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 regulations the term is Alzheimer’s Special Care Unit or Program. 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, architectural features including easy-to-navigate layouts, staff with specialized training, and social activities designed to stimulate memory.
An SC special care unit must provide the following information to anyone interested in living there:
– 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
South Carolina residential care communities, including memory care, are regulated by the state’s Department of Health and Environmental Control’s Division of Health Licensing. There are 140 memory care homes in South Carolina. There are also 180 board and care homes, which offer the same services as assisted living, sometimes including memory care, in smaller house-like settings for fewer than 12 residents. For free help finding memory care of any size to fit your family’s needs and budget, click here.
The average cost of memory care per month in South Carolina is $4,699, which is about $56,388 annually. This is below the national average of roughly $5,000 per month for memory care. Assisted living, without the extra help for people with dementia, usually costs about $1,000 less per month.
The state’s most expensive place for memory care is Hilton Head Island, on the southern tip of Lowcountry, where memory care costs about $6,457 per month and $77,484 annually. The least expensive city for memory care is Sumter (Midlands), for about $2,583 per month and $30,996 per year. South Carolina’s biggest city is Charleston, where memory care costs $4,233 per month and $50,796 annually. In Columbia, memory care costs about $5,058 per month and $60,696 annually.
If you live in northern or western SC, it is possible to find more affordable memory care outside the state. North Carolina’s average costs are less expensive than South Carolina, at roughly $4,484 per month. Georgia, the state’s other neighbor, is even more affordable, at about $4,125 monthly. Georgian cities near the SC border with less expensive memory care include Augusta, for $3,659 monthly, and Savannah, where southern South Carolina residents can find memory care for an average of $4,125 per month.
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
Assessments are conducted by a medical professional working for the community, and the cost of assessing may be included in the base rate or it may be covered by a one-time “community fee” that pays for move-in expenses. Community fees usually run between $1,500 and $2,500.
The purpose of the assessment is to determine unique needs, so the residence can create a written care plan that accounts for a person’s personal, emotional, and physical issues. Special diets, how a person likes to socialize, and what recreational activities will encourage participation would also be part of the assessment. The service plan should give staff a good idea of a resident’s general strengths and weaknesses.
Regulations say that memory care is for residents with a “probable diagnosis” of Alzheimer’s or related disease like frontotemporal, vascular, or Lewy body dementia. Diagnosing dementia is difficult, however, often involving expensive tests like PET brain scans, and going that far is not necessary to move into memory care. Rather, a person’s symptoms must indicate that they need the services provided in memory care.
And while it is possible to move into memory care on short notice in South Carolina, this is not a good idea. You want to spend as much time as possible investigating options. The process should involve asking questions of staff and residents at different communities. Even eating a meal at a potential new home is a good idea. Ideally, you would begin your search before a move becomes necessary, when the person with dementia can provide more input.
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.
Unlike many other states, South Carolina regulations do not specifically require dementia-friendly physical designs for memory care communities. Features like simple layouts, circular hallways (so strolling residents don’t encounter dead ends), bright lighting and paint colors, and secure outdoor areas have been demonstrated to help with dementia symptoms. For this reason, while you’re investigating options for your loved one’s new home, keep an eye on whether they’ll be comfortable within the space.
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.
A person can be evicted from residential care (including memory care) for the following reasons:
– Has become dangerous to themselves or others
– Needs treatment from a licensed nurse daily
– Develops an unstable or complex medical condition
– Takes medication requiring frequent dosage adjustment
Very generally, someone whose medical condition cannot be treated at a residence cannot live there. If a home requires residents to be ambulatory, for instance, then someone who loses the ability to walk cannot live there.
Normally, homes are required to give 30 days’ notice before evicting someone, but this is not explicitly stated in SC regulations. It’s very important to know specific details about a residence’s eviction policy before agreeing to move in, because unfair evictions are a big problem in assisted living throughout the country. Can aggressive or inappropriate behavior get someone kicked out of memory care? What about nonpayment of bills? How do you appeal? Be sure to ask why a person can be evicted, and what the process is, before signing a contract. Get the answer in writing. If your loved one in memory care has received an eviction notice, and you need to know next steps, click here.
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.
Community Supports is another South Carolina Medicaid program that can help cover some personal and health care costs in assisted living (including memory care communities) for people with intellectual disabilities including dementia. Benefits include money for behavioral support, assistance with activities of daily living like eating and bathing, assistive and medical devices, and respite services (also called Adult Day Care) for people who spend time in residential care but haven’t fully moved in yet. Applicants are screened and assigned a case manager to help navigate benefits if they qualify. For more information, including how to apply, click here.
Because those who see combat have increased rates of traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD), 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 enhanced monthly benefit 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 income improvement 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 (2021) maximum amount a veteran can receive through A&A is $27,540 per year, and surviving spouses can receive as much as $14,928. Learn more here.
There are also three veterans homes in South Carolina, which are residential care facilities that provide long-term care for veterans:
– E. Roy Stone Veterans Pavilion, located in Columbia
– Veterans Victory House, in Walterboro (in the Lowcountry, west of Charleston)
– Richard Michael Campbell Veterans Nursing Home in Anderson (Upstate)
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. For contacts and more information, click here.
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.