How much an adult care home operator gets paid depends on several factors. 

Adult care homes are licensed, single family residences that offer 24-hour care for up to five adult residents in a homelike setting. Operators provide individualized care while supporting and honoring a resident’s independence, preferences and choices. The Adult Care Home Program (ACHP) provides licenses to operators in Multnomah County for different populations:

  • Aging patients and people with physical disabilities (APD)
  • Mental health and addictions (MHA)
  • Intellectual and developmental disabilities (I/DD)

This differs from the approach of other states.

Be aware that I/DD care homes are closing because the number of I/DD residents has decreased in Multnomah County. ACHP no longer encourages new operators to apply for licenses to open I/DD adult care homes.

Multnomah County has a great need for new APD and MHA care homes.

Pay Rates

Pay rates depend on:

  • The resident population served.
  • The classification level of care provided. For example, APD 2 pays more than APD 1 because APD 2 residents need a greater amount of skilled care.
  • Whether residents pay privately or through Medicaid.

Private Pay

With private pay, the resident has a contract to pay the adult care home operator each month for specific care and services. Private pay rates are negotiable and based on the services provided. What other operators charge also influences the rates of a new adult care home. Rates for private pay residents commonly range from $4,000 to $5,500 per month.

Medicaid Rates as of January 1, 2024

Aging Patients and People With Physical Disabilities

Monthly rates for APD residents range from $2029 to $3136, plus $733 room and board payment. The resident’s Medicaid case manager calculates the total payment based on an assessment of care needs.

Mental Health and Addictions

The average monthly rate for MHA residents is $2738, plus $733 room and board payment.

Intellectual and Developmental Disabilities

The monthly rates for I/DD residents are based on a support needs assessment. The average monthly rates is $3,500 to $5,500, plus $733 room and board payment. If someone has exceptional needs the rate can go up to approximately $9,000. This is uncommon and new operators shouldn’t count on getting such a high rate.

Adult care home operators are small business owners. They must budget for monthly expenses, such as food, supplies, utilities and staffing expenses. They also are required to have enough money available to cover unexpected costs. Becoming an operator is a major financial commitment! 

Learn more about how to become an adult care home operator and how to compete in the adult care home market.