South Carolina Residential Alzheimer’s Care (Memory Care): Laws, Costs & Financial Help

Last Updated: March 30, 2024


Assisted living residences in South Carolina are called community residential care facilities. These homes provide room, board, and personal care services including healthcare (but not full-time nursing care). They 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 dementia, the requirements go even further.

Communities for people with dementia are often called memory care, but in South Carolina they use the term Alzheimer’s Special Care Unit or Program. To have this designation, they must offer special living units with care and treatment that are different 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.

A South Carolina special care unit must provide the following information to all potential residents:

– Criteria for admissions, transfer, and discharge
– The process for planning care for your loved one
– Information on staffing and training
– Information on the physical environment (its 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 approximately 140 memory care homes in South Carolina. There are also roughly 180 board and care homes, which offer the same services as assisted living, sometimes including memory care, in smaller home-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.

 Bad News: South Carolina ranks as the No. 1 highest death rate from Alzheimer’s disease in the country. About 52 South Carolinians per 100,000 die annually due to complications from Alzheimer’s.


How Much Does Memory Care Cost in South Carolina?

The average cost of memory care per month in South Carolina is $4,730 in 2024. This is below the national average of $5,884 per month for memory care. The state’s most expensive place for memory care is Hilton Head Island, on the southern tip of Lowcountry, where memory care costs $5,884 monthly. The least expensive city for memory care is Sumter (Midlands), for $3,498 per month. In Charleston, memory care costs $5,168 monthly.

 Did You Know? South Carolinians can receive free assistance to help families locate a memory care home that meets their needs and budgets. Get help here

If you live in northern or western South Carolina, it is possible to find more affordable memory care outside the state. North Carolina’s average costs are a bit more expensive than South Carolina’s, running $5,248 per month. Georgia, the state’s other neighbor, is even more affordable, at $4,612 monthly. Georgian cities near the South Carolina border with less expensive memory care include Augusta, $4,730 monthly, and Savannah, where southern South Carolina residents can find memory care for an average of $4,572 per month.

South Carolina Memory Care / Assisted Living Costs (updated Mar. 2024)
Region / City Daily Cost Monthly Cost
Statewide $156 $4,730
Charleston $170 $5,168
Myrtle Beach $175 $5,327
Florence $149 $4,532
Columbia $141 $4,293
Hilton Head Island $193 $5,884
Greenville $161 $4,889


South Carolina Assisted Living Laws & Regulations

 COVID-19 Related Measures (updated Aug. 2022)
Residents – Their temperatures are checked and patients are also tested regularly.
Visitors – Can visit loved ones, must wear a mask and temperature is checked upon entry.
Staff – Have temperatures checked upon entry and are regularly tested.

Admissions Process & Requirements

To enter into a residential care facility in South Carolina, there must be an assessment of the patient done within 72 hours of admission. This helps determine the person’s specific needs and whether the residence is suitable for them. This is crucial, because an assisted living facility cannot house someone whose needs cannot be addressed there. Someone with dementia 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 oneself 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. This care plan outlines your loved ones personal, emotional, and physical issues. Special diets, how a person likes to socialize, and what recreational activities will encourage participation are also included. 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 that are likely to have Alzheimer’s disease or 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. Therefore, a person’s symptoms must indicate that they need the services provided in memory care.

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.


Facility / Residence

Bedrooms 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).  One toilet and sink is required for every six residents, and one bathtub or shower for every eight.

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.


Staff & Training

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)
– Confidentiality
– Residents’ rights
– Fire response and
– Emergency procedures (completed within 24 hours of starting the job)
– Activity training

Annually staff must complete continuing education.


Evictions & Discharges

A person can be evicted from residential care (including memory care) for the following reasons:

– They have become dangerous to themselves or others
– They need treatment from a licensed nurse daily
– They develops an unstable or complex medical condition
– They take medication requiring frequent dosage adjustment

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 defined in state regulations. It’s very important to know specific details about a residence’s eviction policy before agreeing to move in, because unfair evictions can be a 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 answers in writing. If your loved one in memory care has received an eviction notice, and you need to know next steps, click here.


Financial Assistance for Residential Alzheimer’s Memory Care

South Carolina Community Choices Waiver

The South Carolina Community Choices Waiver is a Medicaid program that helps those who need nursing home level care remain in their own homes or assisted living communities. By providing additional long-term care benefits, the extra helps patients avoid the need to move into a nursing home. Enrollees can live in their own home, that of a family member, an adult foster home, an assisted living facility, or a memory care home. Benefits are based upon an individual’s need and can include assistance with activities of daily living, adult daycare, meal delivery service, home modifications, emergency response systems, respite care, and medical equipment. The Community Choices Waiver pays for additional long-term care services, but not room and board in care facilities. Medicaid has strict financial and medical requirements. In 2024, the Medicaid eligibility requirements in South Carolina include a monthly income of less than $2,829, countable assets of less than $2,000, and a documented need for a nursing home level of care. A waitlist can occur because there is limited enrollment with only 26,651 participants accepted annually. For more information, click here to go to the program’s website. To see if your loved one qualifies for Medicaid, click here for a fast and non-binding Medicaid eligibility test.


Community Supports Waiver

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 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). Applicants are screened and assigned a case manager to help navigate benefits if they qualify. For more information, including how to apply, click here.

  Not sure if your loved one qualifies for Medicaid? See South Carolina Medicaid eligibility requirements or take a fast and simple Medicaid Eligibility Test


Veterans Affairs (VA)

Veterans are statistically more likely to develop dementia. Among the reasons for this is that traumatic brain injuries and posttraumatic stress disorder lead to a higher probability of developing the condition. The VA offers many benefits for Alzheimer’s and dementia as well as different pension types.


VA Pensions

There are three types of VA Pensions available. The benefits change annually and are valid from December 2023 to December 2024. The benefits (and their maximum allowance) are as follows:

1) Basic Pension – This benefit is also known as a death pension. It is for veterans and surviving spouses who are aged or disabled. The qualifying disability does not need to be related to their military service. On an annual basis, the Basic Pension pays:

– Veterans without spouses or children up to $16,551

– Veterans with dependent spouses or children up to $21,674

– Surviving spouses without dependent children up to $11,102

2) Aid & Attendance – Abbreviated as A&A, this is an important program for veterans and their surviving spouses who require assistance with activities of daily living. This means they need assistance with activities like bathing, dressing, and eating. A&A is particularly helpful for people with dementia, especially in the middle and later stages of the disease, when the need for more assistance becomes necessary. A&A is intended to help with the long-term care costs of adult day care, in-home care, assisted living, memory care, and skilled nursing. Based on an individual’s need and the progression of the disease, most of these additional services that support your loved one will become necessary. Annually, the A&A pays:

– Veterans without spouses or children a maximum of $27,609

– Veterans with dependent spouses or children a maximum of $32,729

– Surviving spouses without dependent children a maximum of $17,743

3) Housebound – For veterans and surviving spouses who are permanently disabled and unable to leave their homes, making them require additional assistance. The definition of “home” can include assisted living, memory care, and nursing home. The Housebound pension, like the A&A pension, is meant to help cover long-term care costs. Annually, the Housebound pays:

– Veterans without spouses or children a maximum of $20,226

– Veterans with dependent spouses or children a maximum of $25,348

– Surviving spouses without dependent children a maximum of $13,568

 More information on VA Pensions’ eligibility criteria, payment rates, and the application process is available here.


Veterans Homes

There are also five veterans homes in South Carolina, which are residential care facilities that provide long-term care for veterans:

1) E. Roy Stone Veterans Pavilion in Columbia
2) Veterans Victory House in Walterboro (in the Lowcountry, west of Charleston)
3) Richard Michael Campbell Veterans Nursing Home in Anderson (Upstate)
4) Veteran Village in Florence
5) Palmetto Patriots Home in Gaffney

In addition to nursing home care, assisted living and memory care may be provided. Neighboring states have veterans’ homes, so a loved one might consider looking there for more options as there are no requirements that one must live in the state. For example, North Carolina has four veterans homes statewide and some are located relatively close to their shared border. Additionally, Georgia has two facilities statewide. More info.


Other Options

1)Elder care loans exist for families to cover the costs of moving into memory care while waiting for other financial resources to become available. For example, if one is waiting for a VA pension to be approved or waiting to sell a home. More on bridge loans for memory care.

2) 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 can include assisted living costs.

3) A reverse mortgage can be an option for a married person moving into memory care, if their spouse continues to live in the home. However, if the spouse moves from their home, the reverse mortgage becomes due.