Assisted living residences in South Carolina are officially called “community residential care facilities.” These homes provide room, board, and personal care services including healthcare (but not full-time nursing care), and must be designed to “maximize residents’ dignity, autonomy, privacy, independence, and safety, and encourage family and community involvement,” according to state regulations. For people with Alzheimer’s disease or a related dementia, this mission goes even further.
Living communities for people with dementia are often called “memory care,” but in South Carolina the term is Alzheimer’s Special Care Unit or Program. Beyond typical assisted living, SC memory care must offer special living units with care and treatment that is distinguished from regular assisted living. This usually means enhanced security measures like special locks on doors, design features including hallways that do not dead-end (for people who wander), staff with specialized training, and social activities designed to stimulate memory.
If you’re interested in an SC special care unit, the home must provide:
– Criteria for admissions, transfer, and discharge
– The process for planning care for your loved one
– Information on staffing and training (see below)
– Information on the physical environment (distinguishing features)
– List of activities for residents
– The role of family members
– Costs of care
The average cost of memory care per month in South Carolina is $4,587, which breaks down to about $150 per day and $55,044 annually. A disclosure of fees is required for every new resident upon admission into South Carolina memory care homes. It should include any additional fees beyond the initial agreement, so file this document as defense against any unexpected charges. Assisted living, without the additional services required for memory care, costs South Carolina residents about $3,505 per month and $42,060 annually.
The state’s most expensive place for memory care is Hilton Head Island, where memory care costs about $5,504 per month and $66,048 annually. The least expensive city for memory care is Sumter, for about $2,313 per month and $27,756 per year. South Carolina’s biggest city is Columbia, where memory care costs $4,268 per month and $51,216 annually. In Charleston, memory care costs about $4,706 per month and $56,472 annually.
A resident assessment must be completed within 72 hours of admission, to determine the person’s specific needs and whether the residence is a suitable home. This is crucial, because an assisted living facility cannot house someone whose needs cannot be addressed there; someone with dementia, for instance, should not be admitted into a community residential care home if it doesn’t have a secured special care unit.
Someone with the following issues may not be admitted into South Carolina assisted living:
– Presents a danger to self or others
– Needs daily attention of a nurse, or requires regular hospital or nursing care
– Needs skilled monitoring or observation for a complex medical situation
– Requires frequent intravenous medication
Bedrooms, or living units, must be at least 100 square feet for a single occupancy space, or 80 square feet per person if there are roommates. The most people allowed in one living unit is three. In the entire residence, for every bed there must be 20 square feet of living and recreational areas (not including the bedrooms, hallways, kitchen, dining rooms, bathrooms, and rooms that are only for staff). Dining rooms must be at least 15 square feet per bed. One toilet and sink is required for every six residents, and one bathtub or shower for every eight.
The staff-to-resident ratio in South Carolina differs depending on the time of day. During normal waking hours, there must be one staff member for every eight residents. At nighttime, when most people are asleep, there must be one employee for every 30 residents. Multi-floor residences need an employee on every floor at all times. Assisted living in South Carolina is regulated by the state’s Board of Health and Environmental Control, which may determine that these minimal staff requirements aren’t actually suitable for certain residences, and that more staff are required during particular times. Administrators must be licensed and have at least one year of relevant experience. Administrators must also complete 18 hours of continuing education annually.
Training for all staff must include in-service programs on basic first aid, checking vital signs, communicable diseases, medication management, care of persons with dementia (in memory care), CPR, confidentiality, residents’ rights, fire response and emergency procedures (completed within 24 hours of starting the job), and activity training. Staff must be trained at least annually.
Also called the Elderly and Disabled Waiver, this program helps people who may need nursing-home level care remain in their own homes or assisted living communities. To receive this benefit, the cost of care in the home must fall within a certain percentage of the cost for similar care in a nursing home. Funds from this Medicaid waiver may not cover room and board in memory care, but additional services might be paid for, including medical devices and any costs associated with getting help for activities of daily living like eating and grooming.
South Carolina Medicaid is also called Healthy Connections, and this waiver falls under the Community Long Term Care (CLTC) program. It is administered by the South Carolina Department of Health and Human Services. There may be a waiting list, so apply as soon as possible by contacting DHHS.
Veterans are statistically more likely to develop dementia. Relevant in all states including South Carolina is the VA’s Aid & Attendance pension program for veterans and surviving spouses, which is an amount of money added to veterans’ and survivors’ basic pensions. Applicants must be at least 65 years old (or disabled) and require assistance with activities of daily living (ADLs) like eating, bathing, and mobility. The cash assistance from these pensions can be used as the recipient wishes, meaning it can go toward the cost of memory care. In addition, the cost of residential care can be deducted from one’s income, effectively reducing the amount of calculable income used to determine the benefit amount. The latest (2020) maximum amount a veteran can receive through A&A is $27,194 per year, and surviving spouses can receive as much as $14,761. Learn more here.
There are also veterans homes in South Carolina, which are residential care facilities that provide long-term care for veterans. In addition to nursing home care, assisted living and memory care may be provided. Payment is made directly from the VA to the facility. State veterans homes are typically reserved for veterans whose need for care stems at least 70 percent from their military service. Because there is often a waiting list, contact a home before visiting to see if your loved one is eligible to live there.
Other ways to help pay for memory care include tax credits and deductions like the Credit for the Elderly and the Disabled, or the Child and Dependent Care Credit (if you can claim your elderly loved one as a dependent). Remember also that medical and dental expenses can be deducted, and that may include some assisted living costs.
A reverse mortgage may be a good option for a married person moving into memory care, if their spouse continues to live in the home. Should the spouse move from their home, the reverse mortgage would become due.
Elder care loans are for families to cover initial costs of moving into memory care, if you need a little help at first but can afford costs after the initial payments. For example, if one is waiting for a VA pension to be approved or waiting to sell a home.