South Carolina has a statewide population of 5,148,714, and 937,066 South Carolinians are currently aged 65 and older. By the year 2030, the number of seniors in the state is projected to double to 1.8 million. While many older adults can safely age in place, those who develop complex medical needs can find 24/7 skilled nursing care at one of the state’s 195 licensed nursing homes. These state-licensed facilities provide residents with room and board, around-the-clock medical support and daily therapeutic recreational activities. 

This guide provides an overview of average nursing home costs throughout South Carolina, along with information on programs that help seniors cover long-term care expenses. We’ve also included a list of free and low-cost services for seniors and their families, as well as a summary of the state laws and regulations for state-licensed skilled nursing facilities. 

The Cost of Nursing Home Care in South Carolina

The average monthly rate for nursing home care in South Carolina is $7,298. By comparison, the national average is $7,756, making South Carolina one of the more affordable places to seek long-term care. Rates in neighboring North Carolina are slightly more expensive at $7,300 per month, while skilled nursing care costs less in Georgia, where the statewide average nursing home rate is $6,722. 

$7298

South Carolina

$7756

The United States

$7300

North Carolina

$6722

Georgia

Throughout South Carolina, nursing home costs vary depending on the location. The lowest rates are in Sumter, where skilled nursing care costs an average of $6,083 per month. Rates in nearby Columbia are significantly higher at $7,148, while seniors in Myrtle Beach can expect to pay about $6,600 for a semiprivate room in a nursing home. In the state capital of Columbia, rates run around $7,148 per month, while Hilton Head Island has the highest average nursing home rates in the state at $7,954. 

$6083

Sumter

$6388

Florence

$6600

Myrtle Beach

$7026

Spartanburg

$7148

Columbia

$7330

Charleston

$7730

Greenville

$7954

Hilton Head Island

Nursing home care is the highest level of long-term care offered in South Carolina and includes 24/7 skilled nursing services in a highly specialized, state-regulated setting. Seniors who want a residential placement but don’t need the type of medical care provided in a nursing home can expect to pay around $3,988 per month for assisted living. Those who are able to remain in their own homes will find that homemaker services cost about $4,076 per month for 44 hours of care weekly, while home health aide rates run about $4,195 per month. Adult day health care services, which include nonmedical care in a congregate setting, cost about $1,289 per month. 

$7298

Nursing Home Care

$1289

Adult Day Health Care

$3988

Assisted Living

$4076

Homemaker Services

$4195

Home Health Aide

Does Medicaid Cover Nursing Home Care in South Carolina?

In South Carolina, Medicaid covers the cost of long-term care in a nursing home for individuals who meet certain income requirements and for those who receive doctor’s orders that their condition requires nursing home care. Approximately 1,175,383 people in the state are enrolled in the program. To accommodate those who require extensive care, there are 189 nursing homes in South Carolina. Low-income seniors who need help paying for their care may apply for the Community Choices Medicaid Waiver, which is also referred to as the Elderly and Disabled Waiver.

Medicaid Eligibility in South Carolina

To qualify for Medicaid in South Carolina, an individual must meet certain requirements for their maximum income and assets.

Annual Income Limits

Asset Limits

Single Applicant

$30,276

$2,000

Two-Person Household (Only One Person Applying)

$30,276

$2,000 for applicant, $66,480 for non-applicant

Two-Person Household (Both People Applying)

$30,276

$4,000

Additional qualifications for Medicaid applicants include:

  • Must be a U.S. citizen
  • Must prove South Carolina residency
  • Must assign rights to medical benefits

How To Apply for Medicaid in South Carolina

Seniors have several ways to apply for Medicaid in the state of South Carolina. First, an individual may apply through the Federal Health Marketplace online or by calling (800) 318-2596. Applications may be submitted in person or by mail through local Healthy Connections County Offices or by calling (888) 549-0820 or mailing the documents to SCDHHS P.O. Box 100101, Columbia, SC 29202. Typically, it takes up to 45 days for Medicaid approval, but times may vary depending on the applicant category and the number of individuals applying.

Information You Will Need:

  • Birth certificate
  • Social Security number
  • Income from all jobs or training
  • Retirement benefits
  • Checking and savings information from the past 5 years
  • Copies of life insurance
  • VA discharge papers
  • Proof of citizenship
  • Monthly bill obligations, including rent and utilities
  • Proof of payment for insurance

Additional Medicaid Support & Resources in Florida

The following is a list of free resources that provides additional information on state Medicaid, including how to apply and understanding the coverage amounts.

Resource

Contact

Service

(866) 762-2237

Benefit.gov provides information on what Medicaid is and how it can benefit seniors in long-term care, as well as individuals in other programs. The site provides basic information on income and personal requirements and gives local contact information.

(888) 549-0820

The Health and Human Services Department oversees the Medicaid program for South Carolina. It also provides information on Medicare and the different parts and gives details on eligibility requirements. Downloadable application forms are available on the website.

(877) 552-4642

Health Connections is South Carolina's Medicaid plan. The website offers information on enrolling in an eligible health plan and locating health care providers that accept the insurance. The website also makes it possible to look at and monitor applications and make changes.

Does Medicare Cover Nursing Home Care in South Carolina?

Medicare provides limited coverage for short-term stays in a skilled nursing facility following a hospital stay, but seniors must meet a number of specific requirements. This benefit is available to beneficiaries who have been hospitalized for at least three days, excluding the date of discharge, so it’s most valuable for those who are recovering from an injury, illness or surgery.

Once seniors meet the hospitalization requirement, Medicare will pay for up to 100 days of skilled nursing per benefit period. The first 20 days are covered in full. Starting on day 21, beneficiaries must pay a daily coinsurance rate. After day 100, seniors are responsible for the entire cost.

What Does Medicare Cover?

Medicare covers a number of specific services, including:

  • Meals
  • A semiprivate room
  • Medications
  • Skilled nursing
  • Physical therapy
  • Occupational therapy
  • Speech therapy
  • Audiologist care
  • Medical supplies
  • Medical social services
  • Nutritional counseling
  • Ambulance transportation

What Isn’t Covered by Medicare?

Medicare does not cover long-term custodial care that addresses seniors’ day-to-day needs. This includes help with daily activities, such as bathing, dressing and using medical equipment.

For more information about Medicare and when it covers Nursing Home Care, read our Guide to Nursing Homes.

Medicare Support and Resources in South Carolina

With so many options to choose from, seniors may find it difficult to navigate the enrollment process of Medicare. Several programs offer trained counselors who can answer questions concerning what Medicare covers and whether personal insurance can offset additional costs that aren’t covered.

Resource

Contact

Service

(800) 868-9095

SHIP provides in-depth insurance counseling to Medicare-eligible seniors, their families and their caregivers. Counselors provide one-on-one assistance with reviewing plan options, adding prescription coverage, explaining bills and reviewing explanations of benefits and can provide information on supplemental insurance.

(571) 527-3900

The NCOA helps seniors understand coverage options, costs and plans that work for their individual situation. The council also provides information on other types of insurance that can fill in any gaps that are uncovered by Medicare, including supplemental insurance.

(803) 734-9000

Sponsored by the Appalachian Council of Governments, the Disability Resource Center explains the various types of Medicare plans to seniors and provides a website with listings to other agencies that offer Medicare assistance in the state.

Other Financial Assistance Options for Nursing Home Care in South Carolina

While Medicaid and Medicare are two of the most common programs used to pay for Nursing Home Care, there are other financial assistance options available, depending on your unique situation.

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 skilled nursing care.

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 nursing care. 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 skilled nursing care. 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 skilled nursing care will not typically be eligible to sign up for a LTC insurance policy.

Free and Low-Cost Resources for Seniors in South Carolina

South Carolina has an array of programs and services that assist seniors and their caregivers when making the decision to transition into a nursing home. Some of these programs create awareness about specific medical conditions and work to bring about change, while others address individual needs to improve the quality of life in long-term care.

Resource

Contact

Service

(800) 868-9095

The Long-Term Care Ombudsman works to resolve concerns of residents in long-term care facilities. The ombudsman also acts as an advocate to bring about improvements in facility care and conditions and monitors care facilities to ensure they maintain state and federal standards.

(800) 868-9095

South Carolina has 10 Area Agencies on Aging (AAA). These agencies provide services that assist seniors with their routine household chores, including shopping, housekeeping, meals, transportation, laundry and yard work. The AAA may also help seniors determine if they qualify for government assistance in paying for long-term care and can help develop a care plan to improve their quality of life.

(803) 734-1959

The Vulnerable Adult Guardian and ad Litem Program provides guardians for senior citizens who’ve been abused, neglected and/or exploited and who require care from caregivers. Volunteers in the program meet with the seniors and review legal, medical and financial records to create an individualized plan.

(800) 272-3900

The Alzheimer’s Association advocates for greater research, development of treatments and early detection of memory impairments. The association hosts a variety of awareness campaigns throughout the year to raise money for the organization, educate seniors and the general public and fund new research.

(888) 346-5592

Low-income seniors may receive assistance with legal matters through the South Carolina legal services. The association can assist with collection issues, injury claims, tax levies, estates, wills and powers of attorney.

COVID-19 Rules for Nursing Homes in South Carolina

The following information is based on research done on several government websites, including scdhec.gov/covid19. These rules apply to Independent Living Communities and other types of senior living facilities. We’ve most recently updated this data on 2/13/2022, 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)

Nursing Home Laws and Regulations in South Carolina

NURSING HOME LAWS AND REGULATIONS IN SOUTH CAROLINA
Licensing Requirements
Nursing facilities must hold a valid license issued by the Division of Nursing Homes. Facilities are inspected prior to licensure, and ongoing inspections occur at least once every three years.
Staffing Requirements
Every nursing home must have a full-time administrator licensed by the South Carolina Board of Long Term Health Care Administrators. Whenever the licensed administrator is not at the facility, a staff member must be delegated to assume the duties normally performed by the administrator. A minimum staff-to-resident ratio of 1:9 must be maintained during the day and 1:22 at night. Facilities with more than eight residents must have at least one awake staff on duty overnight, and multi-floor facilities need to have at least one on-duty staff member on each floor at all times. 
Staff Training Requirements
At least one licensed nurse must be on-site or on-call at all times, and a registered nurse must be designated as the full-time Director of Nursing.All unlicensed caregivers need to complete a criminal record check, basic first aid training and an approved course that outlines infection control procedures, resident rights, fire response, confidentiality, use of restraints and checking and recording of vital signs. 
Admission Restrictions
Nursing homes may only admit individuals with care needs that cannot be safely met in a less restrictive setting. Residents must require hands-on assistance with at least two activities of daily living and/or need continuous monitoring of major medical conditions. 
Care Planning Requirements
Within 72 hours of admission, nursing home staff must complete a resident needs assessment, and a comprehensive care plan must be developed within seven days of admission. This care plan needs to include input from the resident, their family members and/or legal guardian, a physician and the facility administrator, and the plan needs to be reviewed at least once every six months. 
Dietary and Nutritional Services Requirements
Three daily meals plus snacks must be served, and the menu must be approved by a licensed dietician. Residents who need to follow a special diet prescribed by a physician must be provided with meals that meet their medical requirements. 
Specialized Rehabilitative Services
Nursing facilities may offer adjunct rehab services either in-house or at a nearby clinic. These services need to be delivered by a registered provider and may include speech and language therapy, physical therapy, occupational therapy and behavioral counseling. 
Medication and Pharmaceutical Services
Licensed nurses working in a skilled nursing facility may administer prescription and over-the-counter medications in accordance with the scope of their license, including oral and topical medications and regularly-scheduled insulin injections. Licensed nurses may also administer flu vaccines and perform TB screening tests. Non-licensed staff may supervise the self-administration of medications upon completion of a medication management course approved by the facility administrator. 
Activities Requirements 
Licensed nursing facilities need to employ a full-time activity director with an undergraduate degree in recreation, psychology, occupational therapy or a similar discipline. The activity director needs to offer daily recreational activities that are age-appropriate and designed to promote activation among residents. These activities should be posted on a calendar available to all residents. Residents must also have the opportunity to participate in religious services and have reasonable access to pastoral care. 
Infection Control Requirements 
No more than three residents may occupy a single room, and at least one toilet is required for every six residents. Staff must follow infection prevention and control procedures dictated by the Department of Health and Environmental Control. 
Medicaid Coverage
South Carolina's Medicaid program covers nursing home costs for Medicaid beneficiaries who require the level of care provided in a skilled nursing facility.