South Carolina in-home care provider license: opening a non-medical home care agency

South Carolina licenses non-medical home care on its own

South Carolina requires a state license for non-medical home care, not only for home health. The In-Home Care Providers Act, added by 2011 Act No. 18, says an in-home care provider “must apply for and obtain a license issued by the department” ⁠¹. The licensing requirement only took effect once the state’s regulations did ⁠¹. Those regulations are now Regulation 60-122, administered by the S.C. Department of Public Health (DPH), which the regulation names as “the Department” ⁠². The statute still defines the department as the old Department of Health and Environmental Control ⁠¹.

The rule has been amended twice in a short span. Its State Register history lists the original 2014 regulation (Document 4433), an amendment published May 23, 2025 (Document 5352) and another published May 22, 2026 (Document 5407) ⁠². DPH’s copy carries the May 22, 2026 text, and the application form was reissued as 1307-ENG-DPH in August 2026 ⁠²⁠³. Any guidance, template or checklist dated before mid-2026 may not match the rule you will be inspected against. DPH’s copy of the regulation does not summarize what the May 2026 amendment changed, so compare the State Register notice for Document 5407 with the 2025 text, or ask the Bureau of Health Facilities Licensing which requirements are new.

Who needs this license

Regulation 60-122 defines in-home care as care that is “primarily intended to assist an individual with an activity of daily living or in meeting a personal rather than a medical need,” given to help with walking, getting in and out of bed, bathing, dressing, feeding, using the toilet, preparing special diets and supervising self-administered medications, and that does not need the continuing attention of licensed medical personnel ⁠².

An in-home care provider is a business entity, corporation or association, for profit or not, that for compensation provides or arranges those services in any of three ways ⁠²:

• through its own employees or agents;
• through contracts with independent contractors; or
• by referring other people to deliver the care, when the person making the referral has a financial interest in the care those people deliver.

The third point catches referral and registry models. If you match clients with caregivers and take a cut, you are an in-home care provider under the rule, even if the caregivers are not your employees ⁠².

The license also covers representation. No one may “establish, operate, maintain, or represent itself (advertise and/or market)” as an in-home care provider without the license ⁠². Marketing before the license is issued is itself a violation. If DPH finds you providing services without a license, you must stop operating at once and make sure clients are safe ⁠².

Who is excluded

The regulation lists five exclusions ⁠²:

1. A home health agency, a hospice, or an entity licensed under S.C. Code section 44-7-260 (the general health facility licensing statute).
2. An individual or agency that provides only house cleaning.
3. A direct care entity as defined in S.C. Code 44-7-2910(B)(1)(e), a direct caregiver as defined in 44-7-2910(B)(2)(e), or someone providing services defined in 44-21-60.
4. An individual hired directly by the person receiving care or by their family.
5. A 501(c)(3) church or religious institution that provides in-home care for free or for a nominal fee that covers incidental costs.

So a self-employed caregiver hired by a family does not need the license. Once you hire or contract with a second caregiver and place them with clients, you are a provider.

In-home care or home health agency

The line is skilled care. Regulation 60-122 defines skilled care as a service ordered by a physician or other authorized healthcare provider, that requires registered nurses, licensed practical nurses, therapists or similar professionals, and that is furnished by or under the supervision of those personnel ⁠². Section 700 says caregiver services are “strictly limited to non-medical tasks” and lists what is allowed ⁠²:

• meal planning, preparation and limited help with eating;
• bathing, grooming, personal hygiene and toileting;
• dressing;
• help in and out of beds, chairs or vehicles, and repositioning;
• help with walking, including walkers, rollators, canes and crutches;
• cleaning the client’s home and doing laundry;
• shopping (with receipts given to the client and the client’s money accounted for in writing) and running errands;
• transportation to appointments and shopping;
• addressing safety hazards in the home;
• help with communication;
• medication reminders.

Skilled care, meaning services ordered by a physician that need nurses or therapists, is outside this license; the regulation excludes home health agencies and hospices from the definition of an in-home care provider ⁠². If one company runs both kinds of service, Regulation 60-122 requires separate lines of business: separate representations to the public, separate caregiver records and separate client records ⁠².

If clients will live in a facility you run rather than in their own homes, look at a community residential care facility license instead. Daytime group programs fall under the day care facility for adults license.

The office, the name and extra locations

Primary office. You must keep at least one in-state office as your primary office. It has to be in a commercially zoned or unzoned area ⁠². For a zoned site you need a county or municipal zoning permit to operate the provider; in an unzoned area you need a letter from the county or municipality saying a provider may operate there ⁠². The primary office is where all records are kept and from which you oversee any other locations ⁠². This rules out a home office in a residential zone.

Name. Your name may not be the same as or similar to that of any other South Carolina licensed provider, and DPH decides what counts as similar ⁠². A franchise location must include its geographic area in its name ⁠².

Multiple locations. A branch office needs a registration approved by DPH before you open it or advertise it ⁠². The registration expires with the provider’s license in effect when it was approved ⁠². The application form has space for three extra locations and asks for an attached sheet if you have more ⁠³.

The owners’ background check and drug test

South Carolina screens the licensee before the license, not only the staff. The people who must sign the application are the individual owner or partners, or two officers if the applicant is a corporation ⁠²; DPH’s form also names the head of a limited liability company and, for a governmental unit, the head of the department ⁠³. Each signer must have:

• A SLED name-based criminal records check. It must be no older than 90 calendar days when DPH receives it ⁠².
• A five-panel drug screen (urine, hair, saliva or blood) for cannabis, cocaine, amphetamines, opiates and phencyclidine, taken no earlier than 30 days before DPH receives the application ⁠². Someone other than the person tested, and not related to them by blood or marriage, must receive and review the results. A positive result means denial unless a physician states it came from a prescribed medication ⁠². If you test in-house rather than through a lab, you must document the names, dates, times and signatures of the person tested and the reviewer, the kit’s manufacturer and model, the results, and the kit’s lot number and expiration date ⁠².

The license must be denied, and may later be revoked, if a signer must register as a sex offender or has been convicted of or pleaded guilty or no contest to ⁠²:

• abuse, neglect or exploitation of a vulnerable adult under the Omnibus Adult Protection Act;
• unlawful conduct toward a child or cruelty to children;
• any violent crime under S.C. Code 16-1-60;
• any other drug-related felony; or
• forgery, embezzlement or breach of trust with fraudulent intent under 16-1-90(E).

Signers must report any such conviction to DPH immediately ⁠². The signers stay subject to random drug testing after licensure ⁠¹⁠².

Because both deadlines run back from the date DPH receives the application, schedule the drug screen and SLED check last, after the office, insurance and policies are ready.

Insurance and bonding

Regulation 60-122 section 302 requires three kinds of coverage, kept for the whole license period ⁠²:

1. Liability insurance or a surety bond

   of at least $100,000 per occurrence and $300,000 aggregate.

2. Indemnity coverage

   to compensate clients for injuries and losses caused by your services.

3. Workers’ compensation insurance

   under S.C. Code 42-5-10 and following.

Evidence of all three goes in with the initial application, and the form asks for copies of the liability and workers’ compensation coverage at renewal too ⁠²⁠³.

Policies DPH expects before it licenses you

An initial license is not issued until you show DPH you are in “substantial compliance” with the standards ⁠². Regulation 60-122 requires written policies and procedures addressing each section of the regulation on client care and operations, available to staff at all times, and reviewed at least every two years with the administrator’s signature ⁠². The rule names specific policies and plans:

• Random drug testing program. Required by S.C. Code 44-70-70; you pick the method, but the policy must describe it, and a copy goes in with the application ⁠¹⁠²⁠³.
• Communicable disease reporting and exclusion. How caregivers report health information to the administrator, and when caregivers with communicable diseases or symptoms are kept away from clients ⁠².
• Disaster plan. What services, if any, you will provide during a disaster and how you will notify clients or responsible parties if staff cannot reach them. Each client gets a copy ⁠².
• Infection control. Screening, standard precautions and transmission-based precautions ⁠².
• Client rights. Clients must get written notice, before care starts, of their rights to the agreed services, respect for property, freedom from abuse, neglect and exploitation, dignity, and confidential records. Both you and the client sign it ⁠².
• Service agreement. Before care starts, the provider and client sign an agreement setting out services, fees with advance notice of fee changes, refund policy and termination conditions. Clients served through a Medicaid program do not need one ⁠².

You also need a copy of the licensing standards kept at the office and available to all caregivers, and emergency numbers (fire, police, ambulance, poison control, and staff contacts) available to every caregiver ⁠².

Filing the application

DPH lists the in-home care provider application on its Applications for Licensure page as form 1307-ENG-DPH ⁠⁴. The August 2026 version is a short packet ⁠³:

1. Mark the reason

   Initial, renewal or change request. Do not check “initial” for a change of ownership of an existing licensed provider ⁠³.

2. Part A, provider information

   Name, primary office address and county, any multiple locations, administrator, and a contact person who will receive all correspondence and the license itself ⁠³.

3. Part B, ownership disclosure

   Licensee name and ownership type; Secretary of State documentation if you are an entity; a list of officers for a corporation or partnership; and a list with the name, address and percentage of every shareholder, partner or member owning 5% or more ⁠³.

4. Attachments

   The random drug testing policy, liability insurance or bond, and workers’ compensation coverage ⁠³, plus the signers’ SLED checks and drug screen results and evidence of indemnity coverage required by the regulation ⁠².

5. Sign under oath

   The signers swear the application is true and that they will comply with Regulation 60-122. The signature block is notarized ⁠³.

6. Pay and send

   Proof of payment must accompany every application ⁠³. Email is DPH’s preferred method, to [email protected]; the mailing address is Bureau of Health Facilities Licensing, P.O. Box 2046, West Columbia, SC 29171, and the phone number is 803-545-4370 ⁠³.

The regulation says fees are paid “via a secured portal or specific website” ⁠². The regulation does not name the portal, and neither it nor the form says how to pay online, so ask the Bureau of Health Facilities Licensing (803-545-4370) how to submit the fee and proof of payment. The DPH pages reviewed also do not say whether DPH inspects before the first license is issued, and neither the regulation nor the form states a processing time; ask the Bureau both questions before you sign a lease.

Before issuing your license, DPH can also require payment of any outstanding fees or penalties, and if you already hold another DPH license, that operation must be in substantial compliance first ⁠².

Fees

Source: Regulation 60-122 sections 103.I to 103.L ⁠². Fees are not refundable, except that if DPH denies an application it may refund part of the fee based on the months left in the licensure year ⁠². A revoked license cannot be reinstated: you reapply as a new provider, pay the initial fee again and forfeit the time left on the old license ⁠².

Hiring caregivers: background checks, drug tests and registries

In-home care providers are “direct care entities” under S.C. Code 44-7-2910, so you must run a criminal record check before you hire or contract with a caregiver ⁠⁵⁠⁶. The statute sets the scope by residency ⁠⁶:

• If the applicant can show 12 months of South Carolina residency (SC driver’s license or ID, SC rent, mortgage or utility receipts, SC pay stubs, or SC bank records), a state check is enough.
• If not, you run a state check before employment and start a federal check after employment. If the applicant can verify residency in another state for those 12 months, you may instead run only a state check in that state.

For fingerprint-based state and federal checks, you email DPH’s Verification of Application and Authorization for Background Check form to [email protected], give the applicant the privacy notices, and DPH issues a service code for fingerprinting at an approved vendor such as IdentoGO ⁠⁵. You must have a valid relationship with the applicant when they are fingerprinted ⁠⁵. DPH cannot forward the results to in-home care providers; under SLED’s direction it makes an eligibility determination and sends you that instead ⁠⁵.

Regulation 60-122 adds its own caregiver rules. A caregiver must ⁠²:

• be at least 18, shown by government ID or other valid documentation;
• be able to read, write and communicate effectively with the client and supervisor;
• have a valid driver’s license and proof of insurance if driving is part of the job, with a copy of the official driving record in the file;
• have no adverse findings on the Sex Offender Registry or Nurse Aide Registry;
• have no conviction or no-contest plea within 10 years for forgery, larceny, embezzlement or false pretenses (Title 16, Chapter 13) or for drug offenses, and none at any time for vulnerable adult abuse, neglect or exploitation or for a violent crime.

Each caregiver must pass a five-panel drug screen taken no earlier than 30 days before your job offer, reviewed by a nurse, the administrator or hiring staff ⁠². A positive result bars employment unless a physician states it came from a prescribed medication. Caregivers are then subject to your random testing program ⁠¹⁠².

Every staff member with client contact completes a health self-assessment before first client contact, disclosing communicable diseases such as influenza, measles, tuberculosis, HIV and hepatitis; a nurse, the administrator or hiring staff reviews and signs it ⁠².

Training before the first visit

Section 404 requires training before client contact and at least once a year after that, unless a certificate sets another interval ⁠²:

• basic first aid;
• care specific to clients’ conditions, such as Alzheimer’s disease, other dementias and cognitive disabilities;
• confidentiality of client information;
• documentation and recordkeeping;
• ethics and interpersonal relationships;
• lifting and transfer techniques, if applicable;
• infection control;
• preventing abuse, neglect and exploitation.

The regulation sets no hour minimum. Training can come from licensed or certified people, books or electronic media. In-service records must be signed and dated by trainer and trainee, though computer-based training needs only the trainee’s signature ⁠².

The regulation requires an administrator who is responsible for overall management, but sets no education or experience requirement for that person ⁠². Medicaid does; see below.

Client records and service documentation

Regulation 60-122 is specific about paperwork ⁠²:

• Document every caregiver visit: services provided, significant changes in the client’s condition, the caregiver’s name and signature and the date. Records must be kept or updated weekly.
• Complete a care services plan within seven business days after services begin, covering services, expected times and frequency, expected duration, and goals. Revise it when any of those change.
• Complete a closed client’s record within 30 calendar days and keep client records at least five years after services end.
• Keep backups if you use electronic records.

Incidents, inspections and penalties

Incident reporting. Fractures, hospital admissions or deaths from an incident, and confirmed or suspected crimes, abuse, neglect or exploitation by a caregiver must be reported to the client’s responsible party and to DPH within 24 hours or by the next business day, through DPH’s electronic reporting system ⁠². A written investigation report follows within five calendar days ⁠². Abuse, neglect or exploitation allegations also go to Adult Protective Services at the Department of Social Services, or to Child Protective Services ⁠². Incident records are kept five years ⁠².

Inspections. DPH can inspect or investigate any provider without notice ⁠². If you are cited, the administrator signs a plan of correction stating the fix, how recurrence will be prevented and completion dates, due by the date on the report ⁠².

Penalties. Violations are classed I, II or III, marked in the rule text by “(I)” and “(II)”; unmarked standards are Class III ⁠². Fines run from $100 to $5,000 per violation ⁠²:

Scroll the table sideways to see every column.

Training, client care services, infection control, client rights, the health self-assessment, the caregiver minimum qualifications on registry findings and convictions, and the records of in-house drug screens are Class I standards; the policies, insurance, administrator, client records and disaster plan standards are Class II ⁠². DPH may also deny, suspend or revoke a license, and sanctions can be appealed under S.C. Code 44-1-60 ⁠¹⁠².

Renewal, changes and closing

The license must be renewed every year with an application, compliance documentation and the $800 fee ⁠². Miss the expiration date and you owe a $200 late fee; if renewal, fee and late fee are not in within 30 days of expiration, you are unlicensed ⁠². The form reminds licensees that renewal is due even while an ownership change or other approval is pending ⁠³.

Request an amended license, at $50 each, before moving the office or changing the provider’s name or postal address ⁠². A change in controlling interest, or a change in legal entity such as a sole proprietorship becoming an LLC, requires a new license application before the change, even if ownership stays the same ⁠². The license cannot be transferred or assigned ⁠¹⁠².

To close, temporarily or permanently, notify DPH in writing, then, within the 10 business days before closing, tell DPH how records will be kept and which clients need transfer (a permanent closure also requires the dates and amounts of client refunds), and give every client written notice at least 10 business days before closing ⁠². On permanent closure you return the license and report refunds; after a temporary closure of more than a year, DPH decides whether to inspect before you reopen ⁠².

Getting paid through SC Medicaid

The South Carolina Department of Health and Human Services (SCDHHS) buys personal care, attendant care and respite through its home and community-based services waivers. Its July 1, 2025 scope of services says providers not licensed by DPH “will not be allowed to enroll as a Medicaid provider for these services,” and a provider that loses the DPH license must terminate its SCDHHS contract immediately ⁠⁷.

Medicaid adds requirements beyond Regulation 60-122 ⁠⁷:

• The owner or administrator must have experience in in-home personal care or a similar service and at least three years of administrative experience in health care.
• Aides work under a registered nurse or licensed practical nurse supervisor, who visits the participant’s home before services start and records the visit in the Electronic Visit Verification system.
• Aides must pass competency testing or a competency training and evaluation program run by an RN or LPN before serving waiver participants, and complete at least 10 hours of in-service training per calendar year.
• SLED background checks are required for all employees, including office managers and the nurse supervisor, before hire and at least every two years, and the CNA registry must be checked on the same schedule.

Sources

1. 1
   South Carolina Legislature, S.C. Code Title 44, Chapter 70: In-Home Care Providers Act Checked 12 Oct 2026 · Back to text ↑
2. 2
   South Carolina Department of Public Health, Regulation 60-122: Standards for Licensing In-Home Care Providers (amended May 22, 2026) Checked 12 Oct 2026 · Back to text ↑
3. 3
   South Carolina Department of Public Health, Licensure Application for In-Home Care Provider, form 1307-ENG-DPH (08/2026) Checked 12 Oct 2026 · Back to text ↑
4. 4
   South Carolina Department of Public Health, Applications for Licensure Checked 12 Oct 2026 · Back to text ↑
5. 5
   South Carolina Department of Public Health, Background Checks for Direct Caregivers Checked 12 Oct 2026 · Back to text ↑
6. 6
   South Carolina Legislature, S.C. Code Section 44-7-2910: criminal record check for direct caregivers Checked 12 Oct 2026 · Back to text ↑
7. 7
   South Carolina Department of Health and Human Services, HCBS Provider Manual, Scopes of Services: Personal Care, HASCI Attendant, Respite (July 1, 2025) Checked 12 Oct 2026 · Back to text ↑

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