South Carolina in-home care inspections and incidents: no notice, plans of correction and 24-hour reports

DPH "shall utilize inspections, investigations, applications, and other pertinent documentation regarding a proposed or licensed provider in order to enforce this regulation." R.60-122 §201 The rule names three kinds of visit:

• Inspection: "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." R.60-122 §102.L
• Investigation: "A visit by individuals authorized by the Department to a licensed or unlicensed in-home care provider for the purpose of determining the validity of allegations received by the Department relating to statutory and regulatory compliance." R.60-122 §102.M DPH says it investigates complaints and serious incidents. DPH, How DPH Inspects
• Consultation: "Consultations may be provided by the Department as requested by the provider or as deemed appropriate by the Department." R.60-122 §203

Who comes. DPH says "Inspectors are healthcare professionals". DPH, How DPH Inspects

How often. R.60-122 sets no inspection interval, and DPH has not published one for in-home care providers that we could find. Compare home health agencies, which the statute says are inspected at least once a year. S.C. Code 44-69-70 By our reading, an in-home care provider should be ready on any business day.

Before the first license. "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 Because an inspection can be of a "proposed" provider, DPH may visit before licensing, but the rule does not say it always does. How DPH licenses you: the South Carolina guide.

Class I. Section 202, inspections and investigations, is marked (I): failing to allow an unannounced visit or to give access is a Class I violation. Its plan of correction paragraph, 202.C, is marked (II). R.60-122 §202, §205.D

"When there is noncompliance with licensing standards, the provider shall submit an acceptable written plan of correction to the Department that shall be signed by the administrator" and "returned by the date specified on the report of inspection or investigation". R.60-122 §202.C The plan describes:

1. the actions taken to correct each cited deficiency;
2. "The actions taken to prevent recurrences (actual and similar)"; and
3. the actual or expected completion dates of those actions. R.60-122 §202.C

• Class II. Paragraph 202.C is marked (II), so a missing or late plan is itself a Class II violation. R.60-122 §202.C
• Online. DPH says "The facility administrator should submit the POC online". DPH, Submit a Plan of Correction DPH says its Plan of Correction Submission Form is for administrators responding to citations from a Bureau of Health Facilities Licensing inspection. DPH, Plan of Correction Submissions
• Follow-up. DPH says it sometimes makes a follow-up inspection to verify that violations were corrected. DPH, How DPH Inspects
• Correction times. A Class I condition or practice must be abated or eliminated immediately, unless DPH sets a fixed period for correction. R.60-122 §205.A A Class II or Class III citation says how long the provider has to correct the violation. R.60-122 §205.B-C

Our suggestions. Answer each deficiency separately, in the report’s order. Give a real completion date, name who is responsible, and keep the evidence of each correction with your copy of the plan. If a deficiency comes from a policy, revise the policy and have the administrator sign and date the review, as 301.B requires for every review. R.60-122 §301.B DPH weighs your efforts to correct cited violations when it decides on enforcement. R.60-122 §205.E

• Class I: what DPH determines presents an imminent danger to clients’ health, safety or well-being, or a substantial probability of death or serious physical harm. R.60-122 §205.A
• Class II: other violations DPH determines have a negative impact on clients’ health, safety or well-being. R.60-122 §205.B
• Class III: every standard not marked (I) or (II), and also practice that is against best practices as DPH interprets them. R.60-122 §205.C
• How to tell which. "The notations “(I)” or “(II)”, placed within sections of this regulation, indicate those standards are considered Class I or II violations if they are not met, respectively." Unmarked standards are Class III. R.60-122 §205.D For example, 301 (policies) is marked (II). R.60-122 §301 The full list of sections and their marks is on the South Carolina guide.
• What DPH weighs. In deciding on an enforcement action, DPH considers the conditions and their impact or potential impact on clients (for example evidence that contracted services were not provided, or direct evidence of abuse, neglect or exploitation), the provider’s efforts to correct cited violations, its history of compliance, and any other pertinent conditions. R.60-122 §205.E
• What DPH can do. When DPH finds a provider in violation of a statute, rule or regulation on its operation, it may, with proper notice to the licensee, impose a monetary penalty or deny, suspend or revoke the license. R.60-122 §204 The Act itself makes every license subject to suspension or revocation for failing to comply. S.C. Code 44-70-50(2)

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."

By our reading: a first citation for missing written policies (a Class II standard) would sit in the $300 to $800 band if DPH chose a monetary penalty. The schedule applies "when a decision is made to impose monetary penalties", so a citation does not always mean a fine. R.60-122 §205.F Before May 22, 2026 the rule also counted each day a violation continued as a subsequent offense; the 2026 text dropped that line. What changed on May 22, 2026.

DPH publishes Healthcare Quality administrative and consent orders in monthly reports that name the party, summarize the inspections, investigations and violations, and list what the party had to do, including any civil monetary penalty. DPH, Healthcare Quality Enforcement Actions So an order against your agency would be published with its name. DPH also says consumers can use inspection reports to compare providers. DPH, How DPH Inspects

Our count. We read all 19 monthly reports from January 2025 to July 2026. 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 cites the 2026 rule yet. DPH enforcement reports, July 2025 and February 2026 This is our count, not a DPH statistic. The reports list orders only, so by our reading a citation closed with a plan of correction would not appear in them.

How one late renewal became an order. In the February 2026 order, DPH staff had emailed the provider a renewal fee invoice and reminder before expiry, then a citation by mail imposing a late fee, then notice that the license had expired. A consent order followed with a $300 penalty and a completed renewal application, and DPH agreed to rescind the expiration letter if the provider complied. DPH enforcement report, February 2026 DPH’s fees: $800 to renew, a $200 late fee from the expiry date, and unlicensed if not renewed within 30 days of expiry. R.60-122 §103.J These are DPH’s fees, not CareRulebook prices.

Suspension and revocation. Reinstating a suspended license costs DPH’s $400 fee. R.60-122 §103.K.1 A revoked license is reinstated only by applying again as a new provider with the initial fee; any time left on the revoked license is forfeited. R.60-122 §103.K.2 The Act says sanctions may be appealed under S.C. Code 44-1-60. S.C. Code 44-70-40(8) We have not saved 44-1-60, so this page does not describe the appeal steps.

The reports were read to July 2026, two months after the rewrite took effect. By our reading, it is too early to tell how DPH will enforce the new duties against existing agencies.

An incident is "An unusual, unexpected adverse event that causes harm, injury, or death to clients." R.60-122 §102.I "The provider shall document every incident, and include an incident review, investigation, and evaluation as well as a corrective action taken, if any." R.60-122 §501.A

What goes to DPH and the responsible party

The four reportable incident types in 501.B are a minimum; the rule says reportable incidents include, but are not limited to, them. R.60-122 §501.B

• a bone or joint fracture while in the care of a caregiver;
• hospital admission or death resulting from an incident while in the care of a caregiver;
• confirmed or suspected crimes against a client by a caregiver;
• confirmed or suspected client abuse, neglect or exploitation by a caregiver.

The responsible party is a person authorized by law to make decisions for the client, such as a guardian, conservator or someone with a health care or other durable power of attorney. R.60-122 §102.T "The provider shall also notify the Department within twenty-four (24) hours or the next business day from the incident, via the Department’s electronic reporting system or as otherwise determined by the Department." R.60-122 §501.B The 24-hour report collects what is known at the time: at least the type of incident and a brief description, the date it is believed to have happened, any witnesses and the reporter’s contact details. R.60-122 §501.B DPH’s page says "Please complete the online accident/incident form". DPH, Accident/Incident Reporting

The written investigation report

"The provider shall submit a separate written investigation report within five (5) calendar days of every incident required to be reported to the Department", containing 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, the other agencies notified and the reporter’s contact details. R.60-122 §501.C

Where DPH’s page and the rule differ

DPH’s page says serious accidents or incidents, as the regulation defines them, need an initial report within 24 hours of occurrence and, once investigated, a full report within 5 days. The rule itself says 24 hours or the next business day, and 5 calendar days. DPH, Accident/Incident Reporting By our reading, follow the stricter of the two for each report: send the first report within 24 hours where you can, and count the five days as calendar days.

Before May 22, 2026

Before May 22, 2026, the rule required serious incidents to be phoned to the next of kin or responsible party immediately and reported to the Department in writing within three days. R.60-122 (2014 text) §501 The 2026 rule shortened the clock to DPH, changed the call to the next of kin or responsible party from immediately to within 24 hours or the next business day, added the separate five-day report, and moved reports to DPH’s electronic system.

Which class

Section 501 carries no (I) or (II) mark, so by our reading a missed or late incident report is a Class III violation under 205.D. R.60-122 §205.D The event behind the report may break other standards with a higher class, such as the client’s assurance of freedom from abuse, neglect and exploitation in Section 900, which is marked (I). R.60-122 §900.A

Three separate duties can apply to one event. The DPH report does not replace the APS report, and the agency’s reports do not replace the caregiver’s own.

Caregivers are mandated reporters

• Named in the Act. The Omnibus Adult Protection Act names caregivers, alongside nurses, social workers, staff of facilities and others, among the people who must report. S.C. Code 43-35-25(A) The Act defines a caregiver as "a person who provides care to a vulnerable adult, with or without compensation, on a temporary or permanent or full or part-time basis". S.C. Code 43-35-10(2)
• Who is protected. A vulnerable adult is "a person eighteen years of age or older who has a physical or mental condition which substantially impairs the person from adequately providing for his or her own care or protection". S.C. Code 43-35-10(11)
• When the duty starts. The duty starts when a listed reporter has reason to believe a vulnerable adult has been, or is likely to be, abused, neglected or exploited. Proof is not needed. S.C. Code 43-35-25(A)
• Personally, and on time. "A person required to report pursuant to this section is personally responsible for making the report". "A person required to report under this section must report the incident within twenty-four hours or the next working day." S.C. Code 43-35-25(C)-(D) "No facility may develop policies or procedures that interfere with the reporting requirements of this section." S.C. Code 43-35-25(F) The Act’s definition of a facility does not name in-home care providers; by our reading, an agency’s procedures should not interfere with a caregiver’s report either. Telling the office first is fine as long as the caregiver still reports on time.
• Where. For care in the client’s own home, Adult Protective Services: DSS takes reports at 1-888-CARE4US (1-888-227-3487) or online. DSS, APS reports page, archived June 6, 2026 Incidents in facilities as the Act defines them go elsewhere. S.C. Code 43-35-25(D)(1)-(2)

"Knowingly and wilfully"

• Failing to report. "A person required to report under this chapter who knowingly and wilfully fails to report abuse, neglect, or exploitation is guilty of a misdemeanor", with a fine of up to $2,500 or up to a year in prison. S.C. Code 43-35-85(A) By our reading, the offense needs a knowing and wilful failure, not an honest mistake, but the Act does not define those words and we would not rely on the difference. Train caregivers to report whenever they have reason to believe, and to report when unsure.
• The harm itself. Knowingly and wilfully abusing, neglecting or exploiting a vulnerable adult is a felony, with up to five years in prison, and longer where it causes great bodily injury or death. S.C. Code 43-35-85(B)-(F)
• Getting in the way. Threatening or intimidating a vulnerable adult, a witness or anyone cooperating with an investigation, or wilfully and knowingly obstructing or impeding an investigation, is a misdemeanor with a fine of up to $5,000 or up to three years in prison. S.C. Code 43-35-85(G)-(H)
• Protection for reporters. A person who reports in good faith, or takes part in the investigation or a resulting court case, is immune from civil and criminal liability that might otherwise follow. S.C. Code 43-35-75(A) "It is against the public policy of South Carolina to change an employee’s status solely because the employee reports or cooperates with an investigation". S.C. Code 43-35-75(B)

Children

Non-medical caregivers are not on the list of mandated child abuse reporters, but anyone "may report, and is encouraged to report, in accordance with this section", to the county department of social services or a law enforcement agency. S.C. Code 63-7-310(D)-(E) For mandated child abuse reporters, such as nurses, knowingly failing to report is a misdemeanor with a fine of up to $500, up to six months in prison, or both. S.C. Code 63-7-410 R.60-122 still requires the provider to report allegations involving clients to Child Protective Services as appropriate. R.60-122 §501.D

Complaints about a licensed provider go to DPH’s online form or 1-800-922-6735. DPH, File a Complaint A complaint can lead to an investigation, which DPH can make at a licensed or unlicensed provider. R.60-122 §102.M

R.60-122 has no complaints section, and the client rights list does not mention DPH’s line. Giving clients DPH’s number and your own complaints procedure is our suggestion, not a rule. DPH, File a Complaint Medicaid personal care adds its own complaint information duties through SCDHHS: see Medicaid personal care.