Nearly 1 out of every 5 people in South Carolina is aged 65 or older. Popular retirement destinations such as Myrtle Beach have brought in lots of seniors seeking a relaxed lifestyle, mild climate and lots of community engagement. Estimates put the senior population at 1.5 million by 2030, out of a total population of 5.8 million. 

According to our 2022 Senior Living Report, South Carolina ranks 49th overall, with low marks in healthcare and transportation dragging down state performance. However, South Carolina is also home to MUSC Health, one of the best hospitals in the country with national rankings in seven specialties, including cancer treatment, according to U.S. News & World Report. South Carolina scores mid-range for categories such as Senior Living and Community Involvement, and when combined with senior-friendly tax policies, it creates an appealing option for seniors seeking long-term care. Assisted living averages only $3,612 per month, which is well below the median national price point. 

This guide to assisted living in South Carolina offers a look at expected care costs for long-term options and financial resources that may be available to senior residents. It also provides information about government agencies and nonprofits that offer seniors services, along with a brief look at some of the rules and regulations surrounding senior residential communities.

The Cost of Assisted Living in South Carolina

In South Carolina, the median cost for assisted living is $3,612 per month, according to the Genworth 2021 Cost of Care Survey. The national median is almost $900 more at $4,500, but costs are more consistent with the geographic region surrounding South Carolina. Florida, North Carolina and Tennessee are all with $150 of each other and a maximum of $538 more than in South Carolina. In Georgia, seniors can save a nominal amount because the median price is about $75 less.

$3612

South Carolina

$4500

The United States

$4010

North Carolina

$4150

Tennessee

$3535

Georgia

$4000

Florida

Assisted living rates have a wide range depending on the location in South Carolina. Seniors in the center of the state often pay substantially less than those on the coast or in the southern part of the state. For example, the Hilton Head Island Area is the most expensive for assisted living at $4,500, and Myrtle Beach is next at $4,070. Charleston is another coastal city and is the third most expensive region at $3,945. Sumter and Columbia, both central regions, average $2,663 and $3,270, respectively. Greenville and Spartanburg in the west are the closest to the state median, at $3,743 and $3,600. 

$4070

Myrtle Beach

$3945

Charleston

$3743

Greenville Area

$3600

Spartanburg

$3270

Columbia

$2663

Sumter

$4500

Hilton Head Island Area

Long-term care options include various levels of care, some provided at home and others in a residential setting. For those who need help during the weekday but who otherwise live with a caregiver, adult day health care is the most affordable option, at an average of $1,408 per month. For those who need some help with daily activities but who don’t need daily nursing care, assisted living is an option that includes room and board at $3,612. Agencies that offer services in the senior’s home average $4,433 per month for homemaker services and $4,481 for home health services. Seniors who need around-the-clock nursing care may need to find accommodation at a nursing home while a semiprivate room typically costs $7,285 per month.

$3612

Assisted Living

$4433

Home Care

$4481

Home Health Care

$1408

Adult Day Health Care

$7285

Nursing Home Care (semiprivate)

Does Medicaid Cover Assisted Living in South Carolina?

Medicaid in South Carolina offers two programs that may pay for some or all of the cost of assisted living, allowing low-income seniors to find long-term, residential care that would otherwise be out of reach. These two programs — Optional State Supplement Program and Healthy Connections Home and Community-Based Waivers — have similar eligibility requirements but operate differently. 

What Assisted Living Services Are Covered by Medicaid in South Carolina? 

Medicaid offers help with many assistive services but may not cover room and board costs in an assisted living community. A multidisciplinary team develops an individual care plan that might include:

  • Assistance with some or many activities of daily living or instrumental activities of daily living
  • Medication assistance
  • Various therapies (physical, occupational, speech, etc.)
  • Nursing care on an intermittent basis

These waiver programs may not be available in all areas, and there may be a waiting list to access services and subsidies. 

Assisted Living Waiver Programs in South Carolina 

Optional State Supplement Program

The Optional State Supplement Program is available to seniors who meet the eligibility guidelines for Supplemental Security Income and reside in a nursing home or residential care facility. This program pays the facility directly to help supplement resident income, making it more affordable for seniors to continue living in an assisted living facility. This program doesn’t offer direct services to seniors. Instead, it offers a financial subsidy that can be applied to room and board or other assistive services.  

To qualify for this program, applicants must be at least 65 years old or disabled and meet both medical and financial eligibility requirements. 

Before enrolling in the OSS program, applicants should apply for SSI with the Social Security Administration and complete an application for nursing home, residential or in-home care through Healthy Connections. These applications should be submitted to the local SCDHHS office. If approved, seniors can designate the facility which will receive funds if they are already a resident or work with SCDHHS to locate a facility with openings. 

Healthy Connections – HCBS Waivers

Healthy Connections manages all long-term care Medicaid Waivers in South Carolina. Some HCBS waivers may pay for assistive care in an assisted living community, but these waivers typically exclude room and board fees. Some examples of the type of care covered by this waiver include: 

  • Personal care (help with bathing, dressing, mobility, housekeeping, etc.)
  • Attendant care
  • Companion care
  • Limited skilled nursing
  • Personal emergency response system monitoring
  • Limited incontinence supplies

To qualify for this program, seniors must meet both financial and medical eligibility requirements and often must be otherwise qualified for a level of care offered in nursing homes. 

To apply, visit a local SCDHHS office, fill out an application online or by mail. 

How to Know If You’re Eligible for Medicaid in South Carolina

The South Carolina Department of Health and Human Services is the agency that handles Medicaid eligibility determinations throughout the state. Applicants who qualify for SSI through the Social Security Administration typically also qualify for Medicaid and may be enrolled at the same time in both programs.  

To qualify, applicants must:

  • Be at least 65 years of age or be blind or disabled
  • Be a U.S. citizen or legal resident and a permanent resident of South Carolina
  • Meet income guidelines

As of 2022, a senior who would otherwise qualify for nursing home coverage may have an annual income of no more than $30,276. 

2022 Medicaid Income Limits for Seniors in South Carolina

.

Annual Income Limits

Asset Limits

Single Applicant

$30,276

$2,000

Two-Person Household

(Only One Person Applying)

$67,692

$68,480

Two-Person Household
(Both People Applying)

$60,552

$4,000

Assistive care services are available in residential treatment facilities, assisted living communities or in-home. In addition to financial eligibility guidelines, seniors must also complete an assessment with their doctor that states assistive services are medically necessary. For HCBS waivers, the assessment must show that seniors need help with some or all of the following:

  • Activities of daily living 
  • Instrumental activities of daily living 
  • Medication assistance
  • Health support 

How to Apply for Medicaid in South Carolina

Medicaid applications can be completed online via Healthy Connections. Paper applications are available at SCDHHS offices and online. Paper copies can be mailed or dropped off in person at the nearest SCDHHS office. 

Information You Will Need 

When applying for Medicaid, some documentation may be requested, including: 

  • Proof of identity and age
  • Proof of citizenship and state residency 
  • Proof of income, including tax returns and other retirement benefits
  • Proof of assets, including bank statements, retirement accounts and trusts 
  • Social Security number 
  • Proof of any current health insurance policy, including Medicare

How to Get Help Applying for Medicaid 

If seniors need help with their Medicaid application, there are several government and nonprofit agencies that are available. These agencies offer help understanding benefits, how to apply and where to find all of the necessary documentation.

Resource 

Contact 

Description 

(877) 552-4642

South Carolina Health Connections Choices is the organization that determines eligibility for home and community-based services for seniors and the disabled. Enrollment counselors are available over the phone, Monday through Friday during normal business hours to help with the application process. 

(800) 726-8774

SC Thrive is a nonprofit organization that helps seniors navigate the complex list of benefits that may be available to them. It offers assistance with Medicaid applications over the phone, online or in-person. 

(888) 549-0820

The South Carolina Department of Health and Human Services handles all Medicaid applications and has a helpline available for those with questions about the application process. 

Does Medicare Cover Assisted Living in South Carolina?

The short answer is that no, Medicare does not cover the cost of assisted living in South Carolina. Assisted living facilities are considered to be a “residential setting” and not a “clinical setting,” (think nursing homes). While Medicare doesn’t cover the cost of care received in an assisted living community, it does still cover things like approved medications, doctor visits, medical equipment, etc., just like it would if you lived at home.

For more information about when Medicare can be used to pay for senior living in a nursing home, and for Medicare-related resources, see our guide to Nursing Homes in South Carolina.

DEV NOTE: Please include a link to the section on the appropriate nursing home state page that discusses Medicare.

Other Financial Assistance Options for Assisted Living in South Carolina

Seniors who are not eligible (due to location, financial situation, or other factors) for other types of financial assistance, do still have some options. See the table below for an overview of some of the most common ways to make Assisted Living affordable.

How to Apply

How It Works

Aid and Attendance

Learn more and apply online at va.gov.

Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for Assisted Living.

Reverse Mortgages

Learn more about your options and how to apply at ftc.gov

If you own a home, you may be able to use a reverse mortgage to help pay for Assisted Living. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.

Long-Term Care (LTC) Insurance

Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov.

Seniors who already have long-term care insurance may be able to use it to pay for Assisted Living. Most policies cover at least a portion of the cost, but it depends on the specific policy terms. Note that older adults who are already in need of Assisted Living will not typically be eligible to sign up for a LTC insurance policy.

Free and Low-Cost Resources for Seniors in South Carolina

Several government and nonprofit agencies serve older adults in Florida, helping them obtain the care they need and understand their options for paying for services. The following resources can also connect seniors with social and recreational programming, community-based services and financial and legal aid. 

Resource 

Contact 

Service 

(800) 772-1213 

While the Social Security Administration is a national program, every state has local offices that can help with disability applications and supplemental security income. These programs are separate from standard Social Security and require an application. Many state programs require SSA disability standards for enrollment.

(803) 647-2488 

The South Carolina Department of Veterans’ Affairs offers former servicemen and women, along with their dependents, information about benefits that may be available. Claims assistance is available through this program so veterans can get help applying for the Aid & Attendance benefit, along with other programs designed to help veterans access safe and appropriate housing and support.

(800) 868-9095 

South Carolina's Multipurpose Senior Centers offer residents a place to gather, share meals in a congenial setting, participate in wellness classes and generally remain active in their communities. These centers also act as a first stop for many seniors seeking benefits assistance. Public benefits counseling and transportation services are just a small sample of the help that may be available at a local senior center. 

(800) 868-9095

The Long-Term Care Ombudsman program helps South Carolina seniors navigate the bureaucracy of residential care, explaining resident rights and providing advocacy when needed. This office also is a first stop for complaints of abuse or neglect in a residential care setting. 

(888) 895-7873 

The South Carolina program, Legal Assistance for Seniors, offers seniors legal advice and representation based on financial and social need. Services are offered in one of 11 categories including, income protection, health care, long term care, housing, abuse and neglect. These programs are provided by licensed, practicing attorneys in partnership with the State Bar association and other, local providers. 

COVID-19 Rules for Assisted Living in South Carolina

The following information is based on research done on several government websites, including sdhec.gov and The CDC. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 3/16/22, but since COVID-19 is a rapidly evolving pandemic, contact your local senior living facility or Area Agency on Aging for more specific and up-to-date information.

Visitation Policies

Rules for South Carolina Communities

Are loved ones allowed to visit to provide emotional support?

Yes (Conditions Apply)

Are relatives allowed to visit for end-of-life care?

Yes

Are residents required to quarantine after visiting with a loved one?

No

Are visitors required to wear PPE (including masks) in order to visit residents?

Yes

Are non-medical contractors (such as hairdressers and entertainers) allowed in senior living facilities?

Yes

Are visitors checked for elevated temperatures?

Yes

Are visitors required to answer questions about health, travel, and potential virus contact?

Yes

Outings & Social Activities

Rules for South Carolina Communities

Are residents allowed to leave (errands, visiting family, etc.) for non-medical reasons?

Yes

Are residents who leave required to quarantine when they return?

No (Conditions Apply)

Are senior living communities required to cancel all group outings?

No

Are residents allowed to eat meals together in a common area?

Yes (Conditions Apply)

Are residents allowed to gather in common areas for group activites?

Yes (Conditions Apply)

COVID-19 Safety Measures for Staff and Residents

Rules for South Carolina Communities

Are staff members regularly required to do a temperature check?

Yes

Are staff members regularly tested for COVID-19?

Yes (Conditions Apply)

Are staff members members regularly required to do a health and safety screening, including questions about travel, contact with positive cases, etc?

Yes

Are residents regularly screened for COVID-19 symptoms?

Yes

Are residents regularly checked for elevated temperatures?

Yes

Are residents regularly tested for COVID-19?

Yes (Conditions Apply)

Assisted Living Laws and Regulations in South Carolina

Assisted living facilities in South Carolina comply with regulations set by the Agency for Health Care Administration, Bureau of Health Facility Regulation. These regulations ensure a high standard of care for residents by setting minimum requirements for care, staffing and environmental features.  

SOUTH CAROLINA LAWS AND REGULATIONS

Assisted Living Service Plan Requirements 

Before admitting a new resident, assisted living facilities are required to arrange for a comprehensive medical examination that outlines the resident’s health status, care needs and dietary requirements. This evaluation should take place within 60 days before admission or 30 days after. Based on this evaluation, it develops a written service plan that addresses the individual’s needs and preferences. Residents, as well as their representative, guardian or attorney, should be allowed to participate in developing the plan.

Assisted Living Admission Requirements 

The assisted living facility’s owner or administrator is responsible for determining whether an individual is eligible for admission. Prospective residents must need help with some activities of daily living, and they should be able to participate in social and recreational activities. Facilities are permitted to admit residents who use assistive devices or require skilled nursing services, as long as the facility can provide that care directly or through a third party.

Assisted Living Scope of Care 

Assisted living facilities provide housing, meals and one or more personal care services. They may hire or contract with licensed healthcare providers to perform nursing tasks, including medication administration and medical monitoring. 

Assisted Living Medicaid Policy 

Florida’s Medicaid managed care program covers assisted living services under its Assistive Care Services provision as well as its Long-Term Care Managed Care Program. To accept payment from Medicaid, assisted living facilities must be licensed. 

Assisted Living Facility Requirements 

Assisted living facilities licensed prior to October 1999 may have up to four residents in a room, and they must have one toilet and one sink per six residents and one bath or shower per eight residents. Those licensed after that date may have only two residents per room, and no more than four residents must share a bathroom. Facilities that serve residents receiving Medicaid assistive care services aren’t required to have apartment-style rooms, but those with residents in the Long-Term Care Managed Program must have private rooms and apartments for residents. 

Medication Management Regulations 

Unlicensed staff in assisted living facilities can help residents with self-administered medication. This includes bringing premeasured medication to the resident, informing the resident of the medication and dosage, confirming that the medication is intended for the resident, placing the medication in the individual’s hand, applying topical medications, returning medication containers to storage and recording when a resident took their medication. Only licensed healthcare workers can administer medication.

Staffing Requirements 

Assisted living facilities must have an administrator responsible for monitoring day-to-day activities and a direct care staff that provides personal care services. There must be at least one staff member on-site at all times who’s certified in first aid and CPR. The state requires facilities to have minimum weekly staff hours, averaging about one full-time employee per 20 residents. Facilities must have enough staff members at all times to care for residents’ scheduled and unscheduled needs, even if that exceeds minimum requirements. 

Staff Training Requirements 

Administrators must complete 26 hours of initial training plus a competency test within 90 days of employment, plus 12 hours of continuing education every 2 years. Within 30 days of employment, unlicensed direct care staff must complete at least an hour of in-service training in infection control and 3 hours of training in topics related to residents’ needs and behaviors.

Background Checks for Assisted Living 

Assisted living facilities require level 2 background screening for prospective employees. An individual is ineligible for hire or continued employment if convicted of an intentional or negligent act that jeopardized the health or safety of a resident, theft from a resident or behaving in a way that could cause the facility to lose its licensing.

Requirements for Reporting Abuse 

Per state law, assisted living facility staff are mandated reporters and are required to report observed or suspected abuse, neglect or exploitation. Reports are to be made immediately to the central abuse hotline at (800) 962-2873 or online through the Florida Department of Children and Families.