Assisted Living in South Carolina
What It Costs Across South Carolina
Understanding assisted living costs in South Carolina means looking beyond the statewide median of $3,612/mo. While that's a good starting point, recent 2024 data from Genworth shows the average monthly cost is closer to $4,650, a significant increase from previous years. The actual price you pay will vary considerably depending on the facility's location and the level of care needed. Expect to find higher costs in popular metropolitan and coastal areas like Myrtle Beach, where prices can reach up to $5,625 per month, and Hilton Head Island, also averaging around $4,500 to $5,600 per month. In contrast, more affordable options often exist in cities such as Spartanburg, with costs starting around $3,975 per month, Florence at about $2,200 to $2,325 per month, and Sumter, averaging around $2,600 per month. Columbia can also offer rates as low as $1,900 per month. Generally, rural areas tend to be less expensive than major cities or tourist destinations. Some luxury options in areas like Tega Cay can even reach $7,500 per month. It's crucial to clarify what services are included, as some facilities offer all-inclusive pricing while others charge for services à la carte.
Will Medicaid Help Pay?
Yes, Medicaid can offer assistance through South Carolina's Community Choices Waiver, also known as a Home and Community-Based Services (HCBS) Waiver. This program is designed for seniors and adults with physical disabilities who require a nursing home level of care but wish to remain in a community setting, including assisted living. The waiver covers essential long-term care services such as help with Activities of Daily Living (ADLs) like bathing, dressing, and mobility, along with home modifications and personal emergency response systems. You can even hire friends or certain relatives (excluding spouses for personal and companion care, but including spouses for attendant care) to provide participant-directed care. However, it’s important to understand that the Community Choices Waiver does not cover the cost of room and board in an assisted living facility. Eligibility is strict: as of 2023, a single applicant generally must have a monthly income of no more than $2,742 and countable assets under $2,000. This program is not an entitlement, meaning meeting the criteria doesn't guarantee immediate benefits, and waitlists can unfortunately range from months to years. To apply, contact your local Healthy Connections Community Long Term Care (CLTC) office.
How to Find a Good Facility
South Carolina has a growing number of assisted living options, with approximately 450 licensed establishments as of 2024. When searching for the right fit, look for facilities that provide a written resident agreement detailing all care, services, dietary needs, fees, and discharge procedures. Ensure there is staff actively on duty 24/7, with specific ratios of at least one staff member per eight residents during peak hours and one per 30 during non-peak hours. Facility administrators must complete 18 hours of continuing education annually, and direct care staff receive training in crucial areas like first aid, medication management, and resident rights. The primary oversight agency in South Carolina is the Department of Public Health (DPH), which licenses and inspects what are officially called Community Residential Care Facilities (CRCFs). You can use the DPH's "Find a Facility" tool to check a facility's license status, expiration date, and recent inspection violations. Disability Rights SC also conducts unannounced inspections of CRCFs and publishes advocacy-based quality reports by county. For specific inspection reports or to file a complaint, you can contact DPH directly at 803-545-4370.
Last updated: March 2026. Sources: Genworth 2024, state licensing agency.