South Carolina has a population of over 5 million people and a large senior community that makes up nearly 18% of its residents. The South Carolina Department on Aging projects that the state’s senior population will double over the next decade, leading to a greater need for senior care options. Currently, the state is home to over 500 senior living facilities, which are officially licensed as community residential care facilities, and accommodate up to 22,000 seniors.

The overall cost of living in South Carolina is modest compared to the U.S. average. As a result, senior living is relatively affordable. For instance, South Carolina seniors pay $3,500 per month for assisted living, which is about 15% lower than the U.S. average of $4,051. This guide covers the cost of senior living in South Carolina and how it compares to surrounding states, as well as the local and state resources that are available to seniors seeking this type of care.

The Cost of Senior Living in South Carolina

Note: There currently isn’t authoritative data on the average cost of Independent Living Facilities nationwide, so instead, we use the cost of Assisted Living to estimate it. Since the cost of Independent Living is typically 30-40% lower than the cost of Assisted Living, the numbers below were calculated by subtracting 35% from the cost of Assisted Living.

Note: Memory care is typically provided in communities licensed as assisted living facilities, and in general, costs 20-30% more than standard assisted living services. No authoritative cost data is available for this type of care, so we estimated memory care rates by adding 25% to assisted living fees in the Genworth 2021 Cost of Care Survey.

Depending on the level of care they need, seniors have four main long-term options, including assisted living, independent living, memory care and nursing home care. According to the 2021 Genworth Cost of Care Survey, nursing homes in South Carolina cost around $7,285 per month for a semiprivate room. Assisted living is around $3,612 and memory care is on average $4,515. Independent living is the least expensive at $2,348.

Independent living communities are for those who want to live a low-stress lifestyle but are still independent and active. Assisted living communities provide help with activities of daily living, such as personal care, transportation and meals. Memory care is often provided in assisted living communities. It provides a safe and secure environment for those with cognitive impairments, while nursing homes offer a complete care option for those recovering from an illness or injury.

The Cost of Assisted Living in South Carolina

Assisted living communities in South Carolina cost around $3,612 per month. The national average is $888 higher. Seniors who prefer to live in Tennessee will find assisted living more costly at $4,105, while those in North Carolina pay around $4,010. Florida residents pay $4,000 per month, while Georgia assisted living communities are the least expensive in the area at $3,535.

The Cost of Nursing Home Care in South Carolina

A semiprivate room in a nursing home in South Carolina costs around $7,285 per month as opposed to the national average of $7,908. Georgia residents have the lowest care cost at $7,011 per month, while North Carolina and Tennessee residents pay $7,483 and $7,148. While often viewed as a popular retirement destination, Florida offers nursing home care at a cost of around $8,654, which makes it one of the costliest states in the Southeast for senior living.

Can You Use Medicaid to Pay for Senior Living in South Carolina?

Senior care helps address the needs of older adults throughout South Carolina; however, these services can be costly. The state has financial assistance programs to help seniors cover the cost of long-term care, including the Medicaid program Healthy Connections. Operated by the state and federal government, Medicaid provides comprehensive coverage for qualifying individuals.

The cost of nursing home care is fully covered for those who need medical assistance. Those in assisted living and memory care communities won’t receive help paying for room and board but may have medical and personal care services covered. These services are covered under state waiver programs, including the Home and Community-Based Waiver and the CHOICES waiver. Independent living isn’t medically necessary, so it typically isn’t covered by state or federal programs.

	Medicaid Coverage Level	Type of Medicaid Coverage	Entitlement?*
Assisted Living	Partial	Waiver	No
Independent Living	None	N/A	N/A
Memory Care	Partial	Waiver	No
Nursing Home Care	Full	Medicaid	Yes

*Entitlement programs mean that everyone who qualifies will receive coverage and be accepted into the programs. If the program is not “entitlement,” then participant caps could be in place, and there may be a waiting list. 

Medicaid’s Coverage of Assisted Living & Memory Care in South Carolina

South Carolina’s Medicaid program doesn’t cover room and board in assisted living and memory care facilities, but it pays for some eligible medical expenses as well as personal care using waivers.

Community Supports a Waiver

The Community Supports Waiver pays for services not typically covered under regular Medicaid. These services include housekeeping, grooming, bathing, meals and transportation. The waiver may also cover items like incontinence supplies, behavioral support, extracurricular activities and vehicle modifications. Eligibility for the waiver program is the same as for regular Medicaid. Seniors may apply for the waiver through the Healthy Connections Medicaid website.

Community Choices Waiver

Also referred to as the Elderly and Disabled Waiver, the Community Choices waiver program is for individuals who require a nursing home level of care but prefer to receive these services at home or in an assisted living community. The waiver pays for certain family members to provide the care, which gives seniors greater control over their options. It also covers personal assistance, medical equipment, supplies and home modifications. Eligibility is the same as for regular Medicaid. To apply, seniors should contact their county’s Department of Health and Human Services office.

Medicaid’s Coverage of Nursing Home Care in South Carolina

Medicaid in South Carolina pays for the cost of memory care provided if an individual meets the income and asset limits and other Medicaid eligibility requirements. The program covers therapy, medical visits, skilled nursing and personal care. Eligibility is based on income and asset limits, and the senior must be at least 65 or older. Seniors who qualify for Medicaid automatically qualify for nursing home coverage. An additional application isn’t needed.

Eligibility for Medicaid in South Carolina

Medicaid applicants must have an income that falls at or below 300% of the federal poverty level. This amounts to $30,276 per applicant. Asset limits should be no greater than $2,000 per adult or $4,000 per couple. In a two-person household with only one individual applying, the remaining spouse may receive a minimum monthly needs allowance under the spousal impoverishment rule. There are also exemptions for personal property, including a home and a vehicle.

2022 South Carolina Medicaid Income Limits

	Income Limits*	Asset Limits
Single Applicants	$30,276	$2,000
Two-Person Household (Only one applicant)	$30,276	$2,000 for applicant $66,480 for non applicant
Two-Person Household (Two applicants)	$30,276	$4,000

*per year

Additional Medicaid eligibility requirements are as follows. The applicant must:

• Be 65 years of age or older or disabled.
• Be a resident of South Carolina.
• Be a citizen of the United States or a legal alien.
• Require nursing home care.

Applying for Medicaid in South Carolina

Seniors may apply for South Carolina Healthy Connections Medicaid online or by calling the helpline at (800) 726-8774. Those who prefer to apply in person should contact their local Department of Health and Human Services office. Applications may also be downloaded and mailed to SCDHHS-Central Mail, P.O. Box 100101, Columbia, SC 29202-3101 or by emailing the application to [email protected].

Before You Apply

Before applying for Medicaid, it’s important to make sure all documents have been gathered for proof of eligibility.

• Copy of birth certificate
• Government-issued photo ID
• Social Security number
• Proof of income from jobs or training for the past four weeks
• Proof of monthly expenses
• Copies of bank statements from the last month
• Award letters for Social Security, SSI, veterans benefits and alimony
• Proof of ownership or property
• Copies of life and health insurance
• Additional legal documents that might help prove eligibility, including wills and trusts

How to Get Help

Medicaid applications can be tricky to complete, and it’s often hard to get answers to the questions you have. The following organizations can provide Medicaid assistance and offer help with additional benefit programs.

Resource	Contact	What You Should Know
Benefits.gov	(800) 610-1863	Benefits.gov is a government website that provides up-to-date information on Medicaid eligibility and the application process. The site also helps determine eligibility for Medicaid and additional financial help programs.
South Carolina Department of Health and Human Services	(855) 472-3432	The Department of Health and Human Services provides assistance to seniors who have questions regarding Medicaid and other state benefit programs.
SC Thrive	(800) 726-8774	SC Thrive is an online database that helps seniors sign up for Medicaid and other state benefit programs. The agency offers trained counselors who can provide information on indigent assistance, prescription drug coverage and long-term care.

Can You Use Medicare to Pay for Senior Living in South Carolina?

Unfortunately, Medicare does not cover the cost of assisted living, independent living, or memory care. Unlike nursing homes, these care types are not considered to be “clinical settings” and so are not eligible for Medicare coverage. That being said, those who live in these communities can still use Medicare to cover the cost of approved medications, doctor visits, medical equipment, etc.

When it comes to nursing home care, it gets much more complicated. Medicare does provide limited coverage for a qualified stay in a nursing home,but there are strict rules and requirements of which you should be aware. This benefit is available to seniors who have been hospitalized for at least three days, excluding the date of discharge.

Once you’ve met the hospitalization requirement, Medicare will pay for up to 100 days in a skilled nursing facility (per benefit period). While the first 20 days are covered in full, there is a daily coinsurance rate that must be paid starting on day 21. After day 100, seniors are responsible for the entire cost.

	Medicare Coverage	Medicare Coverage Duration	Coinsurance Requirement?
Assisted Living	None	N/A	N/A
Independent Living	None	N/A	N/A
Memory Care	None	N/A	N/A
Nursing Home Care	Limited	100 Days Per Benefit Period	Yes – After 20 Days

What Nursing Home Care Services Does Medicare Cover?

Medicare covers a number of specific services, including:

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

What Nursing Home Care Services Aren’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.

Seniors who are unfamiliar with Medicare may have difficulty deciding which part to apply for based on their needs. The following organizations provide information on the different components of Medicare, including Medigap and prescription drug coverage.

Resource	Contact	What You Should Know
South Carolina State Health Insurance Program (SHIP)	(800) 868-9095	SHIP provides in-depth counseling for Medicare applicants. The program is funded by the federal government and provides answers to the most common Medicare questions and additional help with other supplemental programs.
South Carolina Department of Insurance	(803) 737-6180	The South Carolina Department of Insurance works to ensure that South Carolina residents have medical coverage. The agency assists customers with insurance problems and can help seniors locate the best plans to suit their needs.
Mayor’s Office of Aging	(843) 724-7311	The Mayor’s Office of Aging works to improve the quality of life of seniors through insurance workshops and assistance with state and federal insurance coverage. The office provides information on age-related issues and helps seniors address insurance fraud. The office is located in Charleston and is available for local residents.

Are There Other Financial Assistance Options for Senior Living in South Carolina?

Depending on your unique situation, there may be other financial assistance options to partially or fully cover the cost of senior living in South Carolina. Below, we cover some of the common ways that seniors can make senior living options such as assisted living or memory care more affordable.

	How to Get Started	What You Should Know
Aid and Attendance	Apply online at va.gov.	If you are a veteran and you receive a VA pension, you may also be eligible for the Aid and Attendance benefit. This benefit takes the form of a monthly cash allowance that you receive in addition to your standard pension. This benefit is used by veterans who need long-term care services, including care received at an assisted living facility.
Reverse Mortgages	Research and learn about the different types at ftc.gov.	If you own a home, you may be able to use a reverse mortgage to access some of the equity in your home. Like traditional loans, reverse mortgages do need to be repaid with interest, typically within 12 months, so seniors should carefully weigh this option alongside other financing methods.
Long-Term Care (LTC) Insurance	Learn about how to receive LTC insurance benefits at acl.gov.	While those who currently need assisted living will typically not be eligible, if you purchased an LTC insurance policy in the past, you may be able to use it to help pay for assisted living. While most policies cover at least a portion of the cost, you still need to check the specific terms of your policy.

Free Senior Living Resources for Seniors in South Carolina

Seniors living in South Carolina can find multiple organizations that serve the best interests of the older population. Help from these resources may be found over the phone or online. These organizations can provide assistance with everything from transportation to and from senior centers to advice on long-term care.

	Contact	What You Should Know
South Carolina’s information Highway (SCIWAY)	Online Only	SCIWAY is one of South Carolina’s largest online databases for programs and services. Seniors may search through over 50,000 links on topics like education, jobs, real estate and activities.
Senior Resources	(803) 252-7734	Senior Resources provides a searchable online database of resources specifically picked for seniors. The database focuses on food, active living and home assistance.
South Carolina’s Long-Term Care Ombudsman	(800) 868-9095	The South Carolina Long-Term Care Ombudsman serves as an advocate for seniors in long-term care facilities. The ombudsman accepts complaints against communities and works to resolve these issues.
AARP South Carolina Chapter	(888) 687-2277	AARP is the world’s largest nonprofit serving the aging community. The orgnaization helps seniors search for the best residential care facility to suit their needs. It also provides numerous discounts and information on topics of interest to older adults.
South Carolina Department on Aging	(803) 734-9900	The South Carolina Department on Aging provides a list of programs and services for older adults within the state. Some of these programs include caregiver support, Alzheimer’s resources, nutrition and senior center activities. Most programs are searchable by county or topic and offer a brief overview of the service along with contact information.

Covid-19 Rules and Restrictions for South Carolina Senior Living Facilities

The following information is based on research done on several government websites, including scdhec.gov/covid19 and cms.gov. These rules apply to nursing homes 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.

Visiting Loved Ones

Can I visit my relative in person if he/she wants emotional support from me?	Yes (Conditions Apply)
Can I visit my relative in person for end-of-life compassion care?	Yes
Will my loved one be required to self-quarantine after I visit him or her?	No
Do I need to wear PPE and/or a cloth mask if I do visit my relative in person?	Yes
Are Hairdressers and other non-medical contractors still allowed in senior living facilities?	Yes
Does the state recommend or require that senior living facilities assist families with setting up virtual visit alternatives?	Yes
Are visitors being screened for elevated temperatures?	Yes
Are visitors being asked questions about health, travel, and potential virus contact?	Yes

Outings and Group Activities

Are residents allowed to leave the facility for non-medical reasons?	Yes
Are residents of senior living facilities who leave and return required to self-quarantine?	No (Conditions Apply)
Are senior living facilities required to cancel all group outings?	No
Are residents still eating together in the dining hall?	Yes (Conditions Apply)
Are facilities still allowed to host group activities within the community?	Yes (Conditions Apply)

Safety Measures for Staff & Contractors

Are staff members and contractors being screened for elevated temperatures?	Yes
Are staff members and contractors being tested for Coronavirus?	Yes (Conditions Apply)
Are staff members and contractors being asked questions about health, travel, and potential virus contact?	Yes

Safety Measures for Residents

Are staff members required to regularly screen residents for coronavirus symptoms?	Yes
Are residents relied on to screen themselves and self-report potential coronavirus symptoms?	No
Are staff members required to take residents’ temperatures?	Yes
Are residents being tested for coronavirus?	Yes (Conditions Apply)

Senior Living Laws and Regulations in South Carolina

Note: All these rules typically apply to non-clinical senior living facilities, such as independent living, assisted living, and memory care facilities. Nursing homes and other senior living facilities with a clinical setting may have additional or slightly different requirements and regulations.

South Carolina’s senior living facilities are governed by the state’s Bureau of Health Facility Licensing, which enforces laws and regulations to ensure that facilities are safe and that residents receive proper care.

Scope of Care

Senior living facilities in South Carolina provide housing and personal care services for two or more residents. They also provide three meals plus snacks daily to meet dietary needs, with no more than 14 hours between the last meal of the day and breakfast the following day.

Care Plan Requirements

Within 72 hours of admitting a new resident, a direct care staff member must assess the resident’s needs to determine the level of care needed and to confirm that the facility can meet those needs. Within seven days, the facility must develop an individualized care plan that outlines the resident’s needs, requirements and arrangements for visits with authorized health care providers, advanced care directives, dietary needs and recreational and social activities.

Medication Management Requirements

Staff members who have been trained by someone who is licensed to administer medications may administer routine medications, including injections required for diabetes management and anaphylactic reactions. A staff member who is a licensed nurse may administer flu shots and vitamin B-12 injections. Facility staff members may monitor diabetic residents’ blood sugar levels, but sliding scale insulin injections aren’t permitted.

Self-administering medications by residents is only permitted upon the specific written orders of their physician or another authorized health care provider. These orders must be obtained on a semiannual basis, or the staff must verify that the resident remains capable of self-administering medication quarterly. Senior living facilities may elect to not permit self-administration.

Staffing Requirements

All senior living facilities must designate an administrator to oversee the facility’s activities and functions and a recreational program staff member to provide or coordinate activities for residents. At all times, there must be an extensively trained staff member on duty who can take action in the event of an injury, illness or emergency.

The number of staff members that must be on-site is determined by the number of residents and their care needs. During the day, there must be at least one staff member per eight residents, and at night, there must be one staff member per 30 residents. In facilities with more than eight residents, at least one staff member must be awake and dressed at night. Facilities that have residents with dementia must have an awake staff member at all times.

Caregiver Screening Requirements

Before hiring a prospective staff member, licensed senior living facilities must perform a criminal background check on the candidate. Those who have been convicted of, or who pled no contest to, abuse, neglect or exploitation of a child or a vulnerable adult are ineligible for hire.

Caregiver Training Requirements

All staff members are required to receive training relevant to their job duties and responsibilities. At least annually, they must be trained on topics, such as basic first aid and CPR, medication management, the use of restraint techniques, OSHA standards regarding blood-borne pathogens and resident confidentiality. Direct care staff must also receive annual training on procedures for checking and documenting vital signs.

Medicaid Coverage

The state covers services received in senior living facilities under Healthy Connections, the Medicaid state plan, via two waiver programs.

Abuse and Neglect Reporting

Suspected or confirmed cases of abuse, neglect or exploitation must be reported by staff members to the South Carolina Long-Term Care Ombudsman Program. Anyone else who has a concern or needs to file a complaint pertaining to how residents in a facility are treated can also contact the ombudsman at 1-800-868-9095.

Memory Care Regulation

Memory care services are provided in senior living facilities in Alzheimer’s special care units. These units feature a secure program that is segregated from the general population. Senior living facilities that provide dementia care must have a sufficient number of direct care staff to ensure that memory care residents’ needs are met, and staff must receive dementia-specific training on topics, such as communication techniques, resident safety and understanding and coping with behaviors.

Frequently Asked Questions

How much does assisted living cost in South Carolina?

On average, seniors in South Carolina pay $3,500 per month for assisted living expenses. In most cases, this monthly fee covers housing, meals, activities, housekeeping and some levels of personal care.

Does Healthy Connections pay for assisted living?

Healthy Connections, which is South Carolina’s Medicaid program, doesn’t directly cover assisted living. However, it has two waiver programs, including the Community Choices Waiver and the Community Supports Waiver, which cover some care services for eligible seniors.

Does Medicare pay for assisted living?

While Original Medicare doesn’t cover assisted living, some Medicare Advantage plans offer this coverage. Medicare Advantage plans are provided by private insurers, and benefits and costs vary by region.

What are “Activities of Daily Living?”

Activities of Daily Living, also called ADLs, are the everyday tasks that are necessary for health, safety and quality of life. There are five main ADLs, including bathing, toileting, eating, dressing and personal grooming. Instrumental activities of daily living, or IADLs, include medication management, shopping for groceries, meal preparation and cleaning and managing a home.

What is the difference between assisted living and nursing homes?

The main difference between assisted living and nursing homes is the level of medical care that is provided. Seniors in assisted living are generally able to live somewhat independently in their own apartment or suite, but they typically need assistance with one or two ADLs or IADLs. Nursing home residents typically need 24-hour medical monitoring and skilled nursing services.

Learn More About Senior Living in South Carolina

For more information about specific types of senior living in South Carolina read our Guide to Assisted Living and Independent Living.

The Top Cities for Senior Living in South Carolina

Learn more about the cost of senior living in the top South Carolina cities. Additionally, find reviews and information about assisted living facilities and other senior living communities across the state.