Assisted Living in South Carolina

Agency: Department of Health and Environmental Control, Division of Health Licensing
Phone: (803) 545-4370
Website: www.scdhec.gov/health/licen/

A community residential care facility offers room and board and a degree of personal assistance for a period of time in excess of 24 consecutive hours for two or more persons 18 years or older. It is designed to accommodate residents' changing needs and preferences, maximize residents' dignity, autonomy, privacy, independence, and safety, and encourage family and community involvement. Included in this definition is any facility that offers a beneficial or protected environment specifically for individuals who have mental illness or disabilities and facilities that are referred to as 'assisted living,' provided they meet the definition of community residential care facility.

Facility Scope of Care:
A facility must not admit or retain any person whose needs cannot be met by the accommodations and services provided by the facility. Facilities may not provide nursing services.

Move-In/Move-Out Requirements:
Facilities may not admit or retain residents who are dangerous to themselves or others, in need of daily attention of a licensed nurse, or require hospital or nursing care

Resident Assessment:
A resident assessment is required but there is not a specific required form. The assessment must include a procedure for determining the nature and extent of the problems and needs of a resident/potential resident to ascertain if the facility can adequately address those problems, meet those needs, and to secure information for use in the development of the individual care plan. Included in the process is an evaluation of the physical, emotional, behavioral, social, spiritual, nutritional, recreational, and, when appropriate, vocational, educational, and legal status/needs of a resident/potential resident. Consideration of each resident's needs, strengths, and weaknesses also must be included in the assessment.

Medication Management:
Medication administration by unlicensed staff who have been trained to perform these tasks is permitted.

Physical Plant Requirements:
Private resident units must be a minimum of 100 square feet and multiple-occupancy resident units must provide a minimum of 80 square feet per resident.

Residents Allowed Per Room:
A maximum of three residents is allowed per resident unit.

Life Safety:
South Carolina is in the process of adopting standards, rules, and regulations promulgated through the State Fire Marshall's Office, the International Building Code, the International Fire Code, and various National Fire Protection Association (NFPA) standards, to include specifically NFPA 72 (fire alarm code) and NFPA 13 (sprinkler system code), and establish guidelines to be followed by licensed community residential care facilities.

Alzheimer's Unit Requirements:
Facilities offering special care units or programs for residents with Alzheimer's disease must disclose the form of care or treatment provided that distinguishes it as being especially suitable for the resident requiring special care.

Staff Training for Alzheimer's Care:
Training must be provided to all staff members/direct care volunteers prior to resident contact and as often as the facility determines is necessary, but at least annually. Training may be done by licensed/registered persons or through the use of video tapes or books. Training should be specific to the needs of residents in the facility, including communication techniques, understanding and coping with behaviors, resident safety, and appropriate activities.

Staffing Requirements:
An administrator must be in charge of all functions and activities of the facility and must be available and responsible within a reasonable time and distance. There must be at least one staff person for every eight residents during all periods of peak resident activity (from 7 a.m. to 7 p.m., or as otherwise approved by the Department of Health and Environmental Control). During night-time hours, at least one staff member must be on duty for every 30 residents. Additional staff members must be provided if the department determines that the minimum staff requirements are inadequate to provide appropriate care, services, and supervision to the residents of a facility (for example, to ensure a resident's personal safety when safety precautions are needed until the resident is assessed by a physician or other authorized healthcare provider for relocation to a higher level of care and subsequently relocated to an appropriate facility).

Staff Education Training:
Staff must complete in-service training programs that include training in basic first aid; procedures for checking vital signs (for designated staff); communicable diseases; medication management; care of persons specific to the physical/mental condition being cared for in the facility; use of restraints (for designated staff); OSHA standards regarding bloodborne pathogens; CPR for designated staff; confidentiality; and fire response and emergency procedures. In-service training must be provided on a continuing basis and not less than annually.

Medicaid Policy and Reimbursements:
There is no Medicaid home and community-based services waiver at this time.