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Care Home Corner.

​Welcome to the Care Home Corner blog where we reflect on the business of caring for seniors and individuals with disabilities in Oregon. 

7 Ways an Accountant will Benefit Your Care Home Business

1/30/2021

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By Guest Author Yohannes Zewudie with Yohannes Tax & Accounting
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The Oregon Department of Human Services identifies adult foster care home licensees as independent business owners. Owners, who are responsible for Adult Foster Home (AFH) businesses are usually expected to wear so many hats to discharge their responsibilities and achieve their company’s vision. Trust and relationships created with owner(s), customers, employees, government (federal & state) agencies and the society determine the success of businesses.
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Small businesses, including adult foster homes, deserve the opportunity to be successful in their line of business. Regardless of the business size, accounting as a profession plays a significant role in creating a conducive environment for success. It is with this in mind that I argue small businesses should consider having an accountant if not a certified public accountant (CPA) to achieve their ultimate goal. 
Here are seven ways an accountant will benefit your adult care home business:
1. Effective and Efficient Business Management

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Businesses need historical, current and projected financial information to make the right decision in their business. Without complete and accurate financial recordkeeping and reporting, a small business owner cannot say for sure the true profitability of his/her business. Small businesses that tend to measure their profitability and success based on available cash flow or bank balance are only looking at one criterion. Business owners who rely on incomplete or wrong information usually make decisions that impact their business negatively.  
 
Accounting, as a support function to owners, is tasked with recording business financial data, analyzing them and generating timely and reliable financial reports to show the true picture of business status and profitability. It is for this reason that small businesses need accountant who can assist them in running and evaluating their business.  
2. Peace of Mind

In the ever increasing federal and state regulatory environment, small businesses are required to comply with various tax laws and regulations. Among other, businesses including AFHs have to report:  
  • Federal Payroll & Income Taxes
    • Social Security and Medicare Taxes (FICA taxes)
    • Federal Unemployment Insurance Taxes (FUTA)
    • Federal Income Taxes
  • State Payroll & Income Taxes
    • State Payroll Taxes
    • Transit taxes (Tri-County Metropolitan Transit District (TriMet) and Lane Transit District (LTD)
    • Employment Taxes (State Unemployment Insurance or SUTA):
    • Workers’ Benefit Fund Assessment (WBF)
    • Workers’ Compensation Insurance
  • Local and City taxes
  • Periodic Payroll Reporting
  • W-2, W-3, 1099 and other annual reporting

​Many AFHs are not well-equipped to meet these and other regulatory and compliance requirements. Having an accountant who properly handles these mandatory compliance requirements gives AFH owners peace of mind for them to focus on other important business matters. 
Having an accountant who properly handles these mandatory compliance requirements gives AFH owners peace of mind for them to focus on other important business matters. 
3. Ease of  Annual Business and Personal Income Tax Reporting

The United State Internal Revenue Service (IRS) and the State of Oregon expect taxpayers to:
  • File a timely return;
  • Make accurate reporting; and
  • Pay the required tax amount by the due date. 

Small businesses and their owners face challenges in compiling the necessary business records during tax season. Without a good recordkeeping and tracking method, it is daunting for small businesses to fully meet the tax reporting requirement.

Lack of proper accounting system could result in understated business income and/or deductions that may result in higher taxes, interest and penalties.  If the owner or business deliberately attempt to evade taxes or willfully fails to file or pay taxes, they could be subjected to criminal tax fraud cases.
 
AFH owners can ease the stress associated to tax return filing by hiring an accountant who:
  • Maintains proper financial recordkeeping throughout the year;
  • Maintains proper classification of taxable income and non-taxable income;
  • Claims all available and qualifying business deductions;
  • Files annual & quarterly tax returns in a timely manner; and
  • Pays timely quarterly estimated payments.
4. Utilize Available Business and Financing Opportunities

More than large and medium businesses, small businesses tend to miss out on available business and financing opportunities due to lack of information or poor financial recordkeeping. The missed opportunity to utilize the Small Business Administration Paycheck Protection Program (PPP) is a very good example. Significant number of small businesses failed to utilize federally available PPP. An accountant comes handy to assist small businesses to have the necessary records and enable them seize these available business and financing opportunities.
5. Quality of Life

AFH owners assume so many duties and responsibilities (manager, receptionist, purchaser, accountant, janitor and many others) in a single day to be successful. Since AFH owners are not expected to be knowledgeable or proficient in every task, they might have to work more than 12 hours a day to accomplish all these tasks. These business burdens make the owners unhappy and inefficient. The opportunity cost of spending too much time at work may also negatively impact their health, family dynamics and other social life.
 
An accountant can shoulder one burden and perform the accounting-related duties in the right way. Delegating the accounting tasks to the right professional would result in the following:
  • Improved quality of work.
  • Standardized financial reporting.
  • Reduced owner work-related stress.
  • Increased owner productivity and job satisfaction
  • Potential long term cost reduction.
6. Financial Consultation

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Based on available company financial data and their business environment, a certified public accountant can provide knowledge-based financial consultation to AFH businesses. These consultations could have a significant impact on tax savings and business growth.
7. Representation in Federal and State Audits

In case of federal or state audits, a CPA can represent an AFH to handle their audit. Unlike an accountant, which is limited to the return prepared by him/her, a CPA can represent any business in federal or state audits. 

"While all CPAs are accountants, not all accountants are CPAs”. A CPA is an accountant that passed the rigorous testing and strict licensing requirement to practice in the state. CPAs are expected to abide by the code of ethics and must update themselves by taking the required continuing educations every year.
A CPA is an accountant that passed the rigorous testing and strict licensing requirement to practice in the state. CPAs are expected to abide by the code of ethics and must update themselves by taking the required continuing educations every year.
​The benefits listed above are not an exhaustive list as to why adult foster care homes need an accountant, if not a CPA. It is always advisable for small businesses to reach out to professionals and seek advice on how they can achieve their ultimate business goals.

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About the Author

Yohannes Zewudie is a certified public accountant with over 15 years of experience. He owns Yohannes Tax & Accounting Services, located in Clackamas County, Oregon. His company's mission is to provide complete and accurate tax and accounting services to small and medium businesses at a competitive price. You can reach Yohannes at [email protected] or at 612-987-0621 (cell).

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A New Normal: Screening & Admission During COVID-19

4/28/2020

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Article by Tracey Diani
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Photo by Allie Smith on Unsplash. For use with attribution.
The world as we’ve known it has come to a complete halt. Schools are closed, businesses have shut their doors, farms are losing their crops, and millions of people are adapting to a new way of life that very few ever imagined would happen in their lifetime. COVID-19 has wreaked havoc on cities, states, and countries around the world. 

As we all adjust to new ways of life, some things are still very much the same. The need still exists for people to receive care. There are specific challenges for caregivers who are tasked with providing intimate care and assistance with activities of daily living, yet this time, our seniors greatly rely on top-tier caregivers who are essential workers. 

Invaluable methods of adjusting include teleconferences and video screenings, which have become extremely vital pieces to the placement puzzle as we search for the ideal placement for patients.

As a lifelong optimist, I cannot help but accentuate the silver lining I see in the near and distant future for us all. An adult foster home provider is now able to conduct the screenings and assessments over the phone and in live video calls. It’s small adjustments such as these that are opening our minds to new ways of running adult foster homes.

This option means owners and operators can schedule multiple screening appointments and gather much-needed information from home. Providers can make multiple calls to all the necessary parties involved together with all the information they need to make an informed decision regarding admission of new residents.


I want to share five ways to integrate new admission policies and options in your home during the pandemic: 
  1. Request a COVID-19 test be completed prior to admission, and be sure to check the State's list of facilities with positive COVID-19 cases.
  2. Get in touch with the potential resident and family to schedule a video conference.  Some facilities may offer appointments through Zoom, Google Hangouts, FaceTime, Google duo, Facebook Messenger or other platforms.  You may even want to give a virtual tour of your adult care home and the bedroom they would be living in. You may want to schedule more than one video appointment throughout the week at different times of the day to give you more perspective on the person's situation.  Sometimes a phone call will do the trick to obtain all the information you need as well.
  3. Request medical records that indicate diagnosis, current medication list, important contacts, and other important information to be emailed or faxed to you.
  4. Be in constant contact with the discharge planners, social workers, case managers and diversion transition workers who are involved in the care and placement of your potential resident. It is so important for the people you are working with to have an idea of your timeline and whether or not you are planning to admit the individual. 
  5. As soon as you have made a decision whether or not to admit, communication with the resident and all other parties involved is paramount.

Keep in mind, policies and procedures around wearing masks, social distancing, going out in public are changing weekly if not daily. Please be sure to call the institution that you are working with, whether it’s a hospital, post acute rehabilitation center, nursing home or assisted living facility, please check with them to see what their policies are and help them to keep them in place.

I see a glimmer of hope as humanity comes together during times of crisis. I encourage all of us to take a moment to reflect on the good things we have in our lives, and some positive changes. We can use new options to effectively screen and admit residents. We can adjust to our new normal and make it through this together.

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About the Author
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Tracey Diani is a consultant & training support coordinator with Oregon Care Home Consulting & Training.

​Email Tracey

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On the Topic of Residents: Connect with the people seeking the care you provide

2/16/2020

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Article by Alyssa Elting McGuire, MA, MPA
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Originally posted 6/10/19. Updated 2/16/20.

One of the more common questions I’ve been asked, both when I was with licensing, and now as an independent consultant is, “How do I find residents?” My advice has always been to start thinking about your strategy to market your adult foster home from the very start of the process, and use a multi-pronged approach to getting your business noticed.

To better assist my clients now, I continuing to seek out beneficial resources and partnerships that will allow them to most effectively get the word out about their vacancies to the right people. That is key. To the right people. You want to go where people are looking for the care you provide. Don’t simply cast the marketing net wide, but instead be deliberate and strategic in your approach.

There are a several avenues for finding potential residents, both private pay and Medicaid consumers. The list below is not comprehensive, but is a start. The options listed below provide similar services, yet are targeted to different audiences. Just like your stock options, you want to diversify. I’d like to tell you a bit more about each option. 

Placement agencies: These agencies receive a fee from the adult foster home provider for successful placement. Generally the fee is between 75 – 100% of the resident’s payment for the first month. Their target market is individuals and families looking for placement in a long-term care facility, including adult foster homes. A good resource to connect with a referral agent is the Oregon Senior Referral Agency Association(OSRAA), which also has a page to post your vacancies.

Posting Websites: The target market for vacancy websites is individuals and families looking for placement in an adult foster home. Laria Care Finder is a local business that allows you to post detailed information about your home, about yourself as a provider, and about your vacancies. You can also add your business to the Alzheimer’s Association Community Resource Finder.

Discharge planners, care managers, and social workers: Get to know discharge planners, care managers, and social workers at your local hospitals and skilled nursing facilities. Contact the facilities to introduce yourself and let them know what level of care your provide.
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State diversion/transition program: The State has a program specifically to move Medicaid consumers from nursing facilities to community-based facilities, such as adult foster homes. You can locate the local diversion/transition (D/T) programs by contacting your local licensing authority (LLA), also know as your local licensing office.

As you can see, there is no single avenue to find residents. What it takes is a solid, strategic plan, and being both proactive and persistent. Put yourself out there and develop professional relationships with others so they both know and trust you, and the care you provide.

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About the Author

Alyssa Elting McGuire is the founder and consulting & training director for Oregon Care Home Consulting & Training.

Email Alyssa

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Giving all and getting back: How caregivers can advocate for their own well-being

12/12/2019

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Guest article by Michelle Walch
michellewalch.com
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Adult foster care home work is a 24-hour, seven day-per-week job. Care home staff not only help with resident meals, errands, bathing and medical tasks, but these staff also give very much of themselves physically and emotionally. Many find the work rewarding, but it can be physically and emotionally challenging. That said, it is important to manage your own well-being so you can provide the best care.  

What is Burnout?

“Burnout” occurs when someone is physically, mentally, and emotionally overwhelmed, according to Healthline. The rate of burnout is 53.3% for caregivers, and the rate of severe burnout is 27.1%, according to a Japanese study.

​When you live where you work, you never really have a place to take a break. You are always on duty. Many caregivers don't reach out for help and don't take a break from their work. As a result, exhaustion takes its toll.

What are the Signs/Symptoms?

Be aware of the burnout warning signs:
  • anxiety 
  • isolation
  • depression
  • lack of energy
  • fatigue
  • insomnia

It is important to know the difference between burnout and depression. Depression is a disorder of your state of mind. Burnout is a reaction to severe stress in your environment. The World Health Organization (WHO) calls it occupational burnout to describe work-related stress. This is different from the medical condition of depression.

An article in Psychology Today has a compassion fatigue questionnaire (similar to burnout) and suggestions on self- care if you scored high on the questionnaire.

When you live and work in the home, how do you build a break into your schedule?

Planning and Prevention

Alyssa Elting McGuire, of Oregon Care Home Consulting, recommends planning to prevent burnout. "Self-care is like being in an airplane when the oxygen mask comes down. You give yourself oxygen before you give it to someone you are caring for. When you take care of yourself, you can then take care of others."

A care provider in Washington County, Oregon, offered suggestions to prevent burnout:
  • Allocate time for self-care
  • Schedule breaks for both staff and yourself
  • Don't over commit. Be okay with saying "no," and setting boundaries.
  • Honor your personal needs
  • For providers, trust your caregivers. You have well-trained caregivers. Trust them to take care of the residents while you're away.
  • Pre-plan a time weekly (on say, Sunday evening) to review records and take care of what needs to be done
  • Recognize the difference between what needs to be done now, and what can wait
For providers, trust your caregivers. You have well-trained caregivers. Trust them to take care of the residents while you're away.
Why Self-Care is Important for Caregivers
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You love your job, and give it your all, but to keep performing well, recognize when you need a break or help. When you are stressed out, it may negatively affect your ability to take care of others. But there are things you can do to take care of yourself. Reach out for support and get the help you need.

How do you plan for, and prevent burnout?


Like this article? Share with someone you know who would find this useful.
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Michelle Walch is a health and wellness copywriter based in Canby, Oregon. Visit her website.
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Care Provider Spotlight: Vicky Barbu & Adriana Gavozdea

11/1/2019

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Article by Alyssa Elting McGuire, MA, MPA
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November is National Caregiver Appreciation Month. In honor of the work adult care home providers and staff do day-in and day-out, I would like to take time to recognize and appreciate the work they do by telling their stories. Recently, I interviewed provider Vicky Barbu and her business partner and daughter Adriana Gavozdea about their experiences moving to America and starting their adult foster home in Tigard.  They shared their stories of how they came to work in the adult care home field and provided their ideas on what makes adult care home providers, and other staff, successful.

Interviews have been edited for clarity and brevity.

Interview with Adriana Gavozdea

How long have you worked in the adult foster/care home business?
 
I’ve worked in this business for eight years, since I moved here from Romania. My mom owned the adult foster home for eight years prior. I came here to start a new life, and I actually started this job two days after I landed. My mom trained me at her level because someday when she wants to retire, I can take over the home. We work together, and we’re a team.
 
What do you love most about the work you do?
 
I love that I make a difference, honestly. For example, when a resident can’t brush their teeth and you help them, it makes their day better. Recently, a client who wasn’t doing well was having trouble putting on her sandals. She asked me to do if for her, but instead I coached her and watched her closely, and she did it by herself. She was so happy at the end and thanked me so much. That’s my joy.
 
What do you believe makes someone’s work successful?
 
Compassion, and you have to be built for this. What I mean by that, is I’ve met people in this industry who didn’t have passion and they were miserable. You have to love what you do and help other people. If you do it for the money, you may succeed financially, but at the end of the day you’ll be so burned out, it won’t matter. You have to like to help people.

​Anything else you’d like us to know about you?
 
I think we’re amazing!  My mom and I were doing other things back in Romania. I never worked in healthcare before. She was an accountant and I was CEO, and we ended up in America, starting a new life from scratch. You land here and have to start all over. My mom arrived at age 45 and I arrived here when I was 30.
Since we have other skills, there is always another option, but we want to do this.

​We’re not stuck in this job, but we like this work. We got used to being at home, being home with you kids, be at home for meals. We are so family oriented. In Romania, you take care of the seniors, so we are used to being in the home with the older generations. In Romania, after I gave birth to my daughter, I went back to work. My grandmother took care of my daughter until she was four, and my grandmother was at my house all the time. It’s a cultural thing.
You have to love what you do and help other people. 
 Interview with Vicky Barbu
 
How long have you worked in the adult foster/care home business?
 
I opened my home in 2007, and before that, I was working as a caregiver in another adult foster home. We came to the U.S. in April of 2002, and I started as a caregiver in June. I was a bookkeeper in Romania for manufacturing, and I was also a foster mother.
 
I came to America when I was 45. It’s hard to go back to school with new culture and language. When I arrived, I could understand English, but it was hard for me to talk. I learned to speak English well with residents while working.
 
What do you love most about the work you do?
 
When you are helping residents. When residents really need help and you can give them the help they need, you get to see how happy they are and how well they are feeling. This makes you proud and think, “I did something good today.”
 
What do you believe makes someone successful?
 
I am trying to do my job the best I can do. It is very hard work, and especially working with people with disease processes. Sure, it sometimes makes you crazy, but you have to have patience and try to understand the residents’ needs, that it’s not their personality, but it’s the disease. They don’t necessarily want to do what they’re doing.
 
In this work, you need to have a lot of patience. It’s important to show residents you care about them. Much of the time, we know them very well, so we should try to be their voice (e.g. to medical staff and others).
 
With every resident, you’re learning something new. Use that new information to learn and help the next residents. I learn a lot with every resident. You have to be open to learn new things. You don’t have to know everything. Open your mind and pay attention, and then you will learn.
 
Anything else you’d like us to know about you?
 
I am trying to make everything very smooth for my business behind the scenes. I know what I have to follow, so I’m trying to follow rules and make it run smoothly. My advice is make residents happy and follow the rules, and things will work well. ​
My advice is make residents happy and follow the rules, and things will work well. ​

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About the Author

​Alyssa is the founder and consulting & training director for Oregon Care Home Consulting & Training.

Email Alyssa​


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Caring for the Older Generations, and the Next

3/8/2019

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Article by Alyssa Elting McGuire
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Today, March 8th, is International Women’s Day. March is Women’s History Month. Every day should be a day to celebrate the lives, strengths, and accomplishments of women.

It’s no secret that women make up the majority of caregivers for both seniors and children. It has been researched and written about for years. In families, of course, the care burden is primarily placed on the shoulders of female spouses and daughters. According to the Alzheimer’s Association, “Approximately two-thirds of caregivers are women…and one-third of dementia caregivers are daughters.”
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If we look at the numbers for adult care homes, we can see there isn’t a significant difference between family and professional caregivers, in this regard. There are almost 1,600 adult care homes in Oregon, and based on a quick sampling of the State’s long-term care facility search site, it is clear a significant percentage are operated by women.
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I think we’re starting to see a slow paradigm shift in our culture where there is less expectation of caregiving being “women’s work,” and where more men are proudly taking on caregiving roles. Anecdotally, I’ve seen a significant increase in the number of men who are professional caregivers and nurses opening adult care homes over the past few years and being the primary caregivers, or working along side their female partners. This is a good thing.
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Even with this slow shift taking place, the majority of caregivers are still women. According to a 
2018 Portland State University report on adult foster homes in Oregon, 88% of licensees live in the adult care home, and a third had children under 17 living at home. From this, we can conclude that many women are both providing care for residents and their children. This is both a benefit and a challenge. It really is more of a benefit, though, if we consider these women would be caring for children, or having to find and pay for care for children, regardless of where they worked.

The adult care home business provides women with the opportunity to be their own bosses yet also care for children or aging parents while working at home and making a solid income. What other business truly provides this opportunity for women?
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In this regard, one significant benefit of owning an adult care home is that parents can stay home with their children while working. The adult care home business provides women with the opportunity to be their own bosses yet also care for children or aging parents while working at home and making a solid income. What other business truly provides this opportunity for women?

So, on this International Women’s Day, let’s take the opportunity to recognize and appreciate the work of women around the world, and also here at home. Let’s continue to recognize the important work of adult care home providers and support those providers who are making an important contribution to both the older generations, and the next.


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Author

Alyssa Elting McGuire, MA, MPA is founder, consulting & training director with Oregon Care Home Consulting.
Email Alyssa


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Why Your Adult Care Home Business Needs an Online Presence

3/2/2019

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Article by Alyssa Elting McGuire, MA, MPA
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I was recently sitting in a class on the topic of website marketing offered through the Small Business Development Center, and I started thinking to myself, “why do so many adult care home businesses not have websites?” I’ll be the first to admit I’m no marketing expert, but I can say I recognize the value of a small business having an online presence.

Why, as an adult care home provider, should you invest the time and money into having a website or an alternative web presence for your adult care home business? I’d like to give you seven reasons why you need an online presence that showcases you and your adult care home.
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  • It’s part of your overall marketing plan. This is your passion, but it is also your business. You need a marketing plan, and you can’t ignore the fact an online presence can be an important marketing tool.
  • Families are looking online for housing options for their loved ones. A business website probably won’t come up first on search engines, but you can make your presence known by using services such as Laria Care Finder where people can find detailed information about your home. Additionally, you can create a Google My Business account to be found through Google and on Google Maps. Also, Google My Business allows you to create a free basic website for your business.
  • It lends you some credibility. In this day-and-age, if nobody can find your business online, they can become a bit skeptical about your business. This is also true if they visit your website, and it’s obvious you haven’t updated it since 2005.
  • You have control over the content. You can post beautiful pictures of the inside and outside of your home, and offer any details that might be of interest to people looking to move to your adult care home.
  • It gives people a personal connection to you, as a caregiver. Post photos of yourself and give information about your approach to providing care, and why you chose to go into this business.
  • It gives you a forum to post client testimonials. Let people know about the great care you provide by posting client and family testimonials (while always keeping confidentiality in mind).
  • Make it easy for people to find you. You want to make it as easy as possible for people to find information about your care home and your contact information.
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You don’t have to be a web designer or developer to create your web presence. If you have some understanding of website development and design, you can create your own site, but your time is money, so I would encourage you to consider hiring out this service, or using a service that will do the work for you to market your home. Let the professionals handle it. It will be worth your time and money, and you’ll be on the right path to creating a professional, online presence for your adult care home business.
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About Oregon Care Home Consulting

Oregon Care Home Consulting & Training is the compass that helps current and future APD adult foster care home licensees successfully navigate the licensing process and have a successful adult foster care home business. ORCHC provides coaching, consultation, training, and ongoing support. This ultimately saves time, reduces stress, and improves compliance, which allows AFH/ACH licensees to focus more time on providing excellent care to seniors and individuals with disabilities.

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Office hours by appointment only

​Oregon Care Home Consulting LLC
​1500 NW Bethany Blvd., Ste. 200
Beaverton, OR 97006
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​Disclaimer: Oregon Care Home Consulting LLC is not affiliated with the State of Oregon or Multnomah County Adult Care Home Program (ACHP). We are not State licensors, therefore we are unable to require compliance or guarantee your adult care home is in full compliance with current state and/or federal requirements. State and/or County licensors make the final determination of compliance. Additionally, we are unable to offer legal or medical advice, and no guidance provided by Oregon Care Home Consulting LLC should be construed as legal or medical advice. Always consult an attorney or doctor, when necessary. 


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