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

Financial Assistance for Nursing Home Care in South Carolina

Most people do not pay for skilled nursing care entirely out-of-pocket. Rather, they utilize financial assistance programs to help cover the cost of nursing care. Of public financial assistance programs, Medicaid provides the most comprehensive coverage of nursing home care. But, not all seniors are eligible for Medicaid. And because each state operates its own Medicaid program within federal guidelines, eligibility and benefits vary from state to state. Below, we provide more information on Medicaid in South Carolina.

South Carolina’s Medicaid Program

As of September 2020, 1,085,401 South Carolina residents were enrolled in Medicaid and CHIP, and 16,903 beneficiaries received skilled nursing care in one of the state’s 156 Medicare/Medicaid-participating nursing facilities. South Carolina’s Medicaid program, known as Healthy Connections, covers a wide range of long-term care services and supports for eligible seniors, including in-home care, adult day health care, transportation to medical appointments and skilled nursing care. 

Healthy Connections is administered through South Carolina’s Department of Health and Human Services. Medicaid-funded nursing home placement is an entitlement in South Carolina, which means that any senior who meets the financial criteria for Medicaid and cannot be safely supported in a less-restrictive setting, such as an assisted living community, automatically qualifies for skilled nursing care coverage. The DHHS assesses each applicant to determine their level of functioning. Only those who are unable to perform at least two activities of daily living without assistance, such as getting dressed, eating, toileting and/or bathing, will qualify for Medicaid-funded nursing home services. 

Medicaid Eligibility in South Carolina

To qualify for Institutional/Nursing Home Medicaid coverage in South Carolina, seniors must

  • Be aged 65 or older
  • Have a monthly gross income of $2,349 or less when applying as an individual
  • Have a combined monthly income of $4,698 or less when applying with a spouse

  • Have no more than $2,000 in countable assets as an individual or $4,000 in joint assets when applying with a spouse
  • Reside in South Carolina
  • Be either a U.S. citizen or have permanent resident alien status

Alternative Financial Assistance Options

  • Medicare: Medicare will cover the cost of one’s care in a skilled nursing facility for the first 20 days of their stay, and a portion of the costs up until day 100. After 100 days, the individual is responsible for all costs. Seniors must also have a “qualifying hospital stay” of at least 3 days prior to their admission to a nursing home in order to qualify for Medicare coverage.
  • Aid and Attendance: 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: 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. This type of funding can be especially useful for married couples when only one partner needs nursing care, as the other residents of the home may continue living there. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.
  • Long-Term Care Insurance: Seniors who already have long-term care insurance may be covered for skilled nursing care. Most policies cover at least a portion of the cost of nursing home care, but it depends on the specific policy terms. Note that older adults who are already in need of skilled nursing care will not be eligible to sign up for a LTC insurance policy.

Free and Low-Cost Resources for Seniors in South Carolina

There are a number of agencies, programs and services that provide free and low-cost assistance to seniors who require long-term care. These services include case management, Medicare counseling, guardianship and advocacy and help with finding local resources. 

ResourceContactService
Long Term Care Ombudsman Program(800) 868-9095South Carolina’s Long Term Care Ombudsmen work to protect the rights of long-term care residents. Ombudsmen respond to complaints from residents regarding issues related to quality of care, safety and transfer or discharge. Ombudsmen services are free and available statewide. 
Area Agencies on AgingCheck website for local AAA or call 1-800-868-9095South Carolina has a statewide network of 10 Area Agencies on Aging. These nonprofit organizations serve as regional resource centers for seniors, and staff provide free information on local long-term care services, assist with case management and refer seniors to financial aid and other support programs. 
South Carolina Vulnerable Adult Guardian ad Litem Program(803) 734-1959South Carolina’s Vulnerable Adult Guardian ad Litem Program helps protect seniors who have either been or are at risk of exploitation, neglect or abuse. Trained volunteers serve as guardians for program participants and work to advocate for those who are unable to fully direct their own care. 
Alzheimer’s Association — South Carolina Chapter(800) 272-3900The South Carolina Chapter of the Alzheimer’s Association offers a range of support groups, seminars and services for people living with memory loss and their caregivers. The AA can help seniors access memory care services, as well as programs that help seniors cover their long-term care costs. 
South Carolina Legal Services(888) 346-5592South Carolina seniors with an annual income at or below 200% of the federal poverty guidelines may qualify for free legal assistance through South Carolina Legal Services. The nonprofit organization provides legal advice on noncriminal matters, such as guardianship and estate planning, and in some cases, can provide legal representation to vulnerable adults. 

Nursing Home Laws and Regulations in South Carolina

Licensing RequirementsNursing 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 RequirementsEvery 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 RequirementsAt 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 RestrictionsNursing 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 RequirementsWithin 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 RequirementsThree 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 ServicesNursing 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 ServicesLicensed 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 CoverageSouth Carolina’s Medicaid program covers nursing home costs for Medicaid beneficiaries who require the level of care provided in a skilled nursing facility.