstrate a past history, if any, of substantial compliance with Oregon laws, rules, codes and permits, and the ability to deliver quality services.⁠¹

5. Wait for the written decision

   ODHS issues a written decision on the potential license within 60 days of receiving all required information. If you disagree, you have 14 calendar days to request a contested case hearing.⁠¹

Before it issues a license, ODHS will consider the intentions you stated in the letter, such as underserved populations and Medicaid participation.⁠¹

Who can hold the license

ODHS looks through the company to its owners. “Applicant” covers each entity holding a 10 percent or more ownership interest. For facilities that serve Medicaid residents, the threshold drops to 5 percent.⁠¹ If the building owner and the operator or management company are different entities, both file applications, but only one fee is paid.⁠¹

Under OAR 411-054-0016, each applicant must:⁠¹

• Pass an ODHS background check and have no convictions for the crimes listed in OAR 407-007-0275.
• Have no ownership in the past five years in any facility, in any state, whose license or certification was involuntarily suspended or voluntarily terminated during a state or federal sanction process.
• Have no ownership in the past five years in a business that failed to repay Medicaid overpayments or civil penalties, or failed to pay employees, workers’ compensation, food, utilities or other operating costs.
• Submit an auditor’s certified financial statement showing resources to run the facility for 60 days, including liquid assets for 45 days. Anticipated Medicaid income does not count as liquid assets. An unencumbered line of credit or a performance bond can demonstrate liquidity.
• Provide a month-by-month pro forma (revenues, expenditures and resident days) for the first 12 months and show how you would cover any cash-flow gaps it reveals.

For Medicaid-serving facilities run by a board of directors, the application must also list each board member’s Social Security number and date of birth, a requirement the rule attributes to CMS.⁠¹

The consultant requirement for first-time operators

If you have never operated or managed an assisted living or residential care facility in Oregon, you must retain an ODHS-approved consultant or management entity. Experience in other states does not count.⁠¹⁠² The rule sets these terms:⁠¹

• The contract must start at least one month before the facility is licensed and run for at least six months after the initial license is issued. ODHS can extend the period if inspections or the consultant’s reports show you are not in substantial compliance.
• The consultant must hold, or employ someone who holds, an active Oregon residential care facility administrator license. It must have at least three years of satisfactory experience operating or managing an Oregon ALF or RCF within the last five years, and it must not appear on the federal OIG exclusion list.
• If you are applying with a memory care endorsement, the consultant needs three years of experience with an endorsed Oregon memory care community within the last five years.
• The consultant reviews your policies and quality improvement program, audits at least monthly, and sends monthly reports to ODHS and to you. You must act on its recommendations.
• To end the engagement, you notify ODHS in writing at least two business days ahead. ODHS answers within five business days, and services continue until it decides.

The statute behind this is ORS 443.420(9), last amended in 2025 (Oregon Laws 2025, chapter 619).⁠² The rules implementing it, OAR 411-054-0016 and 411-054-0017, are, as of 2026-10-12, temporary rules (APD 21-2026), effective August 10, 2026 through February 5, 2027.⁠¹ Check the Secretary of State’s rule page for the permanent version before you sign a consultant contract.

The administrator

Every ALF and RCF must employ a full-time administrator scheduled on site at least 40 hours per week.⁠¹ Since January 1, 2022, every administrator must hold a Residential Care Facility Administrator (RCFA) license from the Oregon Health Licensing Office. The older ODHS-approved administrator pathway is closed.⁠¹

To get an RCFA license, an applicant must:⁠⁴

• be at least 21;
• have a high school diploma, an equivalency such as the GED, or a post-secondary degree;
• have worked in a professional or managerial role in health or social services for at least two of the last five years, or hold a bachelor’s degree in a health or social-service field, or have a combination of experience and education the Office accepts;
• pass a background check that includes a national fingerprint-based check;
• complete at least 40 hours of approved training;
• pass the required exam.

Licensed administrators must meet the annual continuing education requirements and the practice standards of the Long Term Care Administrators Board.⁠¹

If the administrator will be absent for more than 30 days, you must notify ODHS and get approval of the arrangements in advance. If you have no licensed administrator during a transition, you must contact ODHS immediately and send the interim administrator’s qualifications and a background check request.⁠¹

Building standards

Drawings go to the Facilities Planning and Safety Program (FPS) after the letter of intent is filed. They must comply with OAR chapter 333, division 675, the building codes and the Oregon Fire Code, and they must bear the stamp of an Oregon-licensed architect or engineer.⁠¹ ODHS will deny a license if the State Fire Marshal has given notice of noncompliance.⁠²

Source: ⁠¹

Further ALF requirements:⁠¹

• “Adaptable units” are not acceptable. Every unit must be accessible.
• Each unit needs at least 100 cubic feet of storage, including a closet with four linear feet of hanging space, plus lockable storage for valuables.
• Social and recreation space totals at least 15 sq ft per resident.
• Resident corridors longer than 20 feet must be at least 72 inches wide, and no unit may be more than 150 feet from a seating or common area.
• If residents live on more than one floor, the building needs an elevator.
• At least one washer and dryer must be available to residents at no extra cost.

The ALF standard in OAR 411-054-0300 applies to ALFs not licensed before January 15, 2015, and to major alterations whose plans were not submitted before that date.⁠¹

Fire and emergency planning

Unannounced fire drills must be held every other month across day, evening and night shifts, with fire and life safety instruction for staff in the alternate months.⁠¹ Residents are instructed in evacuation within 24 hours of moving in and at least annually after that.⁠¹ Your emergency plan must include supplies to shelter in place for at least three days “without electricity, running water, or replacement staff,” and you must drill the plan at least twice a year. One of the two drills may be a tabletop exercise.⁠¹

From application to opening day

After ODHS has approved a potential license and construction is under way, the rule sets a countdown to licensure:⁠¹

1. 60 days before licensure

   Submit the completed application with the fee, your rental (residency) agreements, disclosure information, and policies and procedures covering administration, personnel and resident care.⁠¹ By statute, the policies must cover staff and administrator training, service planning, medication administration, food preparation and distribution, safety, emergency response and facility closure.⁠² The application must also list every owner at the 10 percent (or 5 percent for Medicaid) threshold, including background check request forms, every state where those owners have held a care facility license, and the ODHS-approved acuity-based staffing tool you will use.⁠¹

2. 30 days before licensure

   Send ODHS verification of your administrator’s RCFA license. Send FPS a signed Project Substantial Completion Notice that requests the onsite licensing inspection.⁠¹

3. Two working days before the inspection

   Send both ODHS and FPS a signed Project Completion/Inspection Checklist. The inspection will not happen until both have it.⁠¹

4. Certificate of occupancy

   Give ODHS and FPS a copy of the certificate of occupancy from the local building agency, showing the occupancy classification and construction type.⁠¹

5. Written confirmation of licensure

   You may not admit any resident until ODHS confirms licensure in writing.⁠¹

6. First inspection

   ODHS inspects no sooner than 90 days and no later than 120 days after the initial license is issued.⁠¹

Before move-in, each prospective resident must receive the Uniform Disclosure Statement (form APD 9098A) on request and the Consumer Summary Statement (form APD 9098CS), separate from the residency agreement. ODHS posts every facility’s Consumer Summary Statement on its licensing website.⁠¹

Fees

Sources: ⁠¹⁠²

Government-operated facilities pay no fee.⁠² ODHS inspects each facility’s kitchen every year. In a year without a full survey, the kitchen inspection is a separate visit with a $200 fee.⁠¹ A memory care endorsement adds its own fee (next section). These are the only fees the ODHS rule sets. The RCFA license fees belong to the Health Licensing Office, and building permit fees are set locally.

Memory care endorsement

To care for residents with Alzheimer’s disease or other dementia in an endorsed memory care community, or to market the facility as one, you need a memory care endorsement on the ALF or RCF license under ORS 443.886 and OAR 411-057.⁠²⁠³ Founders who plan memory care from the start should know these rules:

• Endorsement application fee, due at the initial application and at every renewal: $50 for 16 or fewer endorsed residents, $75 for 17 to 50, and $100 for 51 or more, as published on 2026-10-12.⁠³
• Direct care staff in memory care complete 16 hours of in-service training each year instead of 12.⁠³ The administrator must spend at least 10 hours of annual continuing education on dementia care.⁠³
• The community needs an outdoor recreation area of at least 600 square feet or 15 square feet per resident, whichever is greater, with at least 15 feet in every direction and a perimeter fence at least six feet high.⁠³
• An RCF memory care community must be on the ground floor.⁠¹
• Your required consultant must have endorsed memory care experience (see above).⁠¹

Staffing and training

Oregon sets no numeric staff-to-resident ratio. Instead, the facility must “consistently have qualified awake direct care staff, sufficient in number to meet the 24-hour scheduled and unscheduled needs of each resident.”⁠¹ Several concrete rules follow from that standard:⁠¹

• Acuity-based staffing tool (ABST). You must use the ODHS-developed ABST or a proprietary tool that ODHS has approved through form se528132. A facility using a proprietary tool files an annual statement that the tool has not changed in substance.
• Two direct care staff must be available at all times if any resident needs two-person assistance.
• An awake caregiver must be present in each detached building and each segregated area.
• If you use universal workers who also cook, clean or do laundry, you must increase staffing to cover that work.
• Staffing must be enough to meet the evacuation standard set by the fire authority.
• ODHS can impose minimum staffing based on acuity, a complaint investigation or a survey.

Each facility must have an Oregon-licensed nurse who is regularly scheduled on site and available by phone. A registered nurse must, at minimum, assess every resident who has a significant change of condition.⁠¹

Required training under OAR 411-054-0070:⁠¹

• All employees, before starting work. Orientation must cover the job description, residents’ rights (including the ODHS-approved LGBTQIA2S+ training), abuse reporting, fire and emergency procedures, infectious disease prevention, and ODHS home and community-based services (HCBS) training. Anyone who prepares food needs a food handler’s certificate.
• Direct care staff, before providing care. Staff complete approved pre-service dementia training and an orientation to each resident’s service plan. They work under direct supervision until they demonstrate competence.
• Within 30 days of hire. Staff must demonstrate competence in service plans, activities of daily living, normal aging, recognizing and reporting changes of condition, and food safety. Medication administration requires a documented observation.
• Every year. Direct care staff complete at least 12 hours of in-service training, including 6 hours on dementia care. All staff also complete annual infection control and HCBS training and biennial LGBTQIA2S+ training.

Renewal, ownership changes and what is changing

A license lasts two years.⁠¹⁠² File the renewal application at least 45 days before expiration. A renewal filed with the fee before the expiration date keeps the license in force until ODHS acts.⁠¹ ODHS inspects on each renewal. It renews when you are in substantial compliance with the rules and the kitchen inspection standard and the State Fire Marshal has given notice of compliance.⁠¹ Find the renewal application on the ODHS Provider Resources page.⁠⁵

Licenses do not transfer to a new owner, location or management agent.⁠¹ A buyer or new management company must:⁠¹

• notify ODHS at least 60 days before the change;
• file a full application with background checks, policies, the residency agreement, disclosures (including the Consumer Summary Statement) and the ABST it will use;
• give residents 30 days’ written notice;
• wait for ODHS approval before taking control;
• hire the consultant described above if it lacks Oregon experience.

ODHS inspects 90 to 120 days after the change.⁠¹

Many OAR 411-054 rules, including the definitions, application, applicant qualification, consultant, change of ownership, staffing and inspection rules, are temporary rules filed as APD 21-2026. They are effective August 10, 2026 through February 5, 2027.⁠¹ ODHS must adopt permanent rules or let them lapse by that date, so recheck the rule text before you file.

Sources

1. 1
   Oregon Secretary of State, OAR chapter 411, division 54 (Residential Care and Assisted Living Facilities) Checked 12 Oct 2026 · Back to text ↑
2. 2
   Oregon State Legislature, ORS chapter 443 (Residential Care; Adult Foster Homes; Hospice Programs) Checked 12 Oct 2026 · Back to text ↑
3. 3
   Oregon Secretary of State, OAR chapter 411, division 57 (Endorsed Memory Care Communities) Checked 12 Oct 2026 · Back to text ↑
4. 4
   Oregon Secretary of State, OAR chapter 853, division 35 (Residential Care Administrator Authorizations) Checked 12 Oct 2026 · Back to text ↑
5. 5
   Oregon Department of Human Services, Community-Based Care Licensing Checked 12 Oct 2026 · Back to text ↑
6. 6
   Oregon State Legislature, ORS chapter 442 (Health Planning) Checked 12 Oct 2026 · Back to text ↑

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