South Carolina Adult Care Homes


South Carolina Adult care homes

South Carolina was voted the fourth best place to live for seniors in all of the United States. The cost of living and mild climate make it an ideal place to retire or age as a senior. Our aging adult population enjoys coastal climates, the laid back lifestyle, and as seniors and retirees get older, they may require care at some point. Nursing homes are often the first thing people think of when it comes to senior care and housing, however a nursing home is far from your only option. Adult care homes in South Carolina, also known as residential care homes are private residences that provides a home-like setting. The adult care home, or residential care home provider will typically provide meals, housekeeping, and limited activities.

Unlike a nursing home, residents may require very light assistance or may be dependent with several care needs; it is best to ask individual locations for their specific policies and licenses. Caregivers may perform several functions: personal hygiene and mobility and eating and dressing and toileting and behavior management.

An adult family care home is for a senior who can no longer manage their health and safety in their own home, and may need care. Family care homes are an excellent housing option for aging adults because they offer private residencies in a home-like environment. Some states may use the term Adult Foster Home or Board & Care Home. These homes are not nursing homes.

Other definitions and terms you may hear

Adult care homes are found in normal residential neighborhoods. You may drive past an adult foster home each day on your commute. As you look for adult care homes in your community, it is good to know the other terms/names you may hear: 

  • Residential care home
  • Residential care facility
  • Care Home
  • Adult family home 
  • Board and care home 
  • Adult foster home
  • Nursing Home (although this is an outdated and not an accurate term for this level of care)

Licensing and regulations in South Carolina

Residential care homes are licensed and monitored by the South Carolina Department of Health and Environmental Control’s Division of Health Licensing. They are routinely inspected and it is required that their Department of Health and Environmental Control license is displayed.

A residence or community cannot admit any individual whose needs they cannot meet, nor any individuals who portray aggression, violent or inappropriate behavior.


All residential care homes must have an administrator appointed who is licensed by the State Board of Long-term Healthcare Administrators. The administrator is in charge of all the facilities/homes operations. There must be one dedicated staff member who (in writing) will act as such in absence of the administrator.

In South Carolina, Residential care facilities and homes must have a designated staff member responsible for recreational programming, who will organize and conduct recreational activities.

There must always be a responsible staff member awake and on duty at all times while any resident in on the premises.

What care and support does a South Carolina Adult Care Home provide?

Similar to a nursing home, residents receive 24-hour care, all in a single-family environment. And in addition each home has an operator who may employ additional caregivers to support with the care of residents. All residential care homes, residential care facilities must provide all residents with the appropriate care and assistance with all ADLs (activities of daily living), assistance with medication, a minimum of one organized activity each day, and transportation for appointments.

Caregivers may assist with activities of daily living and some other care needs, including:

  • Personal care
  • Housekeeping
  • Activities
  • Group meals
  • Mobility
  • Behavior management
  • Eating
  • Dressing
  • Toileting
  • Personal hygiene
  • Cognitive support and redirection

What is the cost of an Adult Care Home in South Carolina?

It becomes common knowledge as you search through care options for your aging loved one, the large discrepancies in costs. Adult care homes are no exception. The good news is adult care homes are generally half the cost of a nursing home and are typically less expensive than assisted living. But they will not have the same amenities and variety of activities.

The cost of assisted living in South Carolina is a little under $4,000 per month. The cost of a residential care home or facility is usually a little bit cheaper in South Carolina at $3,300 per month. Costs will change depending on required care, where you live or are looking for housing, and any other additional amenities or specialized care needs.

Typically, the cost for senior living and care is less expensive in the southern regions of the country as well as some of the mid-western states. If you are looking for care in the northeast or on the west coast, expect to potentially pay much more.

How to pay for an adult care home in South Carolina

You want to consider your payment options for assisted living, memory care, and care homes. For these services, Medicare is NOT an option for payment.

The most common payment for these services would be out of pocket Private Pay and assessing a combination of retirement funds, personal savings, and pension payments.

Medicaid can also be an option, be sure to see if you or a loved one qualifies.

Long-Term Care insurance is also a possible option in cases of chronic conditions, be sure to see if you or a loved one qualifies.

For our Veterans and spouses of veterans, be sure to assess Veteran Aid and your eligibility for these benefits.

Medicare – NO:

  • Medicare does NOT pay for Assisted Living.
  • People 65 years and older and individuals with end stage renal disease are eligible for Medicare benefits, no matter their income.
  • Coverage is meant for people in need of short-term care.

Private pay – YES:

  • Many families pay for assisted living with private funds.
  • Private pay can be a combination of retirement funds, personal savings, and pension payments.
  • Family members may contribute funds to pay for assisted living or other senior housing and care.

Medicaid – MAYBE:

  • Medicaid provides health coverage to millions of Americans. Eligible participants include: low-income adults, elderly adults and people with disabilities.
  • Medicaid is administered by state, according to federal requirements. The program is funded jointly by each state and the federal government.
  • Every state has their own individual Medicaid assistance program.
  • National guidelines are in place do decipher how states must spend Medicaid money, but with allowances toward the guidelines.
  • The state determines what levels of care will be covered by Medicaid, who is eligible, and how much the state will reimburse the care community.
  • If you are unsure whether you qualify for Medicaid, you should apply. You may be eligible depending on your household income, family size, age, disability and other factors.

Long-term Care Insurance – MAYBE:

Long term care insurance is a great way to pay for assisted living, and planning ahead is important when considering how to pay for senior housing and care. Nearly 75% of people over the age of 65 will require long-term care and services at some point. Buying into long-term care insurance when a person is in their 50s and 60s is the most common time to do so.

  • Long-term care insurance helps cover the costs of chronic medical conditions.
  • Individuals and couples with the ability to pay into long-term care insurance have the advantage of a head start in allocating funds for senior care.

Veteran Aid and Assistance – MAYBE:

This benefit is available to some military veterans and surviving spouses who live in an assisted living community and those who have in-home care.

  • There are specific guidelines, but a veteran may qualify for as much as $2,050 each month.
  • A veteran with a sick spouse may be eligible for $1,600 per month.
  • If a veteran has passed, their surviving spouse can qualify for $1,300 per month.

Finding the right adult family home for your loved requires information.

Questions to Ask

Finding an assisted living community can be overwhelming. Here are some tips on things to be observant of:

  • Make sure the facility is clean and well maintained. You can tell a lot about the operation by noting what is clean and maintained. Are doorknobs loose or damaged? Do you see any frayed carpet or trip hazards?
  • Visit during lunch hour to observe what the residents are eating. Ask questions about the nutrition program. Is there diversity in meals, healthy fruits and vegetables served at all meals, drink options?
  • Speak to residents and/or family members to learn their perspective.
  • Ask about staff and resident engagement. Get a feel for how staff interact with residents.
  • Ask about the life enrichment programs. Activities are crucial when it comes to quality of life and play a key role in care for older adults.
  • And finally (along with a plethora of more things to consider), get to know the leadership in the building. If you feel good around the Executive Director, Head Nurse, Lead Activities Director and even the Chef or Janitor, it is a good sign you can trust them with the care of your loved one.

Eldercare Locator is a nationwide service that connects older Americans and their caregivers with trustworthy local support resources. Connect with services such as meals, home care or transportation, or a caregiver education or respite from caregiving responsibilities. The Eldercare Locator is a public service of the Administration on Aging (AoA), an agency of the U.S. Administration for Community Living.

Medicare provides a search feature to find & compare providers near you, most senior housing and care providers are included on Find & compare plans in your area. Determine if you qualify for premium savings

Medicaid offers information on how to apply for Medicaid, eligibility criteria, links to local state offices, and additional resources.

The Alzheimer’s Association is the leading voluntary health organization in Alzheimer’s care, support and research. Whether you are living with Alzheimer’s or caring for someone with the disease, information and resources are available. 

Residential care facilities compendium

South Carolina Department of Health

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Written by The Care Availability Team
Experts in the senior care & retirement living industries

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