South Carolina Assisted Living
South Carolina is an increasingly popular retirement destination, offering beautiful beaches, mild weather, and a low cost of living. Personal budgets are further boosted by the state’s income tax system, which doesn’t tax Social Security benefits and has a large deduction for other forms of retirement income.
It you’re considering assisted living in South Carolina, the information below can help you understand the options available, the average costs of assisted living communities in the state, and how South Carolina long-term care is regulated.
The typical resident population in South Carolina's assisted living communities is 68% female. Overall, 75% of residents are ages 75 and older, with 32% of residents ages 75 to 84 and 43% ages 85 and older.
Assisted living facilities in South Carolina are also known as community residential care facilities (CRCFs). These facilities are licensed by the state Board of Health and Environmental Control to provide room, board, and personal care to two or more adults unrelated to the owner. Personal care services are covered under the state Medicaid program.
A CRCF offers room, board, and personal assistance for two or more adults for a time that exceeds 24 consecutive hours.
A special care unit (SCU) for Alzheimer's disease is a facility or an area within a facility that provides a secure, separate unit for residents diagnosed with Alzheimer’s or another form of dementia. A separate unit is needed to prevent contact with residents outside the unit.
A written agreement between the facility and its residents or their responsible person is required. The agreement specifies the following: an explanation of the care, services, and equipment provided by the facility, advance notice requirements for a change in fees, discharge and transfer provisions, refund policies, transportation policies, and the date the resident will receive their personal needs allowance (PNA). The care explanation includes any special diets and assistance with the activities of daily living (ADLs) and their associated fees.
Facilities that market themselves as having an SCU must disclose the form of care and treatment provided for residents with Alzheimer’s or some other form of dementia. This disclosure must include the admission, transfer, and discharge criteria, the care planning process, staffing levels and their training, resident activities, and the cost of care.
A facility cannot admit or retain residents whose needs cannot be met or anyone who exhibits aggressive, violent, or socially inappropriate behavior, is a danger to themself or others, needs daily attention from a licensed nurse, requires hospital or nursing care, or has any of the following needs or conditions:
All facilities must provide assistance with ADLs, medication assistance, transportation, and at least one recreational activity per day.
Within 72 hours of admission, a direct care staff member must assess the resident’s needs. The assessment aims to determine what services are needed and whether the facility can support the needs. The assessment is used to develop a personalized care plan.
Within seven days of admission, the personal care plan must be developed in conjunction with the resident, the facility administrator, and any responsible resident representative. Each plan must be reviewed at least semi-annually and as the needs of the resident change. The plan describes the ADLs the resident requires assistance with, requirements and arrangements for health provider visits, advance care directives, health care power of attorney, suitable recreation and social activities, and dietary needs.
All facilities must provide three meals and nutritious snacks daily. The time between the evening meal and breakfast cannot exceed 14 hours. Residents are occasionally allowed to request tray service if they are medically unable to get to the dining room. If a facility provides special diets, the menus must be prepared by a professional dietician or reviewed by a physician or other medical provider.
Each facility must have a licensed CRCF administrator who is in charge of the activities and functions of the facility and another staff member designated in the absence of the administrator. Each facility has a designated recreational program staff that is responsible for obtaining and maintaining recreational supplies and developing a recreational program for its residents.
Facilities that serve Medicaid-eligible residents must contract with or have an on-staff licensed nurse at least one day a week to provide personal care training to other staff members and to develop a plan to monitor the care plans of residents served by the Medicaid program.
There must be one staff member on duty and accessible at all times when residents are present. This staff member must be either trained or experienced in recognizing and reporting significant changes in each resident’s physical or mental condition.
The ratio of staff to residents depends on the number and condition of the residents. Each building must have one staff member on duty for every eight residents during peak hours and one on-duty staff member for every 30 residents during night-time hours. Facilities with more than eight residents must always have one staff member dressed and awake. Facilities with fewer than eight residents must also have one staff member awake at all times if at least one resident has dementia. Staff must be available on each floor of a multi-floor facility at all times that residents are present.
Every staff member must have an orientation program that covers their job duties and responsibilities, the residents’ needs, and the organization and environment of the facility. They must also receive information on the facility's emergency procedures, disaster preparedness, and fire response training within 24 hours of starting their job.
Training, prior to resident contact, must be provided to all staff members in the context of their job responsibilities on the following:
South Carolina does not require apartment-style units. There can be no more than three residents sharing a room. One toilet is required for every six residents and one tub or shower must be provided for every eight residents.
There are several requirements that each assisted living community must provide for its residents. The facility must offer both general observations and health supervision to assist in identifying each resident's health condition and ability to function. The facility must assist residents with all ADLs and medication services and assess the need for medication attention or nursing services.
When a resident moves into a facility, any medications may be administered as long as the medication is in its original container with a clear and original label. Facility staff is allowed to administer routine medications as long as they have been properly trained to perform these tasks by someone licensed to administer them. Staff members may administer injections for diabetes and conditions associated with anaphylactic reactions under medical protocols. A licensed nurse can only administer influenza and vitamin B-12 injections and tuberculin skin tests.
Resident self-administration of medications is permitted based on specific health care professional orders as long as the resident is deemed to be capable of self-administering medications.
The South Carolina Department of Mental Health operates outpatient mental health clinics around the state that provide assessment, treatment plans, and other services. It also runs programs designed to help people access mental health care and remove mental illness stigma. This includes a screening program that connects veterans with care providers. South Carolina’s branch of the National Alliance of Mental Illness also has resources available to support residents’ mental health.
In South Carolina, ALFs must provide care and services in the resident’s care plan. This can include coordinating medical care and appointments. Communities may also deliver health services, with 40% of communities providing skilled nursing. Many have health care specialists and on-site services, with 60% of communities offering dental care. In addition, 59% of ALFs have hospice services.
Mental health issues are a growing consideration for communities, and services to address these concerns are becoming more common. In South Carolina, 83% of communities conduct depression screenings, and 58% offer mental health counseling. Social work programs are also found in 38% of ALFs. Social workers can provide counseling, conduct assessments, and help ensure residents can access all necessary resources.
Some assisted living residents live with various medical conditions. In South Carolina, 46% have Alzheimer's disease or another form of dementia. In addition, 53% have high blood pressure, 40% have heart disease, 37% have depression, and 22% have diabetes.
A primary service of assisted living that benefits residents is receiving help with activities of daily living (ADLs). These are fundamental tasks that a person must do regularly to sustain life and general health, including toileting, bathing or showering, dressing, transferring (getting in and out of bed or a chair), ambulating (walking), and eating. Signs that a person may benefit from living in assisted living include increased isolation, loss of mobility, noticeable weight loss or gain, and/or neglect of household chores.
Residents in South Carolina’s assisted living facilities often receive help with their ADLs. In South Carolina, 12% of residents need help eating. Other commonly used services include bed transfer (40%), toileting (48%), and walking (51%). Caregivers in ALFs help 56% of residents dress, and 63% of residents need help bathing.
The average cost of assisted living care in South Carolina is $3,612. This cost is $888 lower than the monthly national average of $4,500 per month. The cost of living in South Carolina is less than the national average by 6.4%, with health care costs less than the national average by 4.3% and housing costs less than the national average by 20.4%.
The level of care a person requires impacts the cost of care, as does where you live. The cost of assisted living ranges from a low of $2,663 in the Sumter area to a high of $4,500 per month in the Hilton Head area of South Carolina.
If you live close to South Carolina’s borders, you may find assisted living in a neighboring state is an affordable option. Although, on average, seniors pay more in North Carolina with an average monthly assisted living cost of around $4,010 per month, Georgia’s average is lower than South Carolina at $3,535 per month.
How to Pay for Assisted Living
The Division of Healthcare Facility Licensing is responsible for overseeing assisted living communities in South Carolina. It does this by inspecting them before they’re initially licensed and conducting regular inspections after communities begin operating. The South Carolina Long-Term Care Ombudsman Program advocates for CRCF residents. It investigates and helps resolve more than 8,000 complaints that people living in long-term care make each year.
The field of elder law has evolved to protect the interests of older adults and their families. The South Carolina Department on Aging has legal assistance available through Area Agencies on Aging. Volunteer attorneys offer assistance to people aged 60 and over in a range of areas, including housing, health care, guardianship, and abuse. South Carolina Legal Services also offers free civil legal aid to eligible residents and has elder law attorneys available. There are a number of private elder law attorneys that practice in the state, and the South Carolina Bar can help you find lawyers in your local area.
It you’re considering assisted living in South Carolina, the information below can help you understand the options available, the average costs of assisted living communities in the state, and how South Carolina long-term care is regulated.
The typical resident population in South Carolina's assisted living communities is 68% female. Overall, 75% of residents are ages 75 and older, with 32% of residents ages 75 to 84 and 43% ages 85 and older.
Assisted Living Facility (ALF) Definitions
Assisted living facilities in South Carolina are also known as community residential care facilities (CRCFs). These facilities are licensed by the state Board of Health and Environmental Control to provide room, board, and personal care to two or more adults unrelated to the owner. Personal care services are covered under the state Medicaid program.
A CRCF offers room, board, and personal assistance for two or more adults for a time that exceeds 24 consecutive hours.
A special care unit (SCU) for Alzheimer's disease is a facility or an area within a facility that provides a secure, separate unit for residents diagnosed with Alzheimer’s or another form of dementia. A separate unit is needed to prevent contact with residents outside the unit.
Resident Agreements and Disclosures
A written agreement between the facility and its residents or their responsible person is required. The agreement specifies the following: an explanation of the care, services, and equipment provided by the facility, advance notice requirements for a change in fees, discharge and transfer provisions, refund policies, transportation policies, and the date the resident will receive their personal needs allowance (PNA). The care explanation includes any special diets and assistance with the activities of daily living (ADLs) and their associated fees.
Facilities that market themselves as having an SCU must disclose the form of care and treatment provided for residents with Alzheimer’s or some other form of dementia. This disclosure must include the admission, transfer, and discharge criteria, the care planning process, staffing levels and their training, resident activities, and the cost of care.
Assisted Living Admission and Retention
A facility cannot admit or retain residents whose needs cannot be met or anyone who exhibits aggressive, violent, or socially inappropriate behavior, is a danger to themself or others, needs daily attention from a licensed nurse, requires hospital or nursing care, or has any of the following needs or conditions:
- Daily monitoring or observation of a complex medical condition.
- IV medications or fluids.
- Medications that require frequent dosage adjustments or regular injections.
- Urinary catheterization that the resident cannot perform.
- Dependency for all ADLs for more than 14 days.
- Nasogastric tube feeding.
Assisted Living Services and Service Planning
All facilities must provide assistance with ADLs, medication assistance, transportation, and at least one recreational activity per day.
Within 72 hours of admission, a direct care staff member must assess the resident’s needs. The assessment aims to determine what services are needed and whether the facility can support the needs. The assessment is used to develop a personalized care plan.
Within seven days of admission, the personal care plan must be developed in conjunction with the resident, the facility administrator, and any responsible resident representative. Each plan must be reviewed at least semi-annually and as the needs of the resident change. The plan describes the ADLs the resident requires assistance with, requirements and arrangements for health provider visits, advance care directives, health care power of attorney, suitable recreation and social activities, and dietary needs.
Assisted Living Food and Dietary Provisions
All facilities must provide three meals and nutritious snacks daily. The time between the evening meal and breakfast cannot exceed 14 hours. Residents are occasionally allowed to request tray service if they are medically unable to get to the dining room. If a facility provides special diets, the menus must be prepared by a professional dietician or reviewed by a physician or other medical provider.
Assisted Living Staffing Requirements
Each facility must have a licensed CRCF administrator who is in charge of the activities and functions of the facility and another staff member designated in the absence of the administrator. Each facility has a designated recreational program staff that is responsible for obtaining and maintaining recreational supplies and developing a recreational program for its residents.
Facilities that serve Medicaid-eligible residents must contract with or have an on-staff licensed nurse at least one day a week to provide personal care training to other staff members and to develop a plan to monitor the care plans of residents served by the Medicaid program.
There must be one staff member on duty and accessible at all times when residents are present. This staff member must be either trained or experienced in recognizing and reporting significant changes in each resident’s physical or mental condition.
The ratio of staff to residents depends on the number and condition of the residents. Each building must have one staff member on duty for every eight residents during peak hours and one on-duty staff member for every 30 residents during night-time hours. Facilities with more than eight residents must always have one staff member dressed and awake. Facilities with fewer than eight residents must also have one staff member awake at all times if at least one resident has dementia. Staff must be available on each floor of a multi-floor facility at all times that residents are present.
Assisted Living Staff Training Requirements
Every staff member must have an orientation program that covers their job duties and responsibilities, the residents’ needs, and the organization and environment of the facility. They must also receive information on the facility's emergency procedures, disaster preparedness, and fire response training within 24 hours of starting their job.
Training, prior to resident contact, must be provided to all staff members in the context of their job responsibilities on the following:
- Basic first aid, emergency procedures, and care for minor accidents or injuries.
- Procedures for checking and recording vital signs (if required for their job).
- Management and care of residents with contagious or communicable diseases.
- Medication management.
- Care for specific physical or mental conditions that the facility cares for.
- The use of restraints.
- OSHA standards for blood-borne pathogens.
- CPR.
Assisted Living Housing Requirements
South Carolina does not require apartment-style units. There can be no more than three residents sharing a room. One toilet is required for every six residents and one tub or shower must be provided for every eight residents.
What Is Included With Assisted Living Care In South Carolina?
There are several requirements that each assisted living community must provide for its residents. The facility must offer both general observations and health supervision to assist in identifying each resident's health condition and ability to function. The facility must assist residents with all ADLs and medication services and assess the need for medication attention or nursing services.
Medical Provisions
When a resident moves into a facility, any medications may be administered as long as the medication is in its original container with a clear and original label. Facility staff is allowed to administer routine medications as long as they have been properly trained to perform these tasks by someone licensed to administer them. Staff members may administer injections for diabetes and conditions associated with anaphylactic reactions under medical protocols. A licensed nurse can only administer influenza and vitamin B-12 injections and tuberculin skin tests.
Resident self-administration of medications is permitted based on specific health care professional orders as long as the resident is deemed to be capable of self-administering medications.
State Mental Health Resources
The South Carolina Department of Mental Health operates outpatient mental health clinics around the state that provide assessment, treatment plans, and other services. It also runs programs designed to help people access mental health care and remove mental illness stigma. This includes a screening program that connects veterans with care providers. South Carolina’s branch of the National Alliance of Mental Illness also has resources available to support residents’ mental health.
Health Care Services
In South Carolina, ALFs must provide care and services in the resident’s care plan. This can include coordinating medical care and appointments. Communities may also deliver health services, with 40% of communities providing skilled nursing. Many have health care specialists and on-site services, with 60% of communities offering dental care. In addition, 59% of ALFs have hospice services.
Mental health issues are a growing consideration for communities, and services to address these concerns are becoming more common. In South Carolina, 83% of communities conduct depression screenings, and 58% offer mental health counseling. Social work programs are also found in 38% of ALFs. Social workers can provide counseling, conduct assessments, and help ensure residents can access all necessary resources.
Some assisted living residents live with various medical conditions. In South Carolina, 46% have Alzheimer's disease or another form of dementia. In addition, 53% have high blood pressure, 40% have heart disease, 37% have depression, and 22% have diabetes.
Activities of Daily Living (ADLs) Assistance Services
A primary service of assisted living that benefits residents is receiving help with activities of daily living (ADLs). These are fundamental tasks that a person must do regularly to sustain life and general health, including toileting, bathing or showering, dressing, transferring (getting in and out of bed or a chair), ambulating (walking), and eating. Signs that a person may benefit from living in assisted living include increased isolation, loss of mobility, noticeable weight loss or gain, and/or neglect of household chores.
Residents in South Carolina’s assisted living facilities often receive help with their ADLs. In South Carolina, 12% of residents need help eating. Other commonly used services include bed transfer (40%), toileting (48%), and walking (51%). Caregivers in ALFs help 56% of residents dress, and 63% of residents need help bathing.
Cost Of Assisted Living Care In South Carolina
The average cost of assisted living care in South Carolina is $3,612. This cost is $888 lower than the monthly national average of $4,500 per month. The cost of living in South Carolina is less than the national average by 6.4%, with health care costs less than the national average by 4.3% and housing costs less than the national average by 20.4%.
The level of care a person requires impacts the cost of care, as does where you live. The cost of assisted living ranges from a low of $2,663 in the Sumter area to a high of $4,500 per month in the Hilton Head area of South Carolina.
How Costs Compare In Nearby States
If you live close to South Carolina’s borders, you may find assisted living in a neighboring state is an affordable option. Although, on average, seniors pay more in North Carolina with an average monthly assisted living cost of around $4,010 per month, Georgia’s average is lower than South Carolina at $3,535 per month.
How to Pay for Assisted Living
South Carolina Assisted Living Oversight
The Division of Healthcare Facility Licensing is responsible for overseeing assisted living communities in South Carolina. It does this by inspecting them before they’re initially licensed and conducting regular inspections after communities begin operating. The South Carolina Long-Term Care Ombudsman Program advocates for CRCF residents. It investigates and helps resolve more than 8,000 complaints that people living in long-term care make each year.
Legal Resources
The field of elder law has evolved to protect the interests of older adults and their families. The South Carolina Department on Aging has legal assistance available through Area Agencies on Aging. Volunteer attorneys offer assistance to people aged 60 and over in a range of areas, including housing, health care, guardianship, and abuse. South Carolina Legal Services also offers free civil legal aid to eligible residents and has elder law attorneys available. There are a number of private elder law attorneys that practice in the state, and the South Carolina Bar can help you find lawyers in your local area.
