The short answer Oregon licenses non-medical operators as in-home care agencies (with limited/intermediate/comprehensive classifications) and skilled operators as home health agencies, both through the Oregon Health Authority.
What Oregon requires
Oregon
Licensing agency. The Oregon Health Authority (OHA), Public Health Division Health Facility Licensing and Certification, licenses in-home care agencies under ORS 443.305-.350 and OAR ch. 333, div. 536, and home health agencies under ORS 443.005-.095 and OAR div. 027.
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Classification system. In-home care agency licenses come in limited (household/self-care assistance), intermediate (plus medication services), and comprehensive (plus delegated nursing tasks) classifications — pick the classification matching your service mix.
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Renewal and surveys. Licenses renew annually with fees set by rule; OHA performs initial surveys, periodic renewals surveys (generally every three years for in-home care), and complaint investigations with plan-of-correction requirements.
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Background checks. Oregon requires background checks for owners and caregivers through the state's background check system, and in-home care agencies must meet caregiver training and supervision standards in div. 536.
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The federal baseline (applies in every state)
Federal
No federal home care license. There is no federal license for home care or home health agencies. Licensure is a state function: each state (and DC) decides whether and how to license home health agencies and non-medical personal care/companion agencies, so requirements vary dramatically by jurisdiction.
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Medicare certification (42 CFR Part 484). Agencies that bill Medicare for skilled home health must be certified as meeting the Medicare Conditions of Participation at 42 CFR Part 484 (patient rights, comprehensive assessment, QAPI, skilled professional services, home health aide standards, and more), on top of any state license.
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Accreditation with deemed status. Most new Medicare home health agencies obtain certification through a CMS-approved accrediting organization with deeming authority — ACHC, CHAP, or The Joint Commission — whose surveys substitute for the state agency's Medicare certification survey.
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State survey agencies enforce both. State survey agencies (usually the state health department) operate under agreements with CMS to survey Medicare-certified agencies, and most also run the state licensure survey program — initial surveys, renewal/recertification surveys, complaint investigations, and plan-of-correction enforcement per the CMS State Operations Manual.
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Primary sources for this page
- https://secure.sos.state.or.us/oard/displayDivisionRules.action?selectedDivision=1372
- https://secure.sos.state.or.us/oard/displayDivisionRules.action?selectedDivision=1372
- https://www.oregon.gov/oha/ph/providerpartnerresources/healthcareprovidersfacilities/healthcarehealthcareregulationqualityimprovement/pages/forms.aspx
- https://secure.sos.state.or.us/oard/displayDivisionRules.action?selectedDivision=1372
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