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South Carolina · In-Home Care Provider license · R.60-122
To start a non-medical home care agency in South Carolina, you need an In-Home Care Provider license from the Department of Public Health (DPH), which took over from DHEC in 2024. On May 22, 2026 a rewritten rule, R.60-122, came into force for every provider, new or already licensed: written policies for each section of the rule, a primary office in a commercially zoned or unzoned area, service agreements, care services plans, signed rights forms and incident reports to DPH within 24 hours or the next business day.
Quick answer
In South Carolina, "no person, private or public organization, political subdivision, or governmental agency shall establish, operate, maintain, or represent itself (advertise and/or market) as an in-home care provider in South Carolina without first obtaining a license from the Department." (R.60-122 §103.A). The Department is the South Carolina Department of Public Health (DPH), and the license is the In-Home Care Provider license (R.60-122 §102.G). The rule was numbered 61-122 until May 23, 2025 (Document No. 5352), and DPH replaced it in its entirety from May 22, 2026 (Document No. 5407).
The new rule makes a policy manual compulsory: "Written policies and procedures addressing each section of this regulation regarding client care and operation of the provider shall be developed." Policies are reviewed at least every two years, with the administrator signing each review, and the section is marked as a Class II standard (R.60-122 §301). DPH’s application asks to see one of them: "A copy of your Random Drug Testing Policy", with initial and renewal applications (Form 1307-ENG-DPH).
The care is non-medical: "Care services provided by caregivers are strictly limited to non-medical tasks." (R.60-122 §700.B). No nurse is required. Already licensed? "This regulation will apply to all in-home care providers in South Carolina." (R.60-122 §101), and the 2026 text has no transition period (your to-do list).
1,402
In-home care provider licenses in DPH’s facility data, 1,307 of them unexpired (our count, Oct 2, 2026)
DPH Find a Facility24 hours
To report a fracture, hospital admission, death or suspected abuse by a caregiver to DPH (or by the next business day)
R.60-122 §501.B2 years
The longest your policies may go between documented reviews signed by the administrator
R.60-122 §301.BThe South Carolina Department of Public Health (DPH), through its Bureau of Health Facilities Licensing (IHCP@dph.sc.gov). DHEC licensed in-home care providers until 2023 Act No. 60 abolished it on July 1, 2024. The statute still says DHEC, but Act 60 says old references are read as references to the new agency, and DPH says licenses DHEC issued stayed valid.
2023 Act No. 60, Sections 1(3), 14(C); R.60-122 §102.G; DPH, DHEC RestructuringDPH charges $1,000 for the first license and $800 a year to renew. A late renewal adds $200, an amended license is $50 and reinstating a suspended license is $400. These are DPH’s fees, not CareRulebook prices.
R.60-122 §103.I-LYes. The rule says it applies to all in-home care providers in South Carolina, and the rewrite has no transition period or grandfathering clause. Existing agencies took on the new duties on May 22, 2026: written policies for each section, service agreements, care services plans, signed rights forms, a disaster plan and incident reports within 24 hours or the next business day. The primary office must be in a commercially zoned or unzoned area; the zoning permit duty names the applicant, so by our reading existing licensees should hold one too (renewal is an application). Ask DPH.
R.60-122 §101; Document No. 5407Yes, since May 22, 2026. Written policies and procedures must address each section of R.60-122 on client care and operations, be followed, be available to staff at all times and be reviewed at least every two years, with the administrator signing each review. DPH’s application form asks only for the random drug testing policy.
R.60-122 §301; Form 1307-ENG-DPHIn force since May 22, 2026 · Document No. 5407 · errata June 26, 2026
DPH published the proposed rewrite in the State Register on September 26, 2025. It took effect on May 22, 2026, after the General Assembly’s 110-day review period expired on May 3, 2026, and its instruction was: "Replace R.60-122 in its entirety with this amendment." (R.60-122, Document No. 5407 history). DPH corrected one cross-reference in June: "The plan shall be revised whenever there are changes listed in Section 601.B.3.a through d." (State Register 50/6, errata). In its statement of need, DPH wrote that it "anticipates a cost to the regulated community associated with implementing client-focused safeguards and protections" (State Register 49/9).
The rule it replaced was the 2014 text, short and without a general policy duty, client record, rights, infection control or disaster sections (Code of Regulations, Chapter 60, pre-2026 text). Each change below quotes the new rule and, where there was one, the old rule it replaced.
R.60-122 §301 (new)
New general duty: written policies and procedures for each section of the rule, followed and accessible to staff, reviewed at least every two years and signed by the administrator. The only written policy the old rule required in its text was the random drug testing policy (its TB appendix also asked whether the provider had a written TB procedure).
R.60-122 §103.D (new)
The primary office must be in a commercially zoned or unzoned area with a zoning permit or local letter. The old rule had no zoning requirement; it tied the license to a specific location and required the provider to be accessible in person, by phone or by page from 9 a.m. to 5 p.m., Monday to Friday, except state holidays.
R.60-122 §601 (new)
New: an organized client record, visit documentation updated weekly, a signed service agreement (fees, refunds, termination; not for Medicaid clients) and a care services plan within seven business days. The old rule had no client record section.
R.60-122 §900 (new)
Five rights and assurances given in writing and signed before care starts.
R.60-122 §501
Every incident documented and reviewed; listed incidents reported to the responsible party and DPH within 24 hours or the next business day via DPH’s electronic system, then a written investigation report within 5 calendar days. Before: phone the next of kin immediately and write to DHEC within 3 days.
R.60-122 §1001-1002 (new)
A disaster plan given to every client, documented notifications when care cannot be given, and emergency numbers available to caregivers.
R.60-122 §406
Staff complete a communicable disease self-assessment reviewed by a nurse, administrator or HR, and the provider adopts a communicable disease exclusion policy. The old health assessment within 12 months with TB screening and the annual TB risk assessment are gone.
R.60-122 §404
Training is now required before client contact and at least annually. Abuse prevention became its own topic; medication assistance training was removed.
R.60-122 §700, §800 (new)
A list of 13 permitted non-medical tasks (medication reminders only; shopping with receipts) and an infection control standard.
What was dropped. The staff health assessment with tuberculosis screening and the annual TB risk assessment (replaced by a self-assessment), medication assistance as a training topic, the rule that the provider be accessible in person, by phone or by page from 9 a.m. to 5 p.m., Monday to Friday (except state holidays), and the rule that a provider closed for more than a year reapplies as new. The late fee is now a fixed $200 that applies from the expiration date (it was up to 25% of the license fee, $200 on the $800 renewal, and only after 30 days), and 30 days late leaves you unlicensed (pre-2026 R.60-122; R.60-122).
Nothing else is pending, as far as we found. We searched every State Register issue from Volume 48, Issue 8 (August 2024) to Volume 50, Issue 9 (September 2026), and found no proposal to amend R.60-122 after the rewrite. This is our own search, not a DPH statement.
Already licensed: your to-do list →All rule changes we track →
DPH’s data lists 1,402 in-home care provider licenses, 1,307 of them unexpired on October 2, 2026 (DPH Find a Facility, our count). Every one of those 1,307 current licensees, whenever it was first licensed, has been under the rewritten rule since May 22, 2026. We found no DPH guidance on how it will apply the new duties to agencies licensed earlier: DPH’s in-home care page was last updated on November 10, 2025 and still links the old TB Risk Assessment form (DPH, In-Home Care Providers), and DPH’s monthly enforcement reports from January 2025 to July 2026 show two orders against in-home care providers, both $300 consent orders for late renewals, none citing the new rule (DPH enforcement actions). DPH inspects without notice, so it is worth working through the list now.
Check your agency against this list. Each item is a duty the old rule did not have, or did not have in this form.
Written policies for each section of R.60-122
Followed, available to staff in print or electronically at all times, with a review period of no more than two years and each review documented and signed by the administrator. Marked Class II.
R.60-122 §301A primary office in a commercially zoned or unzoned area
The rule requires every applicant or licensee to keep an in-state primary office in such an area. The zoning permit (or, in an unzoned area, the local letter) is a duty of "the applicant"; by our reading existing licensees should hold one too, since renewal is an application. Ask DPH. Register any other office with DPH before you use it.
R.60-122 §103.DA signed service agreement for every client not served under a Medicaid program
Services, fees and advance notice of fee changes, your refund policy and termination terms, signed by both sides before care. Not required for clients receiving care under a Medicaid program.
R.60-122 §601.B.2A care services plan for every client
Types of service, expected times and frequency, expected duration, goals and objectives, within seven business days of starting care and revised when any of these change.
R.60-122 §601.B.3Visit notes for every visit
What was done, significant changes in the client’s condition, the caregiver’s name and signature and the date, kept or updated weekly.
R.60-122 §601.B.1Signed rights and assurances
The five rights in writing before care starts, signed and dated by the agency and the client or responsible party.
R.60-122 §900A disaster plan given to every client
Which services, if any, you will give in a disaster and how you will tell clients if staff cannot come; document each notification or attempt.
R.60-122 §1001The new incident process
Document and review every incident; report the listed ones to the responsible party and to DPH within 24 hours or the next business day; file a written investigation report within five calendar days.
R.60-122 §501Health self-assessments and a communicable disease policy
For staff with client contact, reviewed and signed before client contact, plus a policy on reporting illness and excluding or restricting sick caregivers. No TB test or TB risk assessment is required any more.
R.60-122 §406Training on eight topics, every year
Including prevention of abuse, neglect and exploitation as its own topic, before client contact and at least annually, signed by trainer and trainee.
R.60-122 §404Registry checks and the new disqualifying offenses
No adverse findings on the Sex Offender Registry or Nurse Aide Registry, and no convictions in the listed categories, both Class I. Caregivers prove they are 18 with government ID or other valid documentation.
R.60-122 §405.E-GDrug test records in the new detail
Lab results, or for office kits the five listed items for every pre-employment and random test, reviewed by a nurse, the administrator or human resources or hiring staff.
R.60-122 §402.B-CInfection control practices and emergency numbers
Staff practices that prevent the spread of disease (Class I), and fire, police, ambulance, poison control and staff numbers available to every caregiver.
R.60-122 §800, §1002Renewal on time
A $200 late fee if the renewal or fee is not in by the expiration date, and unlicensed if it is not in within 30 days of it.
R.60-122 §103.JInteractive check
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You need an In-Home Care Provider license from DPH.
Email DPH’s application form, notarized, with your random drug testing policy, proof of insurance and workers’ compensation, each signer’s SLED check and drug test, your ownership documents and proof that you paid DPH’s $1,000 fee. Your primary office must be in a commercially zoned or unzoned area. No nurse is required. You may not operate, advertise or market before DPH licenses you.
R.60-122 §103.A, D, F-I; Form 1307-ENG-DPHNot settled. By our reading, probably yes. Ask DPH.
The only service-based exemption is an individual or agency that provides only a house cleaning service, and DPH’s rule lists laundry, shopping, errands, transportation and help with communication among the care services a licensed provider gives. Against that, the statute and the rule define in-home care as care primarily to help with an activity of daily living or a personal need, given to help with an activity of daily living, and personal in nature, joined by "and", so a service with no help with daily living may not be in-home care at all. DPH has not answered this in writing that we could find.
S.C. Code 44-70-20(3)(b); R.60-122 §700.BHouse cleaning alone is not in-home care.
The statute says an individual or agency that provides only a house cleaning service is not an in-home care provider. Add hands-on personal care and you need the license. Whether adding only meals, laundry or errands brings you in is not settled; by our reading it probably does, so ask DPH.
S.C. Code 44-70-20(3)(b)That is a home health agency, which this guide does not cover.
A home health agency gives part-time or intermittent skilled nursing ordered by a physician or other authorized provider, under a registered nurse, plus at least one other service. It is licensed under a different law and must obtain a Certificate of Need before licensure. In-home care excludes skilled care.
S.C. Code 44-69-20(5), 44-69-75(A)The rewritten rule has applied to you since May 22, 2026.
R.60-122 applies to all in-home care providers and the 2026 text has no transition period. Check your agency against the new duties: written policies for each section with a review every two years at most, a commercially zoned or unzoned primary office, service agreements, care services plans, signed rights forms, a disaster plan given to clients, the new incident reports and the new staff checks.
R.60-122 §101; Document No. 5407Referral businesses with a financial interest need the license.
The statute’s definition of an in-home care provider includes a business that arranges care through referral of other people when the person referring has a "financial interest in the delivery of those services". The rule defines a caregiver as anyone employed by, contracted by, referred by or acting as an agent of the provider, so the caregiver duties apply to referred caregivers too.
S.C. Code 44-70-20(3); R.60-122 §102.DStart with this license, then enroll with SCDHHS.
SCDHHS will not enroll a personal care provider that DPH has not licensed. Medicaid personal care then adds its own rules, including supervision by a registered nurse or licensed practical nurse, an owner or administrator with three years of health care administrative experience, and an office in a commercially zoned or unzoned area. This guide covers the DPH license only.
SCDHHS Personal Care Scope of Services, B.1-B.3, D.1DPH does not license private duty nursing.
DHEC’s 2015 memo, still linked on DPH’s page, says DPH does not regulate private duty nursing. If you also give in-home care, the 2026 rule requires a separate line of business, with separate marketing, caregiver records and client records. Nurses’ own licensing is outside this guide.
DHEC memo, Aug 13, 2015; R.60-122 §103.C.6The Act does not cover a person hired directly by the client or family.
An individual hired directly by the person receiving care, or by their family, is not an in-home care provider. Once you set up a business that provides or arranges care for pay through employees, contractors or referrals, you need the license.
S.C. Code 44-70-20(3)(d)The Act lists this as exempt.
A church or other religious institution recognized as a 501(c)(3) organization that provides in-home care without compensation or for a nominal fee to cover incidental expenses is not an in-home care provider. Home health agencies, hospices and facilities licensed under 44-7-260 are also outside it.
S.C. Code 44-70-20(3)(a), (e)Tick steps off as you go. Your progress is saved in this browser only.
In-home care is non-medical: help with daily living and personal needs, never skilled care. Skilled nursing needs a home health agency license and a Certificate of Need. Home care, home health or Medicaid?
DPH’s form asks for Secretary of State documents if they apply, a list of officers and everyone owning 5% or more. The name may not match or resemble another South Carolina licensee’s, and a franchise location adds its geographic area.
Get a county or municipal zoning permit to operate the provider there, or, in an unzoned area, a letter from the county or municipality. All records are kept at the primary office. The primary office and zoning.
Liability insurance or a surety bond of at least $100,000 per occurrence and $300,000 aggregate, indemnity coverage for clients’ injuries and losses, and workers’ compensation.
Everyone who signs the application gets a SLED name-based criminal records check (no older than 90 days when DPH receives it) and a 5-panel drug screen taken no earlier than 30 days before DPH receives the application, reviewed by someone unrelated to them.
Written policies for each section of R.60-122. DPH’s form asks for a copy of the random drug testing policy with the application, so write that one to stand alone. Written policies for every section.
Form 1307-ENG-DPH, signed under oath and notarized, with the attachments, to IHCP@dph.sc.gov (DPH’s preferred method) or by mail. Include proof of payment of DPH’s $1,000 fee.
DPH will not issue a first license until you show substantial compliance with the standards. The rule lets DPH inspect a proposed provider, but it does not say whether every applicant gets a visit, and DPH publishes no processing time. How DPH licenses you.
Criminal record check, Sex Offender and Nurse Aide Registry checks, a negative 5-panel drug test taken within 30 days before the job offer, a signed health self-assessment and training on eight topics. Checks, drug tests and health.
Before care starts: a signed service agreement (not needed for Medicaid clients) and the signed rights and assurances form. Within seven business days: the care services plan. Every visit documented, updated weekly. Give each client your disaster plan. Client records and rights.
Post the license or keep it readily available, renew before it expires ($800; a $200 late fee after expiry; unlicensed 30 days after), review policies at least every two years, and expect unannounced inspections.
The duty is in the statute: "An in-home care provider must apply for and obtain a license issued by the department that is effective for a specified time period following the date of issue as determined by the department." (S.C. Code 44-70-30). An in-home care provider is a business, for profit or not, that for compensation provides or arranges in-home care through its own employees or agents, through independent contractors, or "through referral of other persons to render in-home care services when the individual making the referral has a financial interest in the delivery of those services" (S.C. Code 44-70-20(3)). Registries and referral businesses are covered when the person referring has a financial interest in the delivery of the services. The license is needed to advertise or market as well as to operate (R.60-122 §103.A).
In-home care means care "primarily intended to assist an individual with an activity of daily living or in meeting a personal rather than a medical need, but not including skilled care or specific therapy for an illness or injury", such as help with walking, getting in and out of bed, bathing, dressing, feeding, using the toilet, preparing special diets and supervising self-administered medication (S.C. Code 44-70-20(2)). Private pay agencies need the license; nothing in the statute limits it to Medicaid work.
The only service-based exemption is "an individual or agency who provides only a house cleaning service" (S.C. Code 44-70-20(3)(b)). DPH’s rule lists cleaning, laundry, shopping, errands, transportation and help with communication among the care services a licensed provider gives (R.60-122 §700.B). Against that, the statute and the rule define in-home care with three parts joined by "and": care primarily to help with an activity of daily living or a personal need, given to help with an activity of daily living, and personal in nature (S.C. Code 44-70-20(2); R.60-122 §102.J). A service with no help with daily living may not be in-home care at all. Our reading: a business offering meals, laundry, errands, rides or companionship is not exempt and probably needs the license, but the definition leaves room to argue otherwise. DPH has not answered this in writing that we could find; ask DPH (IHCP@dph.sc.gov) before you operate without one.
House cleaning only
An individual or agency that provides only a house cleaning service.
S.C. Code 44-70-20(3)(b)People hired directly by the family
An individual hired directly by the person receiving care or by their family.
S.C. Code 44-70-20(3)(d)Other providers and programs
Home health agencies, hospices and facilities licensed under S.C. Code 44-7-260; residential programs run or contracted by the Office of Mental Health or the Office of Intellectual and Developmental Disabilities (44-7-2910(B)(1)(e)); a direct caregiver employed by or under contract with a direct care entity (44-7-2910(B)(2)(e)); and individuals providing services defined in 44-21-60. In-home care agencies are themselves direct care entities (44-7-2910(B)(1)(h)), so this does not exempt them.
S.C. Code 44-70-20(3)(a), (c)Churches giving care free
A 501(c)(3) church or other religious institution giving care without compensation or for a nominal fee to cover incidental expenses.
S.C. Code 44-70-20(3)(e)Before the license. If DPH finds services being provided without a license, the owner must stop at once and make sure clients are safe, and past violations may count against any later license (R.60-122 §103.A, a Class I standard).
DPH issues one non-medical license, with no tiers inside it. The neighboring routes are different licenses or programs.
| In-home care provider (this guide) | Home health agency | Medicaid personal care | |
|---|---|---|---|
| Covers | Non-medical help with daily living and personal needs (44-70-20(2)) | Part-time or intermittent skilled nursing ordered by a physician or other authorized provider, plus at least one other service (44-69-20(5)) | Personal care paid by Medicaid through an SCDHHS contract (SCDHHS) |
| License | DPH In-Home Care Provider license | DPH home health agency license, after a Certificate of Need (44-69-75(A)) | The DPH In-Home Care Provider license first: "Providers who are not licensed by the South Carolina Department of Public Health (SCDPH) will not be allowed to enroll as a Medicaid provider for these services." (Scope of Services, B.2) |
| Nurse | None required (R.60-122) | Services under a registered nurse (44-69-20) | RN or LPN supervision, which may be contracted (Scope of Services, D.1) |
| Office | Commercially zoned or unzoned (§103.D.1) | Outside this guide | Commercially zoned or unzoned (Scope of Services, B.3) |
Private duty nursing. DHEC’s 2015 memo, still linked on DPH’s in-home care page, says the Department does not regulate private duty nursing and that an in-home care provider offering it "should maintain separate lines of business between its in-home care offerings and private duty nursing offerings" (DHEC memo, Aug 13, 2015). The 2026 rule turns that into a duty for any other service: "If the provider provides services or care other than in-home care services, the provider must maintain separate lines of business regarding such other services or care.", with separate marketing, caregiver records and client records (R.60-122 §103.C.6).
Medicaid adds more. SCDHHS says the owner or administrator of a Medicaid personal care agency "must have at least three (3) years of administrative experience in the health care field" (Scope of Services, B.1). Under R.60-122, Medicaid clients need no service agreement (§601.B.2). This guide and our manual cover the DPH license, not SCDHHS enrollment.
"Care services provided by caregivers are strictly limited to non-medical tasks." The rule then says care services may include the following 13 (R.60-122 §700.B):
Care must be given "rendered effectively and safely in accordance with provider policies and procedures.", and you provide at least the services in the service agreement or care services plan (R.60-122 §700.A). The section as a whole is marked Class I.
The only medication service the rule lists is "Medication reminders." (R.60-122 §700.B.13). The definitions of in-home care, in the statute and in the rule, include "supervising self-administered medications" (R.60-122 §102.J; S.C. Code 44-70-20(2)(b)). Neither says what a caregiver may physically do. Our reading: caregivers remind and observe; they do not hand out doses, fill pill organizers or administer medication, which would move toward skilled care. Ask DPH where it draws the line before you allow more.
Skilled care is a service ordered by a physician or other authorized healthcare provider, furnished by or under licensed personnel, that "Requires the skills of technical or professional personnel such as registered nurses, licensed practical nurses, physical therapists, occupational therapists, and speech pathologists or audiologists" (R.60-122 §102.V). In-home care excludes it.
R.60-122 requires an administrator, not a nurse. A nurse appears only as one of the people who may review drug tests and health self-assessments: "Test results shall be received and reviewed by a nurse, the administrator, or human resources/hiring personnel." (R.60-122 §402.B). The rule sets no supervision schedule; caregivers must be able to follow the care services plan "with minimal supervision, if applicable" (R.60-122 §405.C).
Section 301 is new and short:
Keep a copy of the rule itself where caregivers can reach it (R.60-122 §103.B). Our reading of "each section": one policy for every numbered section that sets a duty on client care or operations, from 103 to 1002, with a table showing which policy answers which section. DPH has not published a checklist.
| Section | Title | What your policies need to address (our summary) | Marked |
|---|---|---|---|
| §101-102 | Purpose, scope and definitions | Applies to all providers. Defines abuse, exploitation, neglect, incident, caregiver, primary office, skilled care and more. | No duties |
| §103 | Requirements for licensure | License before operating or advertising; posting; separate lines of business; primary office and multiple locations; name; application; signers’ checks and drug tests; fees; renewal; amendments; change of licensee; variances. | 103.A is (I) |
| §201-205 | Enforcement | Unannounced inspections and investigations, access to records, plans of correction signed by the administrator, consultations, violation classes and penalties. | 202 is (I); 202.C is (II) |
| §301 | Policies and procedures | Written policies for each section, followed, available to staff at all times, reviewed at least every two years and signed by the administrator. | (II) |
| §302 | Insurance | Liability insurance or surety bond, indemnity coverage, workers’ compensation. | (II) |
| §401 | Administrator | One administrator responsible for overall management and operation. | (II) |
| §402 | Background checks and drug testing | Criminal background check before employment; pre-employment and random drug screens; what to record for in-house tests; the random testing policy. | 402.B is (I) |
| §403 | Staff records | Address, phone, training, all drug test results, background checks and self-assessments for every staff member. | Unmarked (Class III) |
| §404 | Training | Eight topics before client contact and at least annually, with signed and dated records. | (I) |
| §405 | Caregiver minimum qualifications | Literacy, capability, drivers, age 18 with ID, registry checks and disqualifying offenses. | (II); 405.F-G are (I) |
| §406 | Health status | Self-assessment before client contact and a policy on reporting and excluding staff with communicable diseases. | (I) |
| §501 | Incidents | Document and review every incident; 24-hour reports; 5-day investigation reports; abuse allegations to APS or CPS. | Unmarked (Class III) |
| §502 | Provider closure | Written notice to DPH, records and client transfer arrangements, 10 business days’ notice to clients. | Unmarked (Class III) |
| §601 | Client record content | An organized record per client, visit documentation, the service agreement and the care services plan. | (II) |
| §602 | Record maintenance | Storage, completing records within 30 days of discharge, keeping them five years. | Unmarked (Class III) |
| §700 | Client care services | Care given safely under your policies; the non-medical limit and the 13 services listed; continuity if you close. | (I) |
| §800 | Infection control | Staff practices that prevent the spread of disease, including screening and standard and transmission-based precautions. | (I) |
| §900 | Rights and assurances | Five rights, given in writing and signed before care starts. | (I) |
| §1001 | Disaster preparedness | A disaster plan, documented notifications and a copy for every client. | (II) |
| §1002 | Emergency call numbers | Fire, police, ambulance, poison control and staff contacts available to caregivers. | Unmarked (Class III) |
"Marked" is the rule’s own notation: standards marked (I) or (II) are Class I or II violations if not met, and unmarked standards are Class III (R.60-122 §205.D).
| Source | What it requires |
|---|---|
| R.60-122 §301.A | Written policies for every section of the rule Develop written policies and procedures addressing each section of R.60-122 on client care and operations, follow them, and keep them available to staff in print or electronically at all times. |
| R.60-122 §301.A | Follow the policies; staff can reach them Comply with the policies and keep them accessible to staff, in print or electronically, at all times. |
| R.60-122 §301.B | Review at least every two years Set a review period of no more than two years for all policies; document each review and have the administrator sign it. |
| R.60-122 §103.B | Copy of R.60-122 available to caregivers Keep a copy of the licensing standards at the provider, accessible to all caregivers, and comply with local, state and federal law. |
| R.60-122 §700.A | Care given according to policy Render care effectively and safely according to the provider’s policies, and provide at least the services in the service agreement or care services plan. |
| R.60-122 §103.A | Licensed before operating or advertising Do not operate, advertise or market as an in-home care provider before DPH issues the license. |
| R.60-122 §103.C.1 | License posted Post the license in a public area of the business office or keep it readily available. |
| R.60-122 §103.C.6 | Separate lines of businessif the provider offers services other than in-home care If the provider offers other services (for example private duty nursing), keep them separate: separate marketing, caregiver records and client records. |
| R.60-122 §103.D.1 | In-state primary office, zoning permit Keep at least one in-state primary office in a commercially zoned or unzoned area, with a county or municipal zoning permit, or a letter from the county or municipality if unzoned. |
| R.60-122 §103.D.2-4 | Register additional locations firstif the provider operates from more than one office Register each additional site with DPH and get approval before operating from it. |
| R.60-122 §103.E | Name rules Use a name not the same as or similar to another licensee’s; franchises include their geographic area. |
| R.60-122 §103.F | Accurate, sworn application Submit a complete and accurate application with the oath, signed by the owners (or two corporate officers), naming the persons in control; pay outstanding fees and penalties first. |
| R.60-122 §103.G.2 | Signers report convictions Anyone who signed the application reports disqualifying convictions to DPH immediately. |
| R.60-122 §103.J-K | Renew before expiry File the renewal application with any required documentation and the $800 fee before the license expires; late filing adds $200, and 30 days late leaves the provider unlicensed. |
| R.60-122 §103.L | Amend the license before moving or renaming Apply for an amended license before a change of location, or of name or postal address ($50 each). |
| R.60-122 §103.M | New license for a change of owner or entity Apply for a new license before a change in controlling interest or legal entity. |
| R.60-122 §103.N | Variances by requestif the provider seeks an alternative to a standard Request any variance from the rule in the format DPH sets; DPH decides case by case and may revoke it. |
| R.60-122 §202.A-B | Access for unannounced inspections Allow inspections and investigations without notice; give access to all areas and records in a timely way; if staff are out, say when they will return. |
| R.60-122 §202.B; §601.A.2 | Records produced promptly Make all records readily accessible, in a timely manner, for DPH inspections and investigations. |
| R.60-122 §202.C | Plan of correction For any noncompliance, return an acceptable written plan of correction signed by the administrator by the date on the report, covering corrective action, prevention of recurrence and completion dates. |
| R.60-122 §302.A | Liability insurance or surety bond Keep liability insurance or a surety bond of at least $100,000 per occurrence and $300,000 aggregate. |
| R.60-122 §302.B | Indemnity coverage for clients Keep indemnity coverage to compensate clients for injuries and losses from services. |
| R.60-122 §302.C | Workers’ compensation Keep workers’ compensation insurance under S.C. Code 42-5-10 et seq. |
| R.60-122 §401; §102.A | Administrator Designate an administrator with authority and responsibility for all functions and activities of the provider. |
| R.60-122 §402.A; S.C. Code 44-7-2910 | Criminal background check before employment Run a criminal background check under 44-70-60(B) and 44-7-2910 before employing or contracting any caregiver. |
| S.C. Code 44-7-2910(C) | Verify 12 months’ residency; federal check if needed Have each applicant verify 12 months’ residency. SC residents: state check. Otherwise: state check before employment and a federal check started after, or the other state’s check if residency there is verified. |
| S.C. Code 44-7-2920 | Checks through SLED or a SLED/FBI-based vendor Use SLED, or a background check business using current SLED or FBI records; repeat the check after a year or more out of direct care work. |
| S.C. Code 44-7-2910(A)(2) | Agency staff checked tooif the provider uses an employment or staffing agency Use staffing agencies only if they have run a criminal record check on each worker supplied. |
| R.60-122 §405.F | Sex Offender and Nurse Aide Registry checks Confirm no adverse findings on the Sex Offender Registry or the Nurse Aide Registry before a caregiver starts (Class I). |
| R.60-122 §405.G | Disqualifying offenses Do not use a caregiver with a conviction or no-contest plea for forgery, larceny, embezzlement or false pretenses (10 years), drug offenses (10 years), abuse, neglect or exploitation of a vulnerable adult, or any violent crime (Class I). |
| R.60-122 §402.B | Pre-employment drug screen 5-panel screen (cannabis, cocaine, amphetamines, opiates, phencyclidine) no more than 30 days before the offer, reviewed by a nurse, the administrator or HR; no caregiver work until negative (Class I). |
| R.60-122 §402.B.1-5, §402.C.1-5 | Drug test documentation Keep the lab result, or for in-house tests: name, date, time and signature of the person tested and of the reviewer, kit manufacturer and model, results, and kit lot number and expiry. |
| R.60-122 §402.C; §103.F.5; S.C. Code 44-70-70 | Random drug testing policy Write policies that address random drug testing of the application signers and caregivers and describe the method chosen (minimum 5-panel). Submitted with initial and renewal applications. |
| R.60-122 §402.C | Positive random test: off caregiving A caregiver with a positive random test does no caregiving until a physician confirms a prescribed medication or a later test is negative. |
| R.60-122 §403 | Staff records Keep accurate information on all staff: current address, phone, training, all drug test results, criminal background checks and self-assessments. |
| DPH, Background Checks for Direct Caregivers | Keep DPH’s eligibility determinationif a fingerprint-based check is run through DPH For fingerprint checks run through DPH, keep DPH’s eligibility determination in the caregiver’s file. |
| R.60-122 §404 | Training for assigned duties Caregivers receive or obtain the training needed for their duties, from appropriate resources (licensed or certified persons, books, electronic media). |
| R.60-122 §404 | Signed training records Trainer and trainee sign and date all in-service training records (trainer signature optional for computer-based training). |
| R.60-122 §404.A | Basic first aid Basic first aid before client contact and at least annually (Class I). |
| R.60-122 §404.B | Condition-specific caredepending on the clients served (for example dementia) Depending on clients, training in care for their physical or mental conditions, for example Alzheimer’s disease, other dementias or cognitive disabilities. |
| R.60-122 §404.C | Confidentiality Training in confidentiality of client information and records. |
| R.60-122 §404.D | Documentation and recordkeeping Training in documentation and recordkeeping procedures. |
| R.60-122 §404.E | Ethics and relationships Training in ethics and interpersonal relationships. |
| R.60-122 §404.F | Lifting and transfersif caregivers help clients move or transfer Training in proper lifting and transfer techniques, if caregivers help with transfers. |
| R.60-122 §404.G | Infection control Training in infection control techniques. |
| R.60-122 §404.H | Preventing abuse, neglect and exploitation Training in prevention of client abuse, neglect and exploitation. |
| R.60-122 §405.A-C | Literacy and capability Caregivers can read, write and communicate effectively, complete assigned duties, and follow the care services plan with minimal supervision. |
| R.60-122 §405.E | Age 18, with ID Caregivers are at least 18, shown by government ID or other valid documentation. |
| R.60-122 §405.D | Drivers: license, insurance, driving recordif caregivers transport clients Caregivers who transport clients hold a valid license and proof of insurance; verify the official driving record and keep a copy. |
| R.60-122 §406.A-B | Health self-assessment before client contact Staff with client contact complete a self-assessment disclosing communicable diseases, reviewed and signed by a nurse, the administrator or HR before first client contact (Class I). |
| R.60-122 §406.C | Communicable disease reporting and exclusion policy Policies for caregivers to report communicable disease to the administrator, and for excluding or restricting caregivers with communicable diseases or symptoms. |
| R.60-122 §501.A | Document and review every incident Document every incident with a review, investigation, evaluation and any corrective action; keep incident records five years after the client leaves. |
| R.60-122 §501.B | Report serious incidents within 24 hours Report fractures, hospital admission or death from an incident, suspected crimes against a client by a caregiver, and suspected abuse, neglect or exploitation by a caregiver to the responsible party and to DPH’s electronic system within 24 hours or the next business day. |
| R.60-122 §501.C | Five-day investigation report Submit a separate written investigation report to DPH within 5 calendar days with the listed contents (license number, date, client age and sex, witnesses, injury and treatment, cause, internal findings, agencies notified, reporter). |
| R.60-122 §501.D | Report abuse allegations to APS or CPS Report any allegation of abuse, neglect or exploitation of clients to DSS Adult Protective Services under 43-35-25, or to Child Protective Services as appropriate. |
| S.C. Code 43-35-25(A), (C)-(D) | Caregivers are mandated reporters Caregivers who have reason to believe a vulnerable adult has been or is likely to be abused, neglected or exploited must personally report within 24 hours or the next working day (APS for home settings). |
| S.C. Code 43-35-25(F) | Policy must not get in the way of reporting Internal procedures (telling a supervisor first) may not interfere with the reporter’s own duty to report. |
| S.C. Code 43-35-25(G) | Police for emergencies and sexual assault In an emergency, serious injury or suspected sexual assault, contact law enforcement immediately as well. |
| S.C. Code 43-35-75(B) | No retaliation against reporters Do not change an employee’s status because they report or cooperate with an investigation. |
| S.C. Code 63-7-310(D)-(E) | Reporting suspected child abuseif the provider serves children or may observe children in clients’ homesRecommended practice Where children are served or seen, report suspected abuse or neglect to county DSS or law enforcement. Caregivers are not on the mandated list, so this is recommended practice beyond R.60-122 §501.D. |
| R.60-122 §502.A-B | Notify DPH before closing Give DPH written notice of intent and date; within 10 business days before closure, give records arrangements, clients needing transfer, and (permanent) refunds or (temporary) reopening date. Return the license on permanent closure; after more than a year closed, DPH decides whether to inspect before reopening. |
| R.60-122 §502.C; §700.C | Notify clients and help them move Give all clients written notice at least 10 business days before closure, notify them promptly and give them a list of licensed providers for continued care. |
| R.60-122 §602.B | Preserve records on closure Before closing, arrange for preservation of records and tell DPH in writing where they will be. |
| R.60-122 §601.A | An organized record for each client Keep an organized record per client identifying the client and the person responsible for care; paper or electronic; legible, complete, signed and dated promptly (late signatures dated). |
| R.60-122 §601.A.3 | Backup for electronic recordsif records are kept electronically If records are electronic, provide for backup and retrieval in a shutdown or power outage. |
| R.60-122 §601.B.1 | Visit notes, updated weekly Document each visit: services provided, significant changes in physical or behavioral condition, caregiver name and signature or electronic verification, and date; maintain or update weekly. |
| R.60-122 §601.B.2 | Service agreement signed before care A service agreement with the services, fee disclosure and advance notice of fee changes, refund policy and timing, and termination terms, signed and dated by the provider and client or responsible party before care. Later changes recorded and agreed. Not required for Medicaid clients. |
| R.60-122 §601.B.2 | Recording changes to the agreement Changes in services may be handled by recording in the client record the specific change and that it was discussed and agreed with the person who signed, before the change. |
| R.60-122 §601.B.3 | Care services plan Within seven business days of starting care: types of services, expected times and frequency, expected duration, goals and objectives; revise when any of these change. |
| R.60-122 §602.A | Secure record storage Provide space, supplies and equipment adequate to protect and store client records. |
| R.60-122 §602.B-C | Close records in 30 days; keep 5 years Complete the record within 30 calendar days of discharge and keep it at least five years after services end. |
| R.60-122 §700.B | Non-medical tasks only Caregivers do only non-medical tasks from the permitted list (Class I section). |
| R.60-122 §700.B.13 | Medication remindersif the provider offers medication reminders The rule lists medication reminders as the medication service. Our recommendation: the agency policy says what caregivers may and may not do, with no administering and no setting up doses (the rule does not mention setting up doses). |
| R.60-122 §700.B.8 | Shopping: receipts and written accountingif caregivers shop for clients For any shopping for a client, give the client receipts and account for the client’s money in writing. |
| R.60-122 §700.B.10 | Transportationif caregivers transport clients Transportation to appointments and shopping is a permitted service; the driver rules in 405.D apply. |
| R.60-122 §700.B.11 | Home safety hazards Caregivers may address safety hazards found in clients’ homes; the policy says how hazards are spotted, fixed or reported. |
| R.60-122 §800 | Infection control practices Maintain and implement staff practices that prevent the spread of infectious diseases, including screening, standard precautions and transmission-based precautions (Class I). |
| R.60-122 §900.A | Rights and assurances Assure clients of: the agreed services; respect for property; freedom from abuse, neglect and exploitation; respect and dignity; and confidentiality of records, including privacy and disclosure (Class I). |
| R.60-122 §900.B | Rights in writing, signed before care Give clients the rights in writing before care starts; the provider and client or responsible party sign and date it. |
| R.60-122 §1001 | Disaster plan Develop a disaster plan setting out the services, if any, provided in a disaster and how clients or responsible parties are notified if staff cannot come. |
| R.60-122 §1001 | Document disaster notifications; give clients the plan Document notification (or attempts) when services cannot be given in a disaster, and give the plan to each client or responsible party. |
| R.60-122 §1002 | Emergency call numbers for caregivers Keep readily available to caregivers: fire, police, ambulance and poison control numbers, and the staff to notify in an emergency. |
| DPH, File a Complaint (recommended practice) | Complaints procedureRecommended practice Recommended: a written complaints procedure that also tells clients they can contact DPH (online form or 1-800-922-6735). R.60-122 has no complaints section. |
| R.60-122 §405.C (recommended practice) | Supervision of caregiversRecommended practice Recommended: a supervision policy (who supervises, check-ins, visit spot checks). The rule expects caregivers to follow the plan with minimal supervision but sets no supervision schedule. |
84 rows: 71 apply to every in-home care provider and 13 only in the situation shown. Rows citing a statute or a DPH page come from those sources, not from R.60-122. The 3 rows marked Recommended practice go beyond what the rules require.
DPH’s form is the Licensure Application for In-Home Care Provider, 1307-ENG-DPH (08/2026). It is signed under oath before a notary: by the owner or owners of an individual business, by "the head of the limited liability company" for an LLC, and by two officers for a corporation (Form 1307, Part D). The rule says owners sign for an individual or partnership and two officers for a corporation (R.60-122 §103.F). Corporations, partnerships and LLCs attach Secretary of State documents, a list of officers and the name, address and "percentage of all shareholders, partners, or members that possess 5% or more ownership" (Form 1307, Part B).
Send it with the attachments to IHCP@dph.sc.gov, DPH’s preferred method, or by mail to the Bureau of Health Facilities Licensing, P.O. Box 2046, West Columbia, SC 29171; questions to 803-545-4370 (Form 1307, p. 1). "Proof of payment is required for all applications submitted." (Form 1307, Instructions)
Each person who signs gets a SLED name-based criminal records check, and "evidence of this records check must be submitted to the Department by the applicant and the record check must not be older than ninety (90) calendar days upon receipt by the Department." (R.60-122 §103.G). A license must not be issued, and if issued may be revoked, if a signer must register as a sex offender or has a conviction or guilty or no contest plea for abuse, neglect or exploitation of a vulnerable adult, unlawful conduct toward a child or cruelty to children, any violent crime, any other drug-related felony, or forgery, embezzlement or breach of trust with fraudulent intent. "Person(s) signing the licensure application must immediately report to the Department any convictions for the above-referenced offenses." (R.60-122 §103.G.1-2)
Each signer also takes a 5-panel urine, hair, saliva or blood drug screen for cannabis, cocaine, amphetamines, opiates and phencyclidine. "The test must be taken not earlier than thirty (30) days before the Department’s receipt of the licensure application." The result is reviewed by someone who is not the person tested and is not related to them by blood or marriage, and a positive test means denial unless a physician states it came from a prescribed medication (R.60-122 §103.H).
"An initial license shall not be issued to a proposed provider until the applicant has demonstrated to the Department that the proposed provider is in substantial compliance with the licensing standards." (R.60-122 §103.B) The rule defines an inspection as "A visit by individuals authorized by the Department to a proposed or licensed in-home care provider for the purpose of determining compliance with this regulation" (§102.L), and says DPH uses inspections, investigations, applications and other documents about a proposed or licensed provider to enforce it (§201). It does not say whether DPH visits every applicant before the first license, or what DPH looks at. We could not confirm DPH’s practice. Have the whole manual, staff files and client forms ready before you apply.
If you already hold another DPH license, that facility or service must be in substantial compliance before DPH licenses the new one (§103.B).
This is the change most likely to catch a small agency. "An applicant or licensee must maintain at least one in-state office location that is its primary office." "The primary office must be in an office that is in a commercially zoned or unzoned area." "For the primary office, the applicant must obtain a county or municipal zoning permit to operate the provider." If the office is in an unzoned area, the applicant gets a letter from the county or municipality saying a provider may be operated there (R.60-122 §103.D.1). The office duty names "an applicant or licensee", but the permit and letter duties name only "the applicant"; by our reading existing licensees should hold the permit or letter too, since renewal is an application. Ask DPH.
The primary office is "The main office of an in-home care provider where all records are kept, secured, and accessible", and from which the provider oversees any multiple location (§102.S). Before the rewrite, the rule had no zoning requirement: it tied the license to a specific location and required the provider to be accessible "in person, by phone, or page" from 9 a.m. to 5 p.m., Monday to Friday, except state holidays (pre-2026 R.60-122, 103.J).
The rule does not say what evidence DPH wants, and Form 1307 does not ask for the zoning permit. Keep the permit or letter with your license papers.
These are state fees: DPH’s, as R.60-122 §103 sets them and DPH’s FY2026 fees report repeats them. They are paid to the state and are separate from any CareRulebook price.
| State fee | Amount | Per | Source |
|---|---|---|---|
| DPH initial in-home care provider license fee | $1,000 | initial application, non-refundable (state fee) | R.60-122 §103.I |
| DPH annual license renewal fee | $800 | 1-year renewal (state fee) | R.60-122 §103.I |
| DPH late renewal fee | $200 | renewal filed after expiry (state fee) | R.60-122 §103.J |
| DPH amended license fee | $50 | each amendment (state fee) | R.60-122 §103.L.3 |
| DPH reinstatement of a suspended license | $400 | reinstatement (state fee) | R.60-122 §103.K.1 |
Paying. Fees are paid to DPH through a secured portal or specific website and are not refundable; if DPH denies the application, it may refund part of the fee based on the months left in the licensure year (R.60-122 §103.I). DPH’s FY2026 fees report lists the same in-home care fees (FY2026 Fees and Fines Report). A revoked license means applying again at the initial fee (§103.K.2).
Renewal. "Failure to submit the renewal application, licensing fee, and late fee within thirty (30) days of the license expiration date shall render the provider unlicensed." (§103.J) DPH’s two in-home care enforcement orders from January 2025 to July 2026 were both $300 consent orders for late renewals (DPH enforcement actions).
Other costs (not state license fees).
Timeline. Neither the rule nor DPH’s pages give a processing time. DPH’s form warns: "Application must be complete and legible. Any missing information may result in delays in processing this application." (Form 1307, Instructions). The signers’ SLED checks (90 days) and drug tests (30 days) are dated to DPH’s receipt of the application, so time them close to filing. We cannot give you a date; ask DPH.
South Carolina in-home care license key facts
Checked against official sources on October 2, 2026.
"Before being employed as an in-home caregiver by a licensed in-home care provider, a person shall undergo a criminal background check as provided by S.C. Code Sections 44-70-60(B) and 44-7-2910." (R.60-122 §402.A). The check law names in-home care providers as direct care entities (S.C. Code 44-7-2910(B)(1)(h)), and covers anyone whose duties include the possibility of client contact.
A caregiver must "not have adverse findings on the Sex Offender Registry or Nurse Aide Registry" and must not have convictions or no contest pleas for forgery, larceny, embezzlement, false pretenses and cheats (within ten years of providing care), drug offenses (within ten years), abuse, neglect or exploitation of a vulnerable adult, or any violent crime (R.60-122 §405.F-G). The rule does not say which registry searches DPH accepts, so confirm the registry lookups DPH accepts before you rely on one.
Caregivers can read, write and communicate effectively with the client and supervisor, can complete their duties and follow the care services plan with minimal supervision, and are "at least eighteen (18) years of age, as evidenced by a government-issued identification card or other valid documentation" (R.60-122 §405.A-C, E). Caregivers who drive clients hold a valid driver’s license and proof of insurance, and "A copy of the driving record must be maintained in the caregiver’s file" (§405.D).
"All staff members and caregivers who have contact with clients shall complete a self-assessment prior to initial client contact." It discloses communicable diseases such as influenza, measles, mumps, chicken pox, strep throat, tuberculosis, HIV/AIDS and hepatitis, and a nurse, the administrator or human resources or hiring staff reviews and signs it before that first contact (R.60-122 §406.A-B). No TB test or TB risk assessment is required any more, though DPH’s page still links the old TB risk assessment form.
"The provider shall maintain accurate information on all staff members including, but not limited to, current address, phone number, training, all drug test results, criminal background checks, and self-assessments." (R.60-122 §403)
"Caregivers shall receive or independently obtain necessary training to perform the duties for which they are responsible." The following training comes from appropriate resources (for example licensed, registered or certified people, books or electronic media) "prior to client contact and at least annually thereafter unless otherwise specified by certificate" (R.60-122 §404):
"Documentation of all in-service training shall be signed and dated by both the individual providing the training and the individual receiving the training." The trainer’s signature may be left off for computer-based training (§404). The rule sets no hours, no curriculum and no certification. Medication assistance was a topic in the old rule and is gone (What changed).
An incident is "An unusual, unexpected adverse event that causes harm, injury, or death to clients." "The provider shall document every incident, and include an incident review, investigation, and evaluation as well as a corrective action taken, if any." Keep the records for five years after the client stops receiving services (R.60-122 §102.I, §501.A).
Report these to the client’s responsible party and to DPH within 24 hours or the next business day (R.60-122 §501.B):
The list is "not limited to" these. DPH’s report goes "via the Department’s electronic reporting system or as otherwise determined by the Department", with the type of incident, a brief description, the date, any witnesses and the reporter’s contact details. DPH’s page says: "Please complete the online accident/incident form" (DPH, Accident/Incident Reporting).
"The provider shall submit a separate written investigation report within five (5) calendar days of every incident required to be reported to the Department", with the provider name, license number, "the date the incident occurred, the client age and sex, witness names, extent and type of injury and how treated, cause of incident", internal investigation results, other agencies notified and the reporter’s contact details (R.60-122 §501.C).
Non-medical caregivers are not on the child abuse reporting statute’s list of mandated reporters (nurses and other medical professionals are), but anyone "may report, and is encouraged to report, in accordance with this section", to the county department of social services or law enforcement (S.C. Code 63-7-310(A), (D)-(E)). R.60-122 still requires the provider to report allegations involving clients to Child Protective Services as appropriate. Our reading: an agency that serves children makes reporting part of its policy for every staff member.
Signed and dated by you and the client or responsible party before care starts, covering the services you agree to provide, "Disclosure of fees for all care services provided to include advance notice requirements to changes in fee amounts", a refund policy that says when money is returned when care ends, and the terms for ending the agreement, including when a client may be refused further care. Later changes can be recorded in the client record with a note that they were discussed and agreed before they took effect. "For clients receiving care services pursuant to a Medicaid program, a service agreement is not required." (R.60-122 §601.B.2)
Types of care services, expected times and frequency in the client’s home, expected duration, and goals and objectives. "The care services plan shall be completed by the provider within seven business days after care services are initially provided." It is revised whenever any of those four items change (§601.B.3, as corrected June 26, 2026). The rule does not say who writes it or require a nurse to.
Every client is assured of: the care services in the service agreement or care services plan; respect for their property; freedom from abuse, neglect and exploitation; respect and dignity in receiving care; and "Confidentiality of client records, to include privacy and disclosure requirements." (R.60-122 §900.A). "The provider shall inform clients in writing of the rights and assurances in Section 900.A prior to the provider’s provision of in-home care." "The documentation of informed rights and assurances shall be signed and dated by the provider and the client and/or client’s responsible party." (§900.B)
The rights list has no complaint route. Adding DPH’s complaint line (1-800-922-6735) and the APS number to the client’s copy is our suggestion, not a rule; ask DPH whether it expects them.
"All providers are subject to inspection and/or investigation without prior notice." If no staff are there, you tell DPH when they will be back, and inspectors get timely access to all areas and records (R.60-122 §202.A-B). DPH says "Inspectors are healthcare professionals", inspections are unannounced, and it leaves a report of visit after each one (DPH, How DPH Inspects).
Plans of correction. For any noncompliance, the administrator signs and returns an acceptable written plan by the date on the report, describing the actions taken to correct each deficiency, "The actions taken to prevent recurrences (actual and similar)" and the actual or expected completion dates (§202.C). DPH takes them online (DPH, Submit Information).
Classes. Class I violations present an imminent danger or a substantial probability of death or serious physical harm; Class II have a negative impact on clients’ health, safety or well-being; Class III are everything else, including practice against best practices as DPH interprets them (§205.A-D). DPH may impose a monetary penalty, or deny, suspend or revoke a license (§204).
| Frequency | Class I | Class II | Class III |
|---|---|---|---|
| 1st | $500-1,500 | $300-800 | $100-300 |
| 2nd | $1,000-3,000 | $500-1,500 | $300-800 |
| 3rd | $2,000-5,000 | $1,000-3,000 | $500-1,500 |
| 4th | $5,000 | $2,000-5,000 | $1,000-3,000 |
| 5th | $5,000 | $5,000 | $2,000-5,000 |
| 6th | $5,000 | $5,000 | $5,000 |
R.60-122 §205.F: "Monetary penalties assessed by the Department must be not less than one hundred dollars ($100) nor more than five thousand dollars ($5,000) for each violation of any of the provisions of this regulation."
DPH’s facility data, exported on October 2, 2026, lists 1,402 in-home care provider licenses, of which 1,307 have an expiration date on or after that day. Counting unexpired licenses only, the largest counties are Greenville (211), Richland (202), Charleston (84), York (80) and Florence (79). License numbers run up to IHCP-2960; our inference is that many more have been issued over the years than are listed today (DPH Find a Facility, our count). The data does not say which agencies also hold Medicaid contracts.
Twelve about getting started and the 2026 rule, each with the rule or guidance it rests on.
Yes. The rewritten R.60-122 applies to all in-home care providers from May 22, 2026, and the text has no transition period. Existing agencies need written policies for each section of the rule, a disaster plan given to clients, signed rights forms, service agreements, care services plans, the new incident reporting and a primary office in a commercially zoned or unzoned area (the zoning permit duty names the applicant; by our reading existing licensees should hold one too). DPH has not published guidance on how it will inspect existing agencies against the new rule.
"This regulation will apply to all in-home care providers in South Carolina."
Yes. Since May 22, 2026. The provider must develop written policies and procedures addressing each section of R.60-122 on client care and operations, follow them, keep them available to staff in print or electronically, and review them at least every two years with the administrator signing each review. Missing policies are a Class II violation.
"Written policies and procedures addressing each section of this regulation regarding client care and operation of the provider shall be developed."
It depends. Only if it is in a commercially zoned area with a county or municipal zoning permit, or in an unzoned area with a letter from the county or municipality saying a provider may be operated there. That is the rule for the primary office since May 22, 2026. By our reading, a home in a residential zone does not qualify; ask DPH about your address. SCDHHS already required a commercially zoned or unzoned office for Medicaid agencies.
"The primary office must be in an office that is in a commercially zoned or unzoned area."
It depends. Not settled; by our reading, probably yes. The only service-based exemption is "an individual or agency who provides only a house cleaning service", and DPH’s rule lists laundry, shopping, errands, transportation and help with communication among the care services a licensed provider gives. Against that, the statute and the rule define in-home care as care that is primarily to help with an activity of daily living or a personal need, given to help with an activity of daily living, and personal in nature, joined by "and", so a service with no help with daily living may not be in-home care at all. Ask DPH (IHCP@dph.sc.gov) before operating without a license.
"an individual or agency who provides only a house cleaning service"
No. Not for the DPH license. R.60-122 requires an administrator, not a nurse, and caregivers may do only non-medical tasks. If you want to bill Medicaid personal care through SCDHHS, the agency must have RN or LPN supervision (which may be contracted). Skilled nursing needs a home health agency license and a Certificate of Need.
"Each provider shall have an administrator who is responsible for the overall management and operation of the provider."
No. DHEC was abolished on July 1, 2024. Health care licensing moved to the South Carolina Department of Public Health (DPH), whose Bureau of Health Facilities Licensing handles in-home care provider licenses (IHCP@dph.sc.gov). The statute still says DHEC, but Act 60 reads that as DPH. Licenses DHEC issued stayed valid.
"The South Carolina Department of Health and Environmental Control and the South Carolina Board of Health and Environmental Control are abolished."
No. R.61-122 was renumbered R.60-122 on May 23, 2025 when DPH’s health regulations moved to Chapter 60, without changing the text. The content was then rewritten from May 22, 2026. Anything citing 61-122 is quoting the old 2014 rule.
"Amend R.61-122 regulation number and move to Chapter 60 to read:"
It depends. Not as a set submission. Only the random drug testing policy goes in with the application (and again at each renewal). But DPH may not issue an initial license until you show substantial compliance with the standards, and inspections are unannounced, so the full manual should be in place before you apply. Ask DPH whether it inspects before the first license.
"A copy of your Random Drug Testing Policy"
No. Care is strictly limited to non-medical tasks, and the only medication service the rule lists is medication reminders. The definitions of in-home care in the statute and in R.60-122 §102.J also include supervising self-administered medications. Neither says caregivers may administer medication, and skilled care needs a home health agency. Whether caregivers may set up doses or fill pill organizers is not addressed; by our reading they should not, and DPH can confirm.
"Care services provided by caregivers are strictly limited to non-medical tasks."
No. Not under the 2026 rule. The old health assessment with TB screening and the annual TB risk assessment were replaced by a self-assessment that discloses communicable diseases, including tuberculosis, reviewed and signed before first client contact. DPH’s page still links the old TB risk assessment form, and Medicaid contracts may ask for more, so check with your payers.
"All staff members and caregivers who have contact with clients shall complete a self-assessment prior to initial client contact."
No. A person is not eligible to work as a caregiver until they have a negative 5-panel test, taken no more than 30 days before the job offer. This is a Class I standard.
"Persons shall not be eligible for employment as a caregiver unless and until they have a negative test."
It depends. Not for an in-home care provider. The In-Home Care Providers Act has no CON requirement. A home health agency (skilled nursing ordered by a physician, APRN or PA, under an RN) must get a Certificate of Need before licensure.
"A home health agency shall obtain a Certificate of Need before licensure."
DPH’s fees are $1,000 for the first license and $800 a year to renew, paid through DPH’s secured portal or website and not refundable, although DPH may refund part of the fee if it denies the application. A SLED CATCH check for each signer costs $25 plus an online service fee. You also need liability insurance or a surety bond of at least $100,000 per occurrence and $300,000 aggregate, indemnity coverage, workers’ compensation, drug screens and an office in a commercially zoned or unzoned area; those are market prices. DPH’s fees are state fees, not CareRulebook prices.
DPH does not publish a processing time, and the rule sets none. DPH’s form says missing information may delay processing, and DPH will not issue a first license until you show substantial compliance with the standards. Plan for the 90-day window on each signer’s SLED check and the 30-day window on their drug test, which both run to the day DPH receives the application. Ask DPH (803-545-4370) for a current estimate.
Only if it is in a commercially zoned area with a county or municipal zoning permit, or in an unzoned area with a letter from the county or municipality saying a provider may be operated there. That has been the rule for the primary office since May 22, 2026. By our reading, a home in a residential zone does not qualify. The rule has no exception for agencies licensed before that date; ask DPH about yours.
The rule does not say. It requires the service agreement and the rights form to be signed before the provider gives in-home care, and the care services plan within seven business days after care starts, and it applies to all providers from May 22, 2026. By our reading, the safe course is to put in place now a service agreement for every client not served under a Medicaid program, and a care services plan, the rights form and your disaster plan for every current client, and to record the date. Ask DPH whether it expects them for clients who started before May 22, 2026.
The rule asks for a renewal application with any documentation DPH requires to show compliance, and the $800 fee. DPH’s form asks for your random drug testing policy, liability insurance and workers’ compensation coverage with renewal applications too. The statute also says the department verifies that you are running the required criminal record checks before it renews your license.
Fractures, hospital admissions or deaths from an incident, and confirmed or suspected crimes or abuse, neglect or exploitation by a caregiver go to the client’s responsible party and to DPH within 24 hours or the next business day, through DPH’s online accident and incident form, then a written investigation report within five calendar days. Abuse, neglect and exploitation also go to Adult Protective Services (1-888-227-3487), or to Child Protective Services for a child.
Yes, with this license plus SCDHHS enrollment. SCDHHS says providers not licensed by DPH will not be allowed to enroll for personal care. Medicaid personal care must be supervised by a registered nurse or licensed practical nurse, the owner or administrator needs three years of health care administrative experience, and the office must be commercially zoned or unzoned. Medicaid clients do not need the R.60-122 service agreement.
If you cannot verify 12 months of South Carolina residency, run a state check before employment and start a federal fingerprint check after. If you can verify 12 months of residency in another state, a state check in that state may be used instead. For fingerprint checks, you email DPH’s authorization form to HQCBC@dph.sc.gov, the applicant is fingerprinted by an approved vendor such as IdentoGO, and DPH sends you an eligibility determination to keep in the caregiver’s file.
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North Carolina
How to start a home care agency in North Carolina
The DHSR license and the 32-item policy checklist DHSR reviews before licensing.
Georgia
How to start a home care agency in Georgia
Companion care is licensed there too, and DCH’s checklist asks for an RN.
Tennessee
How to start a home care agency in Tennessee
The TDMHSAS personal support services agency license, the electronic desk audit and the 17 policy items the rules list.
Virginia
How to start a home care agency in Virginia
The HCO license, RN supervision at least every 90 days and the 35 policy topics.
Kansas
How to start a home care agency in Kansas
The KDHE supportive care license: no nursing of any kind, 16 assigned duties and policies uploaded into 13 folders for review before licensing.
Texas
How to start a home care agency in Texas
The HCSSA license, HHSC’s $2,625 fee and every Chapter 558 policy.
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