South Carolina in-home care client paperwork

The rule lists four things the agreement includes (R.60-122 §601.B.2.a-d):

1. The care services you have agreed to provide to the client.
2. "Disclosure of fees for all care services provided to include advance notice requirements to changes in fee amounts".
3. "Refund policy to include when monies are to be forwarded to client upon termination of care services".
4. "Provisions regarding termination of the service agreement to include conditions under which the client may be refused further care services".

• Signed before care. "The service agreement shall be signed and dated by the provider and the client and/or the client’s responsible party prior to the provider’s provision of in-home care." (§601.B.2) A responsible party is "a person who is authorized by law to make decisions on behalf of a client", such as a court-appointed guardian or conservator, or someone with a health care or other durable power of attorney (§102.T).
• Changes. 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. (§601.B.2)
• It sets the floor. "Each provider is required to provide at a minimum those services that are designated in the service agreement or care services plan." (§700.A) Neglect is defined against it: "the failure or omission of a caregiver to provide the care, goods, or services necessary to maintain the health or safety of a client pursuant to the service agreement", where the failure has caused or risks injury (§102.R). And when DPH decides on enforcement, it weighs "evidence that services contracted for are not provided" (§205.E.1).
• Medicaid clients. "For clients receiving care services pursuant to a Medicaid program, a service agreement is not required." (§601.B.2) If a Medicaid client also buys extra services privately, the rule does not say whether those need an agreement; by our reading they do, for the private services.

DPH has no form for the agreement, and the rule does not set the notice period for fee changes or the refund terms: you choose them and write them down. Before May 22, 2026, the rule had no client record section (R.60-122 before the rewrite).

The plan covers four items (R.60-122 §601.B.3.a-d):

1. The types of care services provided.
2. The expected times and frequency of care in the client’s home.
3. The expected duration of the care.
4. "Goals and objectives of the care services".

• Seven business days. "The care services plan shall be completed by the provider within seven business days after care services are initially provided." (§601.B.3) The rule does not say whether state holidays count as business days. Counting every weekday, by our reading, meets either reading.
• Revised when things change. DPH corrected a cross-reference in 601.B.3: the care services plan is revised whenever the items in 601.B.3.a to d change. (State Register 50/6, errata)
• Who writes it. The rule does not say, and does not require a nurse (R.60-122 §402.B, §406.A).
• Caregivers follow it. A caregiver must be capable of providing care as set out in the care services plan with minimal supervision, if applicable (§405.C). Who supervises them: South Carolina administrator and office.

Care may begin before the plan is written, but the agreement (for private clients) is signed, and the rights given in writing, before care starts (§601.B.2; §900.B). The plan lists only non-medical tasks: care is strictly non-medical, with medication reminders the only medication service the rule lists (§700.B.13).

"Each visit by a caregiver to a client’s residence shall be documented." "Documentation of visits shall include what care services were provided, any significant changes to the client’s physical or behavioral condition as observed by the caregiver", the caregiver’s name and signature or electronic signature or verification, and the date. "Documentation shall be maintained or updated on a weekly basis." (R.60-122 §601.B.1)

• Signed promptly, paper or electronic. Entries are legible and complete, signed and dated promptly by the person who gave the care. "Records may be signed electronically. If an entry is signed on a date other than the date it was made, the date of the signature shall be entered." (§601.A.1)
• Weekly, by our reading, means the record is brought up to date at least once a week; each visit still gets its own entry.
• Significant changes. The note records changes the caregiver observes. The rule does not say who must be told; a call to the office the same day is a sensible policy, not a rule.
• Shopping. "For any shopping on behalf of a client, receipts must be provided to the client and client funds for such shopping must be accounted for in writing." (§700.B.8)

Every client is assured of five things (R.60-122 §900.A):

1. The care services to be provided under the service agreement or care services plan.
2. Respect for the client’s property.
3. Freedom from abuse, neglect and exploitation.
4. Respect and dignity in receiving care services.
5. "Confidentiality of client records, to include privacy and disclosure requirements".

"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 section is Class I (§900).

The list has no complaint route. Adding DPH’s complaint line and form to the client’s copy is our suggestion, not a rule (DPH, File a Complaint). For Medicaid personal care, SCDHHS already has the agency nurse tell participants of their right to complain, on a statement they sign (SCDHHS Personal Care Scope, E.3.a.iii).

"The provider shall develop a disaster plan that identifies the care services obligations, if any, of the provider to be provided to the client during a disaster event." It sets out how you notify clients or responsible parties if staff cannot provide care because of a disaster, and "the provider’s notification (or attempted notification) to the client and/or responsible party shall be documented". "The provider shall provide its disaster plan to the client and/or responsible party." (R.60-122 §1001)

• "If any". The rule lets you decide what, if anything, you will provide in a disaster. Say it plainly, so clients and families can plan.
• When to hand it over. The rule does not say. By our reading, at the start of care with the agreement and rights form, and at the next visit for clients already in care.
• What counts as a disaster. Not defined in R.60-122.

Before May 22, 2026, the rule had no disaster section (R.60-122 before the rewrite). Emergency call numbers for caregivers are a separate duty (§1002).

• A right. Confidentiality of client records, including privacy and disclosure requirements, is one of the five rights (R.60-122 §900.A.5). The rule does not list the privacy and disclosure requirements it means.
• A training topic. Caregivers are trained in confidentiality of client information and records before client contact and at least yearly (§404.C). Before May 22, 2026, confidentiality of client information appeared in the rule as a caregiver training topic. (R.60-122 before May 22, 2026)
• Storage. Space, supplies and equipment adequate to protect and store client records (§602.A), with backup and retrieval for electronic systems (§601.A.3).
• DPH sees the records. Records must be readily accessible for DPH’s inspections and investigations (§601.A.2). "Photocopies shall be used only for purposes of enforcement of regulations and confidentiality shall be maintained", except to verify identities in enforcement proceedings (§202.B).

• Close it within 30 days. When care ends, the record is completed within 30 calendar days and filed in an active or closed file (R.60-122 §602.B).
• Keep it five years. "Records of clients shall be maintained for at least five (5) years following the cessation of services to the client." (§602.C) Incident records are kept five years after the client leaves (§501.A). How incidents are reported to DPH: South Carolina inspections and incidents.
• At the primary office. All records are kept, secured and accessible at the primary office (§102.S). If you also run another line of business, its client records are kept separately (§103.C.6).
• If you close. Give clients written notice at least 10 business days ahead and a list of licensed providers, arrange to preserve the records and tell DPH in writing where they will be (§502, §700.C; §602.B).

Every record the office keeps, staff files included: South Carolina administrator and office.

Only the service agreement is waived. The care services plan, visit notes, the signed rights form and the disaster plan apply to every client (R.60-122 §601.B.2). SCDHHS adds its own paperwork for Medicaid personal care:

• The authorization. For Medicaid personal care, the SCDHHS authorization sets the amount, frequency and duration of service, and current and past authorizations are printed and kept in the participant’s record. (SCDHHS Personal Care Scope, E.1)
• The SCDHHS Service Plan. For SCDHHS participants, the provider gets an updated SCDHHS Service Plan from the case manager before services start and builds the task list from it. (E.2)
• The nurse visit. Medicaid personal care must be supervised by an RN or LPN (which may be contracted), who visits before care starts and writes the task list. (D.1, E.2-3)
• Advance directives. At the nurse’s first visit for Medicaid personal care, the participant gets written information on advance directives and signs and dates a statement of receipt. (E.3.a.ii)

By our reading, the SCDHHS Service Plan and task list do not replace the DPH care services plan, since §601.B.3 applies to every client; one document can serve both if it carries all four §601.B.3 items. Ask DPH if you want to rely on that.

The rewritten rule took effect on May 22, 2026 (Document No. 5407). "This regulation will apply to all in-home care providers in South Carolina." The text has no transition period (R.60-122 §101). But the service agreement and rights form are tied to the start of care, and the plan’s seven business days run from when care was first provided, which for these clients was before the rule. The rule does not say what clients already in care need, or by when, and DPH has not published guidance.

Our reading: DPH inspects without notice (§202.A), and an inspector looking at a current client’s record will find either the new paperwork or a gap. So the safe course is to put every item in place for every current client now, and date it honestly. Do not backdate anything: a late entry carries the date it was signed (§601.A.1).