Oregon, known as the Beaver State, attracts a great diversity of seniors with its beautiful natural scenery and friendly policies for older adults. Seniors aged 65 and over make up 18% of the state’s population, which is more than the national average of 16.5%. Many of these seniors require regular or short-term care in a licensed nursing home. According to the Oregon Department of Human Services, Oregon has 137 facilities with more than 11,000 beds combined. Oregon also has the lowest nursing home occupancy rate in the United States. 

In Oregon Administrative Rules, the definition of a nursing facility is a permanent residence with two or more people that provides medical services, such as skilled nursing and inpatient beds, but not surgical services. These facilities must be licensed and able to perform complex nursing tasks. A semi-private room in a nursing home in Oregon costs $10,114 per month and a private room is $11,178.

This guide provides information about the costs of nursing home care in Oregon, along with information about financial assistance and free and low-cost resources that may be of assistance to seniors and their families. 

The Cost of Nursing Home Care in Oregon

According to the Genworth Cost of Care Survey 2020, the average price for nursing home care in Oregon is $10,114 per month. This makes Oregon the most expensive state in the region for this type of care. The second most expensive state is Washington at $9,581 per month. California and Nevada average just a few hundred dollars less at $9,247 and $9,262 per month, respectively. The least expensive state is Idaho at $8,669 per month. Each state in the region is significantly more expensive than the national average of $7,756.

$10114

Oregon

$7756

The United States

$9581

Washington

$8669

Idaho

$9247

California

$9262

Nevada

The cost of nursing home care in Oregon can vary by thousands of dollars depending on location. Medford, which is at the very southern end of the state, has the least expensive costs at $9,475 per month. East of the Cascades, the city of Bend has the most expensive nursing home costs at an average of $11,650 per month. Portland, which costs $10,083 per month, is very close to the state average. Salem is the capital of Oregon and has an average monthly cost of $10,646. About 50 miles down the road is the fast-growing city of Eugene, where nursing home care costs $10,235 per month, on average.

$10083

Portland

$11650

Bend

$9475

Medford

$10646

Salem

$10235

Eugene

Nursing home care is the most expensive type of care for seniors in Oregon. Adult daycare is the most affordable option at $2,582 per month, but it may not be an adequate choice for many families. Seniors who are able to stay in their own homes may use homemaker services and home health aides, which cost $5,472 and $5,529 per month, respectively. Assisted living costs $4,659 per month. Residents who require memory care may pay up to 30% more. 

$10114

Nursing Home

$2582

Adult Day Care

$4659

Assisted Living

$5472

Homemaker Services

$5529

Home Health Aide

Financial Assistance for Nursing Home Care in Oregon

Most people do not pay for skilled nursing care entirely out-of-pocket. Rather, they utilize financial assistance programs to help cover the cost of nursing care. Of public financial assistance programs, Medicaid provides the most comprehensive coverage of nursing home care. But, not all seniors are eligible for Medicaid. And because each state operates its own Medicaid program within federal guidelines, eligibility and benefits vary from state to state. Below, we provide more information on Medicaid in Oregon.

Oregon’s Medicaid Program

In Oregon, Medicaid is operated by the Oregon Health Authority (OHA). As of October 2020, OHA had 1,093,766 residents enrolled throughout the state. For eligible applicants, OHA is able to pay for nursing home care through a combination of state and federal funds. According to state research, Medicaid is responsible for paying 60% of all nursing home care in the state. There are 137 licensed nursing facilities in the state, and the occupancy rate hovers around 65%. 

Beneficiaries in Oregon’s Medicaid system are enrolled in the Oregon Health Plan (OHP), which includes funds for long-term care services when they are not covered by Medicaid or other insurance plans. The state extends an abundance of resources to keep seniors out of nursing facilities through Home and Community Based Services and other resources, but it will fund short or long-term stays in nursing facilities when deemed medically necessary. This is determined through a Level of Care Assessment performed by a Service Coordinator. A variety of needs are evaluated through this process, including visual and hearing function, ability to perform ADLs, mobility and communication. 

Medicaid Eligibility in Oregon

In addition to meeting certain physical and cognitive requirements, seniors must also meet specific income and asset limitations to receive long-term Medicaid benefits. An individual cannot earn more than 300% of the Federal Benefit Rate, which is $2,382 per month or $28,584 per year as of 2021. Even though there is an asset limit of $2,000 per individual, the applicant’s primary residence, vehicle, household items and some personal effects are exempt. The applicant may not have more than $603,000 of equity in their home.

In Oregon, being above the income and asset limits does not automatically disqualify applicants from Medicaid. Many seniors spend down to get below the thresholds by paying off debt or putting money into their homes. They may also create Income Cap Trusts, which are a unique financial tool for Oregon seniors.

Seniors can apply for Medicaid online or call OHP Customer Service at (800) 699-9075 for assistance.

Alternative Financial Assistance Options

  • Medicare: Medicare will cover the cost of one’s care in a skilled nursing facility for the first 20 days of their stay, and a portion of the costs up until day 100. After 100 days, the individual is responsible for all costs. Seniors must also have a “qualifying hospital stay” of at least 3 days prior to their admission to a nursing home in order to qualify for Medicare coverage.
  • Aid and Attendance: Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for skilled nursing care.
  • Reverse Mortgages: If you own a home, you may be able to use a reverse mortgage to help pay for nursing care. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home’s equity into cash. This type of funding can be especially useful for married couples when only one partner needs nursing care, as the other residents of the home may continue living there. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.
  • Long-Term Care Insurance: Seniors who already have long-term care insurance may be covered for skilled nursing care. Most policies cover at least a portion of the cost of nursing home care, but it depends on the specific policy terms. Note that older adults who are already in need of skilled nursing care will not be eligible to sign up for a LTC insurance policy.

Free and Low-Cost Resources for Seniors in Oregon

Oregon seniors, and their families, who need help finding a licensed nursing facility have access to several low-cost or free resources provided by the government and private organizations. These resources can also help current nursing home residents and seniors who may want to avoid nursing home placement. 

ResourceContactService
Aging and Disability Resource Connection of Oregon(855) 673-2372Seniors who are exploring their options for nursing homes can contact the Aging and Disability Resource Connection of Oregon to create a plan that meets their current and future needs. Trained counselors provide detailed information about nursing facilities, including licensing, compliance history, abuse reports and surveys. Seniors are matched with financial aid options that can help pay for these facilities. The ADRC can also connect families with services that make transitioning to a nursing home easier. 
Alzheimer’s Association Oregon(800) 272-3900Thousands of seniors in Oregon have Alzheimer’s disease and other forms of dementia. The Oregon chapter of the Alzheimer’s Association can help them locate nursing services and provide general support and information. The  Community Resource Finder provides links to skilled nursing and other valuable services throughout the state. Help with nursing care can also be found on their 24/7 helpline, as well as through online support groups and educational webinars.
Long-Term Care Ombudsman(503) 378-6533 The rights and interests of nursing facility residents throughout Oregon are protected by the Long-Term Care Ombudsman. By investigating complaints and resolving problems, it makes everyday life better for seniors in long-term care facilities. The ombudsman office also advocates for policy change at the state and local level to improve conditions and quality of care. The Oregon Public Guardian is part of the ombudsman office and helps seniors who have difficulty making decisions access the best possible care.  
Senior Law ProjectList of LocationsThe need for a nursing facility often coincides with the need for legal services, including long-term care planning, estate planning and wills and trusts. The Senior Law Project offers free legal assistance to seniors aged 60 and over who are unable to pay for a lawyer. In addition to planning services, it can assist seniors with health benefits, long-term care, Social Security and protection from abuse and exploitation. The Senior Law Project serves people in Multnomah County at locations throughout Portland and Gresham. 
Habitat for Humanity Oregon(503) 206-5248Some seniors in Oregon are forced to move into nursing facilities when their own homes become inaccessible or uninhabitable. Habitat for Humanity volunteers make repairs and improve homes so seniors can avoid institutionalization. Services can include wheelchair ramps, weatherization and handlebars. Habitat for Humanity works with 26 affiliates in Oregon to help deliver these services and ensure that seniors remain safe in their own homes.

Nursing Home Laws and Regulations in Oregon

Licensing RequirementsA person or group of people is required to hold a license to operate a nursing facility in Oregon. Applicants must pass a criminal background check, have a clean performance history, demonstrate financial credibility and have experience in operating a nursing facility. Licenses need to be renewed annually. 
Staffing RequirementsAll nursing facilities in Oregon must be staffed by a full-time licensed nursing home administrator. In facilities with fewer than 40 beds, this administrator may help meet other minimum requirements while on duty.For every resident within a nursing facility, a licensed nurse must be on duty for one hour per week. Facilities must have a licensed charge nurse on each shift, 24 hours per day. Nursing assistants are also required in the following ratios:Day Shift: 1 for every 7 residentsEvening Shift: 1 for every 9.5 residentsNight Shift: 1 for every 17 residentsOregon has specific rules for when shifts can begin and end. 
Staff Training RequirementsStaff at each nursing facility is required to go through orientation training and continual in-service training each quarter. The RN Care Manager is required to pass three credit hours in topics related to long-term care, gerontology or rehabilitation. Certified nursing assistants shall receive a minimum of three hours of in-service training each calendar quarter.
Admission RestrictionsNo nursing facility is allowed to admit a resident who has conditions that the facility does not have the staff or equipment to care for adequately. No person shall be admitted without a direct order from a physician, and no one who is mentally ill or developmentally disabled can be admitted without approval from a legal representative. In addition, the facility cannot place a new resident in any location not included in the most currently approved floor plan.
Care Planning RequirementsWithin 14 days of admittance, a registered nurse must complete a comprehensive assessment of a resident in order to determine their needs and capabilities. The nursing facility will then have seven days to complete a comprehensive care plan. This plan will describe in detail how the facility will meet the medical, nursing, and psychosocial needs of the resident. Whenever possible, the plan will promote the independence of the resident, as well as their potential for discharge.
Dietary and Nutrition Services RequirementsEach nursing facility in Oregon must have a dietary services department that’s responsible for the delivery of sanitary food to residents. The department must be run by a dietary service director who is a registered dietician or someone with the equivalent education or experience. Menus need to have input from a physician, and three meals must be served daily. Dining assistants, who are trained and evaluated, can help residents with feeding. 
Specialized Rehabilitative ServicesNursing facilities must make a rehabilitation program available that aims to restore the functional abilities of residents to the greatest extent possible. Each resident must have their own rehabilitation plan. 
Medication and Pharmaceutical Services In order to ensure compliance with Oregon regulations, each nursing facility must consult with a pharmacist. They will help the facility adhere to correct drug storage, supply and labeling, as well as drug administration. Written policies will describe when residents can self-administer their medications. 
Activities RequirementsAn activity program, which is run by an activity director, must be in place at each Oregon nursing facility. The program will promote normal activities that lead to the self-care of residents. Activity plans for each resident shall be incorporated into each comprehensive care plan. 
Infection ControlTo promote a clean environment, nursing facility employees may not hold duties that may potentially contaminate living areas, such as working trash pickup and housekeeping. The facility must also have a Quality Assurance and Assessment Committee that creates and regularly reviews an infection control program to help prevent the spread of disease. 
Medicaid CoverageResidents who meet the income and asset requirements for the Oregon Health Plan, which is 300% of the Federal Benefit Rate, may have their nursing home stay covered by Medicaid.