Oregon in-home care agency license: classifications, fees and the OHA survey

Choose your classification before you do anything else

Most states have a single non-medical home care credential. Oregon divides its in-home care agency license into four classifications, and almost every later decision depends on which one you pick: who you hire, which policies you write, what you pay and whether Medicaid will contract with you. The classifications in OAR 333-536-0007 are cumulative.⁠²

Scroll the table sideways to see every column.

The rules define the three medication levels precisely:⁠²

• Medication reminding is an audio, visual or spoken reminder for a client who can self-direct. All four classifications may provide it.
• Medication assistance means helping a client who can self-direct with one or more steps, such as opening a container. You need Basic or higher.
• Medication administration means giving medications to a client who cannot or will not self-direct, including setting up secondary containers. You need Intermediate or higher, and the agency must employ a registered nurse.

A client “self-directs” when they know the reason, dose, route and time for each medication. You must document that knowledge on an OHA standardized form signed by the client, and re-evaluate it at least every 90 days. If a client can no longer self-direct and your classification does not cover the services they now need, you must arrange appropriate services without delay or transfer the client to a higher-classified agency within 30 days.⁠²

The classification also limits how you describe your agency. You may not advertise services or use a classification title other than the one you are licensed for. To move up later, you file a revised application, and OHA must approve the change before you offer the new services.⁠²

Who needs the license, and who does not

ORS 443.315 prohibits anyone from establishing, managing or operating an in-home care agency, or claiming to, without an OHA license. The statute defines an in-home care agency as one “primarily engaged in providing in-home care services for compensation” in the client’s residence. In-home care services are personal care services that help a person meet daily needs, “but does not include curative or rehabilitative services.”⁠¹ The personal care tasks listed in the rules are:⁠²

• bathing, grooming and hygiene, and dressing
• toileting
• mobility
• nutrition, hydration and feeding
• care of the body, such as foot or nail care
• medication reminding

On top of personal care, you may offer housekeeping, laundry, shopping, transportation and arranging medical appointments.⁠²

The rules exempt several groups:⁠¹⁠²

• Independent individuals, volunteers, family members and neighbors.
• Agencies that offer only housekeeping, and agencies that only supply on-call staff to facilities.
• Support services provided and funded by the Oregon Department of Human Services (ODHS).
• Organizations licensed, registered or certified under ORS 101.030, 410.495, 443.410, 443.485, 443.725, 443.860 or 443.886. Among them, ORS 443.410 covers residential care facility licenses, ORS 443.725 adult foster homes, ORS 443.860 hospices and ORS 443.886 the memory care endorsement.
• A licensed hospice that provides palliative care.

Referral and matching services. A referral or matching service is exempt only while it stays a matchmaker. It needs a license once it does any one of these things: schedules caregivers, assigns work, sets pay rates, defines working conditions, negotiates for a caregiver or client, or places a caregiver with a client.⁠² If your model is a registry, compare it against that list before assuming you are exempt.

Housekeeping-only clients. An agency with clients who receive only housekeeping and support services does not have to apply the service-plan, caregiver-training, medication, nursing, client-record and quality-improvement rules to those clients.⁠²

Neighboring licenses. A home health agency, which provides skilled nursing or therapy visits, is excluded from the in-home care definition and licensed separately. A licensed home health agency may also provide personal care without a second license, but it must follow the in-home care laws and rules other than licensing (ORS 443.090). See the Oregon home health agency license guide.⁠¹ If you want to care for adults in your own home rather than theirs, look at the adult foster home license. Residential settings for six or more people fall under the assisted living and residential care facility licenses.

Owner and administrator qualifications

The owner carries “full legal, financial, and overall responsibility” for the agency. Violations by owners, staff or representatives count against the agency’s license.⁠² The owner must either be a qualified administrator or employ one. Under OAR 333-536-0052, “qualified” means:⁠²

• a high school diploma, and
• at least two years of professional or management experience in a health-related field or program.

The rules define both kinds of experience:⁠²

• Professional experience means holding a current nursing, CNA, certified medication aide, medical or therapeutic license, certificate or degree used in health-related work, or completing an OHA-approved training program.
• Management experience means hiring, assigning, evaluating and disciplining staff in a health-related field.

The rules also set how the administrator must work:⁠²

• Presence. The administrator organizes and directs the agency “including on premises supervision and direct observation” and must be on site “multiple days per week.” The administrator or a designee must be reachable during every hour that services are delivered.
• Designee. A designee who covers temporary absences must meet every administrator qualification.
• Delegate. A delegate may handle only the tasks the rules specifically allow, and need not meet the administrator qualifications.

Changing administrators requires OHA approval before the change takes effect.⁠²

Background checks on owners and administrators. If an owner or administrator will have direct contact with clients, they submit background information to OHA. OHA itself runs the check at application and every three years after that. “Direct contact” includes meeting a prospective client in person to discuss your services, so most owner-operators qualify. The agency pays for any nationwide fingerprint check.⁠²

Wage and training history. Since 2019, ORS 443.325 has allowed OHA to deny a license to an applicant with a pattern, over the previous five years, of significant and substantiated violations of Oregon wage or employment law in any business the applicant owns or operates.⁠¹ The rules define:⁠²

• a pattern as three or more of the same substantiated violation in five years
• wage and employment law as ORS 653.010 to 653.261 (unpaid wages) and ORS chapter 659A (unlawful employment practices)
• substantiated violations as including final findings or civil penalties from the Bureau of Labor and Industries

Offices, branches and subunits: the 60-mile rule

Your agency serves a geographic service area of 60 miles in any direction from its office. The rules use that distance to sort every additional office into one of two categories:⁠¹⁠²

• Branch office. A branch must be within 60 miles of the parent. It shares the parent’s administration, and scheduling, training and records stay at the parent. A branch may not provide services until OHA has added it to the parent’s license.
• Subunit. An office more than 60 miles from the parent is a subunit. It must have the same owners as the parent, its own staff, and its own billing, scheduling, human resources and training. It is licensed separately: $1,250 extra at initial licensure and $1,000 extra at each renewal, as published on 2026-10-12.

A caregiver may travel with a client outside the service area only if:⁠²

• the client asked for it,
• the trip is written into the service plan, and
• the caregiver documents care daily and checks in with the administrator before leaving, on return, and at least weekly on trips longer than a week.

Two more structural rules apply. You may not hand administrative or supervisory functions to another organization, and agency records must be kept separate from any other business you run.⁠²

Policies and client documents a surveyor will ask for

Because OHA surveys you before you serve anyone, your written systems are most of what the surveyor can evaluate on day one. OAR 333-536-0051 requires written policies and procedures on:⁠²

• administrative and personnel operations, including traveling with clients
• investigating complaints, adverse events, medication errors and abuse allegations
• pre-employment screening and fitness determinations
• client notification of price increases, deposits and refunds, cancellation, termination, and reimbursement for stolen or broken property
• client record management
• infection control
• medical and non-medical emergency response
• medication reminding, assistance and administration
• nursing services
• quality assessment and performance improvement

The disclosure statement. Before services begin, each client or their representative signs a written disclosure statement. Failing to give one is a statutory ground for penalties.⁠¹ Under OAR 333-536-0055, the statement must include:⁠²

• your classification and how involved a registered nurse is
• your charges and billing methods
• your deposit and refund policy
• your policy on reimbursing stolen or damaged property
• how to reach the administrator during service hours
• the clients’ rights notice
• a clear statement that you cannot manage medical conditions that are no longer “stable and predictable”

Client rights. Clients have a right to 30 days’ written notice before you end services. The exceptions are 48 hours for non-payment and immediate notice when safety cannot be ensured.⁠²

Service plans and monitoring. OAR 333-536-0065 and 0066 set a fixed schedule for each client:⁠²

1. Initial evaluation

   Document a dated, signed evaluation of the client’s physical, mental and emotional needs; the service plan is built on it.

2. Service plan

   Write it within seven days after services start, and review it with each caregiver before that caregiver’s first visit.

3. Initial home visit

   Visit between day 7 and day 30 of service.

4. Monitoring

   Monitor quarterly after that. Some quarterly checks may be by phone, but in-person visits may never be more than six months apart.

Records and quality improvement. Keep client records for at least seven years after services end.⁠² A quality-improvement committee must meet and keep minutes at least quarterly. It must include administrative staff and a caregiver, plus a registered nurse at Intermediate and Comprehensive agencies.⁠² You also need an infection control program that covers sharps disposal, standard precautions, personal protective equipment and bloodborne pathogens.⁠²

Caregiver orientation and training hours

ORS 443.011, added in 2019, directed OHA to set minimum training rules for unlicensed in-home caregivers. The resulting rules took effect July 1, 2021 and were amended again effective October 23, 2023.⁠¹⁠² Under OAR 333-536-0070, each caregiver must:⁠²

• be at least 18 years old
• complete at least 4 hours of agency-specific orientation, online or in person, before working independently
• complete at least 8 hours of initial training: 2 hours before providing services and the other 6 within 120 days of hire. Up to 1 hour of competency evaluation may count toward the 8.
• have their competency evaluated, through both direct observation and written or oral testing, before working independently
• complete at least 6 hours of education every year, plus 1 more hour if they provide medication services

Initial training must cover the topics relevant to your services. The list includes:⁠²

• responding to medical emergencies
• adverse behaviors
• nutrition and special diets
• preventing skin breakdown and falls
• infection control and body mechanics
• fire safety
• cultural competence
• abdominal thrust and first aid (CPR is “recommended but not required”)

Who may train. Training must come from a qualified individual, qualified entity or qualified trainer. You can designate a staff member as a qualified trainer if they have at least two years of experience in an agency, long-term care facility, residential care facility or other health care setting.⁠²

Exemptions and transfers. Caregivers with a current Oregon health-care license or certificate, such as a CNA, are exempt from the in-home caregiver training. Previously trained caregivers still need their competency evaluated.⁠²

Records. Each personnel record must show:⁠²

• the training content and dates
• the trainer’s name and signature
• the highest level of service the caregiver is qualified to provide

Medication and nursing services

Medication training. A caregiver who will give medication services needs at least 4 hours of non-injectable medication training from a qualified individual or entity. They must also pass a return demonstration before giving any medication.⁠²

Intermediate and Comprehensive agencies. These agencies must employ a registered nurse to oversee medication administration, and the rules add several duties:⁠²

• Get written or telephone orders from a licensed practitioner. Telephone orders go to the practitioner for signature within 72 hours.
• Have an RN evaluate every client’s medication regimen every 90 days.
• Label secondary containers with the client’s name, the dose time, the fill date and time, and who filled them.

Since January 1, 2024, an agency RN may carry out an out-of-state physician’s order for up to 90 days after a client starts with the agency.⁠²

Nursing services and delegation. Only a Comprehensive agency may provide nursing services, and only for clients who are stable and predictable. RN teaching and delegation of nursing tasks to caregivers follows the Oregon State Board of Nursing rules in OAR chapter 851, division 047.⁠²

Background checks on caregivers

An in-home care agency must run a criminal background check before anyone with direct client contact is hired, contracts with you or volunteers.⁠¹ People convicted of the crimes listed in ORS 443.004(3), some of which carry a look-back period of five or ten years, may not work with clients in any capacity. For other crimes against persons or property, you apply a documented “weighing test” under your written fitness policy.⁠²

What the check must include. You may use a screening vendor that either is accredited by the National Association of Professional Background Screeners or meets all of these criteria: two years in business, a business license and any required private investigator license, and $1 million in errors-and-omissions coverage. The check must include:⁠²

• a name and address history trace
• date-of-birth and Social Security number verification
• county and city records for the past seven years
• a nationwide multijurisdictional database search
• a nationwide sex offender registry search

You also query the federal List of Excluded Individuals and Entities, and you recheck everyone every three years.⁠²

Preliminary hires. A new hire may start orientation before the check clears, but only under active supervision and with no client contact.⁠²

Medicaid clients. If you serve ODHS Medicaid clients, checks for workers who see those clients go through the ODHS Background Check Unit instead of a vendor.⁠²⁠⁴

Applying to OHA, step by step

1. Set up the business and pick a classification

   Have the ownership details, administrator, office address and service area ready. The application asks for “demographic, ownership and administrative information about the agency.”⁠²

2. Write your policies and client documents

   Prepare the policies, disclosure statement, clients’ rights notice and training program described above. The survey checks them against OAR 333-536.⁠²

3. Apply through OHA’s online portal

   OHA’s applicant FAQ (updated August 1, 2025) says that from May 12, 2025, all initial applications must be filed through its online licensing portal at hflclicensing.oregon.gov, and paper submissions are no longer accepted. The fee is paid online or by check payable to Oregon Health Authority, and it is nonrefundable.⁠²⁠³ The FAQ asks for your administrator’s resume with proof of two years of health-related experience, proof of a high school diploma or equivalent, the background check request form for any owner or administrator with client contact, and all policies and forms.⁠³

4. Owner and administrator background checks

   If an owner or administrator will have direct client contact, OHA checks them as part of the application.⁠²

5. Completeness review

   OHA confirms the fee and that the application is complete before scheduling a survey.⁠²

6. Initial survey

   The FAQ says OHA schedules it for a date and time you and the surveyor agree on, after you finish every earlier step; the rules require at least 72 hours’ notice. A survey may include interviews, observation, record review and client audits, and ends with an exit conference.⁠²⁠³ Accreditation or federal certification may stand in for the on-site survey, but only if OHA approves the accrediting body.⁠¹⁠²

7. License issued

   OHA notifies you in writing, and you post the license where the public can see it in your office.⁠² The FAQ says a license issues within ten business days after you pass the survey, and you may not accept clients until you have it.⁠³ If the survey finds deficiencies, you correct them and notify the program before licensure; if OHA does not receive a request for a new survey within 15 days, or you do not comply at the second survey, you must file a new application with a new fee.⁠³

Timeline. OHA’s FAQ (updated August 1, 2025) said that because initial applications had risen sharply, processing was taking six to nine months, and that applications are reviewed in the order received.⁠³ Ask the program for its current wait before you sign a lease or hire staff, because that figure may have changed since the FAQ was updated.

Fees, renewal and changes

Renewal. A license expires 12 months from the date it was issued. File for renewal at least 30 days before it expires.⁠¹⁠²

Changes. Changes to anything in your application must be reported to OHA on a revised application within 30 days. A new administrator, a different classification, or a new branch or subunit requires OHA approval before you make the change.⁠²

Change of ownership. A license cannot be transferred, so a buyer files a change of ownership with OHA and pays the fee above.⁠¹⁠²

Ongoing surveys. After the initial survey, OHA surveys every two years. It also investigates complaints unannounced, as soon as practicable, and begins within two working days when a complaint alleges an immediate threat to a client’s health or safety.⁠²

Deficiencies. If a survey finds deficiencies:⁠²

• you have 10 business days to submit a signed plan of correction
• deficiencies must be corrected within 60 days of the exit conference unless OHA grants an extension

Getting paid through Oregon Medicaid

ODHS buys in-home care agency services for Medicaid clients under OAR chapter 411, division 33. To enroll, an agency needs:⁠⁴

• a copy of its OHA license with the Comprehensive classification
• a Medicaid provider number
• a current Oregon Secretary of State business registration, plus an assumed business name if you use one
• a signed provider enrollment agreement

The Medicaid rules reach past licensing in several ways:⁠⁴

• Services must include medication reminding, assistance and administration, plus nursing services.
• Services must start within five business days of accepting a referral.
• Staffing must cover clients 365 days a year, including holidays.
• Disclosure statements may not mention “buy outs” or “finder’s fees,” and Medicaid clients may not be charged extra fees.

For billing, you must:⁠⁴

• use electronic visit verification
• send ODHS or the Area Agency on Aging a quarterly summary for each client and a monthly service report
• submit claims through MMIS within 12 months of service

Payment is at the hourly rates set in OAR 411-027-0170. You can also bill up to three hours at the ADL rate for the initial assessment, and community transportation mileage tied to an assessed need.⁠⁴

A Limited or Basic agency is therefore limited to private-pay and other non-Medicaid clients.

Penalties for unlicensed or noncompliant operation

Operating without a license carries a civil penalty of up to $500 a day, and each day is a separate violation. OHA can also sue for an injunction and recover its attorney fees.⁠¹⁠² Within 14 days of an injunction, an unlicensed agency must:⁠²

• tell its clients it can no longer serve them
• refund fees for services not delivered
• stop providing services

A licensed agency that breaks the rules faces civil penalties of up to $1,000 per violation, capped at $2,000, and can lose its license. Grounds include:⁠¹⁠²

• failing to provide the disclosure statement
• failing to deliver contracted services
• failing to correct deficiencies
• the five-year pattern of wage-law or caregiver-training violations described above

What changed recently and what to check

• July 1, 2021. A rewrite of OAR 333-536 added the separate administrator, personnel record, client monitoring and infection control rules (OAR 333-536-0052, 0053, 0066 and 0082) and amended the caregiver training rule.⁠²
• October 23, 2023. Amendments changed the definitions, classification, service plan, caregiver training and medication rules. A minor correction followed in 2024.⁠²
• January 1, 2024. Agency RNs may carry out out-of-state physician orders for up to 90 days.⁠²
• May 12, 2025. Initial applications moved to the online portal.⁠³

The rule history on the Secretary of State’s OARD site, read on 2026-10-12, shows the June 6, 2024 correction as the latest entry for OAR 333-536.⁠² That site does not show proposed rules, so before you rely on the text above, ask OHA’s in-home care program whether any rulemaking is pending.

For the rest of Oregon’s care licenses, see the Oregon state overview and the non-medical home care license type page.

Sources

1. 1
   Oregon State Legislature, ORS chapter 443 (ORS 443.004, 443.011, 443.305 to 443.355: in-home care agencies) Checked 12 Oct 2026 · Back to text ↑
2. 2
   Oregon Secretary of State, Oregon Administrative Rules, OAR chapter 333, division 536: In-Home Care Agencies Checked 12 Oct 2026 · Back to text ↑
3. 3
   Oregon Health Authority, Health Care Regulation and Quality Improvement, In-Home Care Initial Applicant FAQ Checked 12 Oct 2026 · Back to text ↑
4. 4
   Oregon Department of Human Services, Aging and People with Disabilities, OAR chapter 411, division 33: In-Home Care Agency Services (Medicaid) Checked 12 Oct 2026 · Back to text ↑

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