A nursing home — formally called a Skilled Nursing Facility (SNF) in Medicare and Medicaid terminology — provides the highest level of care available outside a hospital. Nursing homes are licensed to deliver 24-hour skilled nursing services including wound care, IV therapy, physical rehabilitation, respiratory care, and complex medication management.
In Oregon, nursing homes are licensed by ODHS APD under ORS 442 and OAR 411-086, and are additionally certified by the Centers for Medicare & Medicaid Services (CMS) to participate in Medicare and Medicaid. Most Portland-area nursing homes accept both Medicare (for short-term rehabilitation after a hospital stay) and Oregon Medicaid K-Plan (for long-term custodial care).
Nursing homes serve two distinct populations, and understanding the difference matters for planning:
Short-term rehabilitation: After a qualifying hospital stay of 3+ nights, Medicare covers SNF care for up to 100 days (Days 1–20 at 100%; Days 21–100 with a significant daily copay around $200). Most patients are discharged home or to assisted living after 20–45 days. This is the rehab wing of the nursing home.
Long-term custodial care: For individuals who cannot safely return home or to assisted living due to complex medical needs, nursing homes provide permanent placement. Medicare does NOT cover long-term custodial care. It must be paid privately or covered by Oregon Medicaid (K-Plan) for eligible individuals.
Private-pay nursing home rates in the Portland metro in 2026:
| Room Type | Monthly Range |
|---|---|
| Semi-private (shared) room | $7,500 – $9,500 |
| Private room | $9,000 – $12,000+ |
These rates cover room and board, all meals, nursing care, and most clinical services. Specialty units (ventilator care, dialysis support, behavioral health) run significantly higher.
Oregon Medicaid K-Plan pays nursing homes at a regulated Medicaid rate, typically $7,000–$8,500/month depending on the facility's case mix. Medicaid residents pay all income (minus the ~$90/month Personal Needs Allowance) toward the cost. Medicaid covers the remainder up to the Medicaid rate.
CMS publishes a 1–5 star rating for every Medicare/Medicaid-certified nursing home at Medicare.gov/care-compare. The overall rating is a composite of three domains:
A 4–5 star overall rating is a meaningful positive indicator, but dig into the domains. Some facilities have high staffing ratings but poor inspection records, or vice versa. The inspection report itself — downloadable from Medicare.gov or ltclicensing.oregon.gov — shows the exact deficiencies found.
To verify an Oregon nursing home's license and inspect its history:
When touring a Portland nursing home, ask:
Finding the right nursing home in Portland — whether for short-term rehab or long-term care — is one of the most consequential decisions a family makes. Our free advisory service can identify facilities with strong CMS ratings, available Medicaid beds, and a good track record with ODHS APD inspections.
Call us at (503) 427-8483 or use the matching tool on this page. There is no fee for families.
Our free advisor service helps Portland-area families navigate assisted living, memory care, adult foster homes, and more — at no cost to families.
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