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Assisted Living South Carolina
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 2024 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
When trying to decide how to pay for assisted living, one of the first questions that comes up is "How much does it cost?" With the impact of inflation, it's more important than ever to have up-to-date information when making a financial plan for senior living. To help shed light on real senior living prices, Caring.com has compiled proprietary cost data from its network of over 75,000 senior living providers to offer insight into the average cost of assisted living in South Carolina and its 39 cities.
The Cost of Assisted Living in South Carolina's Top Cities
The price of assisted living in South Carolina can vary significantly between cities. In the center of the state, Columbia's average rate is $3,927. But heading toward the coast, prices drop in Myrtle Beach to $3,726. Other cities offer rates closer to the statewide norm, such as Spartanburg at $4,021 per month, while some towns have lower costs, including Greenville at $3,782.
South Carolina
$4,161
Columbia
$3,927
Myrtle Beach
$3,726
Spartanburg
$4,021
Greenville
$3,782
Inflation's Impact on the Cost of Assisted Living in South Carolina
Inflation has significantly impacted the price of assisted living in South Carolina, with rates rising by 17.37% between 2022 and 2023. In contrast, the national average increased by 9.55%. Nearby states also saw prices rise during that period. North Carolina experienced a similar increase, with statewide prices climbing by 18.1%, while Tennessee reported a sharp rise of 24.17%. Inflation in Georgia was comparatively tame at 5.95%, but Florida was in line with the national average at 9.12%. This trend toward higher rates underlines the importance of financial planning for seniors living in the South.
| Location | 2022 Cost (Historical) | 2023 Cost (Current) | 2024 Cost (Estimated) |
|---|---|---|---|
| South Carolina | $3,545 | $4,161 | $4,526 |
| U.S. Average | $4,070 | $4,459 | $4,802 |
| North Carolina | $4,088 | $4,828 | $4,803 |
| Georgia | $3,730 | $3,952 | $3,895 |
| Tennessee | $3,383 | $4,201 | $4,543 |
| Florida | $3,727 | $4,067 | $4,438 |
The Costs of Other Types of Senior Living
Assisted living isn't the only senior care option in South Carolina. Seniors who don't need daily living assistance can save by choosing an independent living community, which costs $3,023 on average in the state. On the other hand, memory care provides more advanced services than assisted living for the higher price of $4,234.
Assisted Living
$4,161
Memory Care
$4,234
Independent Living
$3,023
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 2023, a senior who would otherwise qualify for nursing home coverage may have an annual income of no more than $32,904.
2022 Medicaid Income Limits for Seniors in South Carolina
| Household Size | Number of Applicants | Income Limits Per Year* | Asset Limits: Applicant(s) | Asset Limits: Non-Applicants |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $4,000 | |
| Two Person | 1 | $32,904** | $4,000 | $66,480 |
| Two Person | 2 | $65,808 | $8,000 |
*Depending on the facility setting, a recipient may not be able to keep income up to this level.
**Income limit is for applicant only.
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.
| Program | Contact | DESCRIPTION |
|---|---|---|
| South Carolina Healthy Connections Choices | (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. |
| SC Thrive | (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. |
| South Carolina Department of Health and Human Services | (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.
Paying for Assisted Living Facilities in South Carolina
Supplemental Security Income (SSI) is a benefits program run by the Social Security Administration for seniors with limited income and means. South Carolina's OSS program supplements the cost of assisted living for residents who meet all the qualifications of the SSI program, except for the maximum income limit.
To be eligible, applicants must:
- Be at least 65 years old and a resident of South Carolina
- Reside at an assisted living facility that's enrolled with SCDHHS
- Be a U.S. citizen or Lawful Permanent Resident Alien
- Have a monthly income of less that $1,435, as of 2018
- Have individual resources totaling less than $2,000, as of 2018
To learn more about eligibility requirements, fill out the Healthy Connections Application for Nursing Home, Residential or In-Home Care. Then, return it to your county SCDHHS office. You can also apply online.
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.
| Name | HowToApply | HowItWorks |
|---|---|---|
| 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
There are many resources in South Carolina that assist seniors in their retirement. Caring.com has compiled information on local organizations, programs and agencies and categorized them into care types for easy reference.
Area Agency on Aging
Retirees can find support and advice on various senior-related issues from their local Area Agency on Aging. The agency provides advice on topics such as financial assistance programs, in-home care and long-term care planning. It also connects seniors and caregivers with community-based resources.
| Program Name | Phone Number | Description |
|---|---|---|
| South Carolina Area Agencies on Aging | The 10 Area Agencies on Aging (AAA) under the ) offer seniors Information about available programs and services, including the State Health Insurance Assistance Program (SHIP), Medicare, the Long Term Care Ombudsman Program, senior centers and the Senior Community Service Employment Program (SCSEP). AAA location info is accessible via the website. |
Cash Assistance Programs
Cash assistance programs in South Carolina provide financial support to help low-income retirees remain in their own homes for as long as possible. Seniors and caregivers can apply for tax rebates and reductions, discounts on vital services and help covering the cost of heating and cooling their home.
| Program Name | Phone Number | Description |
|---|---|---|
| South Carolina Lifeline Program | 800-234-9473 | The LifeLine Program offers a discount on landline or mobile telephone service, ensuring that participants can stay in contact with loved ones. |
Financial Assistance for Senior Care and Senior Living
Whether living in their own home or in a senior living community, South Carolina seniors can find financial assistance from numerous local resources. These organizations help residents cover some of the costs associated with in-home or long-term care and connect them with other helpful community-based resources.
| Program Name | Phone Number | Description |
|---|---|---|
| South Carolina Community Long-Term Care | 888-549-0820 | Community Long-Term Care offers a variety of programs and services to older adults who need personal care assistance to help them delay entry into nursing home care. This includes the Community Choices Waiver that helps individuals aged 18 and older with a disability or seniors aged 65 and older receive services like bathing, dressing and toileting. Other services offered include companionship, home-delivered meals, adult day health care, skilled nursing, respite care and personal emergency response systems. |
Food Assistance Programs
Local organizations help ensure elderly citizens have a balanced diet and receive essential vitamins and minerals to remain healthy. Through nutrition programs, congregate meals, home-delivered meals and food pantries, these programs help South Carolina seniors afford the nutritious food they need.
| Program Name | Phone Number | Description |
|---|---|---|
| South Carolina Meals on Wheels | South Carolina Meals on Wheels works with South Carolina food pantries, senior centers and churches to provide weekday deliveries of hot, nutritious lunches to homebound seniors. Delivery times and options vary by specific MOW partner. There's no charge for the delivery service, though donations are accepted. Many Meals on Wheels partners also offer congregate meal sites that provide a social experience for otherwise isolated seniors. | |
| South Carolina Seniors Farmers' Market Nutrition Program (SFMNP) | 888-227-3487 | The Southern California Seniors Farmer's Market Nutrition Program is a seasonal grant program that provides seniors with fresh fruits and vegetables from local farmer's markets. The program runs from June 1 to October 31. Each eligible senior receives $50 worth of checks to spend at participating markets. Seniors must be over 60 years of age, reside in one of 46 participating counties and meet certain income requirements to be eligible for the program. |
| South Carolina Supplemental Nutrition Assistance Program (SNAP) | 888-227-3487 | The South Carolina Supplemental Nutrition Assistance Program helps qualifying seniors over age 60 obtain nutritious food. Those who are eligible receive their benefits on an electronic benefits transfer card, which functions like a debit card and is accepted at supermarkets, convenience stores and farmers' markets statewide and at participating online retailers. Only food and beverages can be purchased with the card, excluding prepared food items, alcohol and tobacco. Expedited benefits are available within 7 days of application for qualifying seniors. |
Home Repair and Modifications
Seniors and those with disabilities can access a variety of local resources to help them pay for home repairs and modifications. Programs in South Carolina have different eligibility criteria and often assist retirees by providing grants or loans.
| Program Name | Phone Number | Description |
|---|---|---|
| South Carolina Weatherization Assistance Program (WAP) | 803-734-0662 | WAP helps seniors with limited budgets reduce their energy bills by making their property more energy-efficient. This includes installing insulation and replacing windows, doors and older appliances. Replacing HVAC units, hot water heaters and refrigerators. |
Legal Resources
Many organizations offer free or low-cost legal services to South Carolina seniors. Older adults can access advice on issues such as estate planning, living wills and power of attorney. Some firms also act as long-term care ombudsmen, advocating for the rights of seniors in senior living communities.
| Program Name | Phone Number | Description |
|---|---|---|
| South Carolina Long Term Care Ombudsman | 800-868-9095 | The Long Term Care Ombudsman Program was created to ensure residents of memory care communities and other long term care facilities receive high quality care. The program's volunteers investigate complaints about facilities and seek a resolution that supports the best interests of the facility's residents. Before moving into a facility, an ombudsman can help find facilities' inspection records and past citations so families can choose the best facility for their loved one's needs. |
| South Carolina Legal Services | 803-799-9668 | South Carolina Legal Services is a statewide nonprofit with offices in Columbia and other major cities. It's dedicated to ensuring that all residents have equal access to legal services, regardless of their ability to pay. Seniors can contact this organization for help with all types of civil matters, including health care, family law, housing, deceptive sales practices, debt collection and consumer rights. |
Senior Centers
Senior centers in South Carolina bring together residents through recreational activities and events. Many also offer advice and support on senior issues, run wellness and nutrition programs, and connect older adults with other resources in the local area.
| Program Name | Phone Number | Description |
|---|---|---|
| South Carolina Multipurpose Senior Centers | 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. |
Social Security Offices
Social Security offices in South Carolina help seniors and disabled people access the benefits they're entitled to. Older adults can contact their local office for information about receiving retirement benefits, disability allowance and Supplemental Security Income.
| Program Name | Phone Number | Description |
|---|---|---|
| South Carolina Social Security | Social Security is a source of income available to retirees and people who can no longer work because of a disability. The money for Social Security comes from a payroll tax levied on employers, employees and self-employed individuals. When you retire, you'll receive monthly payments based on how much you earned when you were working. |
Tax Assistance
Seniors can apply for tax assistance from several South Carolina resources. Elderly residents and those with disabilities could be eligible for tax exemptions on medical expenses, reductions on property tax and other tax assistance programs.
| Program Name | Phone Number | Description |
|---|---|---|
| South Carolina Homestead Exemption | 803-898-5700 | The South Carolina Homestead Exemption provides an exemption of the first $50,000 of the Fair Market Value of your property in order to reduce tax liability. |
Utility & Energy Bill Assistance
Low-income seniors who are struggling to meet the costs of maintaining their homes can find support from organizations that offer assistance with utility and energy bills. South Carolina retirees could also qualify for emergency funding programs if they're in danger of losing utility services due to unpaid invoices.
| Program Name | Phone Number | Description |
|---|---|---|
| South Carolina Low Income Household Water Assistance Program (LIHWAP) | 803-734-0662 | LIHWAP is a federally funded program that assists residents of South Carolina with water bills and waste management fees. This assistance applies to seniors and individuals who use public water systems or treatment works. |
| South Carolina Low-Income Home Energy Improvement Plan (LIHEIP) | 803-734-0662 | LIHEAP helps seniors pay for high energy bills, especially during winter. The program provides utility bill payment assistance, energy crisis assistance and weatherization and home repair assistance. The program is offered by local county Community Action Agencies. |
Veteran's Services
South Carolina retirees who have served in the U.S. military can find support from local veteran services. These offices and organizations help vets access the benefits they're eligible for and provide advice and information on a variety of issues.
| Program Name | Phone Number | Description |
|---|---|---|
| South Carolina VA Benefits and Health Care | Veterans in South Carolina can access VA health care services, which vary and offer coverage for preventive care, inpatient hospitalizations and emergency care. Disability compensation is available for veterans who became ill, injured or disabled while on active duty. Other VA benefits available to some South Carolina veterans include pension benefits, assistance securing employment, life insurance and access to VA home loans. Eligibility requirements can vary and can be reviewed at a local VA office. |
Assisted Living Laws and Regulations in South Carolina
Assisted living facilities (ALFs) 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 | ALFs must assess the needs of new residents within 72 hours of admission. During the assessment, a staff member determines the individual’s care needs and if the community can meet them. This information is also used to create an individual care plan (ICP) with health care provider visit details, social needs, and more. An ICP must be finished within seven days of admission. Staff review and revise each ICP at least twice per year and if the resident's needs change. |
| Assisted Living Admission Requirements | ALF owners or administrators determine who will be admitted. Residents cannot display serious aggression, violence or socially inappropriate behaviors. They must need help with some activities of daily living and be able to participate in social and recreational activities. Residents will not be admitted if they require hospital or nursing care such as suctioning or intravenous fluids, but skilled nursing services can be provided short-term directly or through a third party. |
| Assisted Living Scope of Care | Assisted living facilities provide housing, meals and one or more personal care services such as assistance with bathing, grooming, or dressing. They may hire or contract with licensed healthcare providers to perform nursing tasks, including medication administration and medical monitoring for no more than 14 consecutive days at a time. The state also requires communities to provide transportation for residents and at least one structured recreation activity per day. |
| Assisted Living Medicaid Policy | Some ALFs accept Medicaid to cover the costs of personal care services. To be eligible for coverage, you must meet the eligibility requirements for Medicaid and be receiving OSS program benefits. South Carolina pays OSS benefits to residents eligible for SSI or who meet all its requirements except for the income limits. Room and board costs are also limited for Medicaid-eligible residents so that their OSS and SSI, minus a personal needs allowance, cover their monthly costs. |
| Assisted Living Facility Requirements | ALFs licensed before October 1999 may have up to four residents in a room, one toilet and sink per six residents and one bath or shower per eight residents. Those licensed later may have two residents per room, and four residents per bathroom. Residents in the Long-Term Care Managed Program must have private rooms and apartments. All ALFs must meet strict state building regulations that specify gross square footage needed per bed, required safety systems, and more. |
| Medication Management Regulations | Unlicensed staff can help residents with routine medications and diabetes or anaphylactic reaction injections if they have been trained by someone who is licensed to administer medications. Some communities allow residents to administer their own medication, but this requires written authorization from a physician or other healthcare provider. This authorization is evaluated and renewed semi-annually. Unlicensed staff may also assist with self-administered medications. |
| Staffing Requirements | ALFs must have an administrator and a back-up administrator as well as direct care staff. The state requires one active-duty staff member per eight residents during the day and per 30 residents in the evening. One staff member must develop and coordinate recreational activities and another is responsible for ensuring residents are present and action is taken in an emergency. Medicaid-eligible residents need a state-licensed nurse to develop and monitor their care plans. |
| Staff Training Requirements | Administrators must complete initial training plus a competency test and 18 annual hours of continuing education. Unlicensed direct care staff must complete in-service training in infection control and topics related to residents’ needs and behaviors. New staff is required to go through an initial orientation and learn emergency and disaster procedures within 24 hours of their first day. The staff member in charge of recreation also needs initial and ongoing training. |
| Background Checks for Assisted Living | Assisted living facilities require background screening for prospective employees, volunteers, and community care sitters. An individual is ineligible for hire or continued employment if they were convicted of or pleaded no contest to an intentional or negligent act that jeopardized the health or safety of a resident, involved theft from a resident or included behaviors that could cause the facility to lose its licensing. |
| Requirements for Reporting Abuse | Elder abuse includes physical, psychological and sexual abuse, as well as neglect or exploitation. Staff members at ALFs are trained to spot and report cases of abuse, and assisted living properties are required by law to report possible instances of abuse. Community residents and their loved ones should also report any suspected abuse to the county's Department of Social Services, Adult Protective Services at 1-888-CARE4US (1-888-227-3487) or make a report online. |
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