South Carolina verified state authority guide
South Carolina Home Care License Requirements: In-Home Care Provider Guide
South Carolina regulates compensated non-medical in-home care through the Department of Public Health In-Home Care Provider pathway. Medicaid HCBS participation adds a separate Healthy Connections program layer when applicable.
Does a non-medical home care business need a license in South Carolina?
South Carolina Code Section 44-70-30 requires an in-home care provider to apply for and obtain a Department license. Chapter 70 defines in-home care as assistance primarily addressing personal rather than medical needs, including activities of daily living such as walking, bathing, dressing, feeding, toileting, special-diet preparation and supervision of self-administered medication.
HCTP routing rule
Service scope → DPH In-Home Care Provider pathway → Chapter 70 / Regulation 60-122 → payer/program overlay → policy → procedure → responsible role → record/proof → review/correction.
What counts as an In-Home Care Provider?
The statutory definition reaches compensated businesses that directly provide or make provision for in-home care through employees or agents, contractual arrangements with independent contractors, or financially interested referrals. The statute also identifies exclusions, including home health agencies and hospices, house-cleaning-only businesses, certain direct-care entities, individuals hired directly by the recipient or family, and qualifying religious institutions providing care without compensation or for a nominal incidental-expense fee.
That means the pathway should be determined from the actual service and business model—not simply from whether the company calls itself companion care, personal care or a referral service.
What is the difference between in-home care and home health?
South Carolina treats these as separate licensing pathways. Chapter 70 describes in-home care as personal, non-skilled assistance that does not require continuing attention or supervision from trained and licensed medical personnel. Home health agencies are separately licensed under South Carolina's home-health law and DPH standards. An agency should classify its service scope before building policies or advertising services.
What must the operating system prove?
South Carolina's licensing framework goes beyond filing an application. The In-Home Care Providers Act expressly addresses criminal record checks and drug testing before employment, and random drug testing after licensure. DPH Regulation 60-122 establishes operating standards for licensed providers, including licensure administration, provider responsibilities, caregiver requirements, records and inspection access.
For HCTP purposes, each applicable requirement should resolve into an operating control: who performs it, when it happens, which form or record proves completion, where that evidence is retained, and how deficiencies are corrected.
How does South Carolina Medicaid change the pathway?
South Carolina Healthy Connections Medicaid uses a separate Home and Community-Based Services Provider Manual for waiver and State Plan services. SCDHHS states that HCBS providers must comply with that manual together with the Provider Administrative and Billing Manual and applicable appendices and supplements.
The HCBS framework includes programs and services such as Community Choices and personal care. SCDHHS updated HCBS provider scopes and standards effective July 1, 2025, including Personal Care and Children's Personal Care. Medicaid enrollment and HCBS requirements are therefore an additional program layer; they do not replace the applicable DPH licensing pathway.
What should a Medicaid personal-care provider document?
The HCBS layer ties provider qualification and service delivery to program-specific scopes and standards, service authorization, person-centered requirements, billing rules and quality assurance. SCDHHS publishes service-specific compliance resources, including a Personal Care Service Provider Checklist, and identifies its HCBS manual as the source for eligible-provider scopes and quality-assurance requirements.
Operationally, the agency should be able to connect the authorized service to the assigned worker, service record, visit evidence, billing support and quality-review process.
Does South Carolina use Electronic Visit Verification?
Yes, for applicable Medicaid in-home services. SCDHHS has long used EVV in portions of its HCBS system and its provider guidance connects EVV to specified Medicaid in-home services and claims workflows, including the Phoenix Provider Portal. Applicability depends on the particular waiver, program and service.
HCTP therefore treats EVV as a separate payer/program overlay rather than claiming that every South Carolina private-pay in-home care provider has the same EVV obligation.
What should a South Carolina agency build first?
First classify the exact non-medical services and confirm the DPH In-Home Care Provider pathway. Then build the licensing controls into policies, procedures, caregiver files, client records and review systems. Only after the base pathway is established should the agency attach Healthy Connections, HCBS, waiver, EVV or other payer requirements that actually apply.
Official South Carolina sources used for this guide
HCTP uses controlling government sources for state-specific regulatory claims rather than competitor summaries.
- South Carolina DPH — In-Home Care Providers
- South Carolina Code Chapter 70 — Licensure of In-Home Care Providers Act
- South Carolina DPH — Regulation 60-122
- South Carolina DPH — In-Home Care Provider Application
- SCDHHS — Home and Community-Based Services Provider Manual
- SCDHHS — HCBS Provider Manual Update
- SCDHHS — Waiver QA, Training and Compliance
- SCDHHS — In-Home Care Services / EVV Update
Build the South Carolina pathway before building the paperwork
Determine the DPH provider pathway first, then attach only the Medicaid, HCBS and EVV requirements that apply to the agency's services.