Macdonald Residence (MacRes) didn’t begin as an assisted living facility. It grew out of something simpler: social visits. As neighbors began needing help with daily tasks, Maybelle responded. In 1999, MacRes became the nation’s first assisted living facility dedicated exclusively to Medicaid-eligible adults. It still holds that distinction today and remains one of a handful of such facilities in the country.
Because it was built through a social health lens, belonging has been at its core from the beginning. In 2022, a new State contract elevated MacRes to the highest acuity level in Multnomah County. This formally recognized it as the right placement for Portland’s highest-need individuals: people with complex behavioral health needs, trauma histories, and mental illness, many of whom are transitioning from long-term unsheltered living and are routinely turned away by other facilities.
When asked to describe belonging at MacRes, the response is often the same: “It feels like being at home.” That’s exactly the environment we cultivate every day.
24-hour, personal care
Home-cooked meals, everyday
Studio units
3/4 bathrooms
Backs up to urban courtyard
Most assisted living facilities aren’t equipped for the complexity our Residents bring. MacRes is. Specialized on-site services include:
At MacRes, long-term trust-based relationships between staff and Residents are not a feature of care. They are the care. Staff invest in Residents through meaningful relationships, a critical factor in delivering high-quality healthcare for Residents whose lives have been defined by instability.
When you move into assisted living, you give up control over a large part of your life. And because of where people come from – the trauma and the poverty – they’ve spent most of their life not being in control of their lives. So, allowing them to have as much autonomy as possible is really just part of fostering dignity."
We never say that Jim lives where I work. We all say, I work where Jim lives – which is just an acknowledgment of the fact that they’re not guests. It’s their home."
The first facility of its kind nationally. Still leading the way.
Because MacRes exclusively serves Medicaid-eligible adults with behavioral health needs, vacancies are filled through collaborative work with case managers. If you or someone you know is interested in becoming a Resident, connect with your case manager to explore the possibility.
If you don’t have a case manager, Multnomah County’s Aging, Disability & Veterans Services can connect you with one to help navigate assisted living options.
Contact Aging, Disability & Veterans Services:
Drag show event on-site
Serving Residents with complex behavioral health needs is expensive. But for Residents whose lives have been defined by instability, trauma, and feeling invisible, care without dignity and sustained relationship isn’t really care at all. People don’t heal in environments where they don’t feel safe, known, or valued.
That’s why we invest in the staffing, training, and consistent presence that make belonging possible here. And that investment comes at a cost that Medicaid rates and restricted rents don’t fully cover. The State contract funds 69 of the 90 staff positions needed.
Donor support fills the gap, making it possible to maintain the staffing levels, wraparound services, and long-term relationships that define the MacRes model.
Our staff don’t just deliver services. They invest in people over time, building the kind of trust that most systems were never designed to earn. If that’s the kind of work you’re looking for, we’d love to have you on our team.