Memory Care in South Carolina

Because of the specialized staff training and resources required to provide high-quality memory care, memory care typically costs more than other types of residential care. On average, memory care will cost 20-30% more than assisted living.

According to the Genworth Cost of Care Survey 2019, the average monthly cost for assisted living in South Carolina is $3,500, which is roughly $500 lower than the national average of $4,051. Based on this figure, families should expect to pay between $4,200 and $4,550 per month for memory care services.

Across the state, the cost of assisted living, and therefore memory care, varies widely. In the capital city of Columbia, assisted living is a little lower than the statewide average at $3,248 per month. About 40 miles to the east in the city of Sumter, assisted living costs just $1,775 per month, making it the most affordable city in the state for this type of care. In Sumter, monthly memory care costs are between $2,130 and $2,308 on average. The Hilton Head Island area is the costliest city for assisted living at $4,184. Families generally pay between $5,021 and $5,439 per month for memory care.

South Carolina Medicaid Programs for Memory Care

Community Choices Waiver

The Community Choices Waiver program, also referred to as the Elderly and Disabled waiver, covers nursing home-level care and assistance with daily living activities at home or in an assisted living facility, enabling program participants to delay nursing home placement. In some cases, individuals can self-direct their care, meaning they can choose their own care providers. Certain family members, including adult children, may be eligible to serve as paid caregivers if they pass the background check and are approved by the state. Some services covered by this waiver program include adult day health care, companion services, case management, durable and disposable medical supplies, personal care and home-delivered meals.

• Who is Eligible: To be eligible for this waiver program, participants must be South Carolina residents at least 65 years of age or disabled, and they must need nursing home-level care. Additionally, they must meet Medicaid’s income and asset guidelines.
• How to Apply: To apply for the Community Choices Waiver, eligible applicants should contact their local Department of Health and Human Services.

Community Supports Waiver

The Community Supports Waiver is available to South Carolina residents with intellectual disabilities who require care in an intermediate care facility. The focus of this waiver program is to help participants remain in their own homes and integrated into their community. Participants have the option to self-direct their care, and some family members, including adult children but excluding spouses or legal guardians, may be hired to provide care services. Some services covered by this waiver program include behavioral support services, personal care, incontinence supplies, case management, adult day health care and environmental modifications.

• Who is Eligible: Eligible applicants must meet the criteria for having an intellectual disability or related disability that requires care in an intermediate care facility. Applicants must also meet the state’s Medicaid income and asset guidelines.
• How to Apply: Eligible applicants should call the South Carolina Department of Disabilities and Special Needs at 1-800-289-7012. A case manager is assigned to provide assistance with completing the application process.

Non-Medicaid Financial Assistance Programs for Memory Care in South Carolina

South Carolina Caregiver Support Program

The statewide Caregiver Support Program is administered on the local level by Area Agencies on Aging. It provides caregivers of those with Alzheimer’s disease with information and assistance with accessing community services, support and counseling, caregiver training and a small grant that may be used to pay for respite care or supplemental services. As of 2020, the average respite grant was $460.

• Who is Eligible: Caregivers who may be eligible for this program include unpaid adults who are caring for someone with Alzheimer’s disease.
• How to Apply: To learn more about the Caregiver Support Program or to apply for services, applicants should call the South Carolina Department of Aging at 1-800-868-9095.

More Ways to Pay for Memory Care

In addition to the state programs mentioned above, those looking for resources to finance memory care may consider:

• Long-Term Care Insurance: Depending on the policy details, long-term care insurance may be used to pay for memory care services. It’s best to sign up for a policy early, as coverage will likely be denied if one already has long-term care needs. More information about the intricacies of long-term care insurance can be found at longtermcare.acl.gov.
• Reverse Mortgages: Reverse mortgages allow some homeowners to take out a loan as an advance from the eventual sale of their primary residence. This can be a good way to fund memory care in the short-term, but the loans will need to be paid back after the sale of the home. The most commonly used type of reverse mortgages for seniors is the Home Equity Conversion Mortgage, which is the only reverse mortgage insured by the federal government.
• Veterans Benefits: The Department of Veterans Affairs offers several programs that veterans and their spouses may use to cover health care needs, such as memory care. More information about these programs can be found on the VA website.
• Life Insurance: Some life insurance policies allow policyholders to cash out their policy before a qualifying death. There may be some downsides to accessing a life insurance benefit early, so be sure to read more about the process.

Memory Care Regulation

In South Carolina, memory care services are provided in community residential care facilities, also called assisted living facilities, and in Alzheimer’s special care units or programs. These facilities are licensed by the South Carolina Board of Health and Environmental Control to provide room, board, and personal care to two or more adults who aren’t related to the facility’s owner. They are required to comply with licensing standards by maintaining continuous licensing, adhering to the number of beds they’re licensed for and complying with local, state and federal laws, codes and regulations.

Inspections of the facility are conducted prior to initial licensing, and all facilities are subject to inspections and investigations at random and without notice.

Facility Scope of Care

Memory care facilities provide living accommodations and personal care services. Core services provided by these facilities include housekeeping services; assistance with daily living activities, such as walking, bathing, dressing, and eating; medication assistance; and transportation to medical appointments.

Facilities are also required to provide three meals plus snacks daily, with no more than 14 hours elapsing between the evening meal and breakfast the next day. If special diets are accommodated, menus must be prepared by professionally qualified dietitians or reviewed by a physician or another qualified medical provider.

Admissions Requirements

Memory care facilities in South Carolina may admit residents with varying abilities and care needs, but there are some restrictions. The table below provides an outline of those who may and may not be admitted.

Care Plan Requirements

A direct-care staff member must assess a resident’s needs within 72 hours after admission. This assessment must include an evaluation of the nature and extent of the resident’s needs and confirmation that the facility can adequately meet those needs.

Within seven days of admission, the facility must develop an individualized care plan that outlines the resident’s needs, including how many daily living activities they need assistance with, requirements and arrangements for visits by or to an authorized healthcare provider, advanced care directives, dietary needs and what recreational and social activities are suitable and desirable for the resident’s well-being.

Medication Management Requirements

Facility staff members may administer routine medications, including medications required for diabetes and conditions associated with anaphylactic reactions, as long as they are trained to do so by someone who is licensed to administer medications. A staff member who is a licensed nurse may administer flu shots and B-12 injections and perform tuberculin skin tests. Staff members may monitor blood sugar levels, but the provision of sliding scale insulin injections by staff members is not allowed.

Residents’ medications that they are taking when admitted to the facility must be in their original labeled containers. Self-administering medications is permitted with specific written orders of a physician or an authorized healthcare provider, which must be obtained on a semi-annual basis. Alternately, the facility must confirm that the resident is still capable of self-administering medication on a quarterly basis. Facilities may prohibit self-administration at their discretion.

Facility Requirements

Apartment-style units and private bathrooms are not required. No more than three residents may share a room, and there must be at least one toilet and sink for every six residents and one tub or shower for every eight residents.

Staffing Requirements

Each memory care facility must have a designated licensed administrator, a recreational program staff member and an extensively trained or experienced staff member available at all times who can take appropriate action in the event of an emergency, injury or illness. Facilities that accommodate Medicaid-eligible residents must contract with a licensed nurse at least one day per week. This nurse is responsible for providing staff training and care plan monitoring for those receiving services through Medicaid.

The number of staff members is determined by the number of residents and their care needs. In Alzheimer’s special care units, there must be one awake staff member for every eight residents at all times. In multilevel facilities with more than 10 residents, there must be staff members on each floor at all times when residents are present. There must be enough staff members and volunteers at all times to provide supervision, direct care and basic services for memory care residents, even if this exceeds the state’s minimum staffing requirements.

Medicaid Policy

Personal care services in assisted living and memory care facilities are covered by South Carolina’s Medicaid State Plan. Services may also be covered under one of two waiver programs, including the Community Choices Waiver and the Community Supports Waiver.

Reporting Abuse

Assisted living facilities are required to report confirmed or suspected cases of abuse, exploitation or neglect to the South Carolina Long-Term Care Ombudsman Program. Anyone else who has a concern or complaint regarding the quality of treatment or care can also contact the ombudsman at 1-800-868-9095.