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South Carolina · education only

Starting a home care agency in South Carolina

If you want to start a non-medical home care agency in South Carolina, you are usually looking at an In-Home Care Provider license from the South Carolina Department of Public Health (DPH) (DPH, In-Home Care Providers, checked on 2026-10-13). That license is separate from forming a company, buying insurance, hiring caregivers, or enrolling with Medicaid. This page walks through the main steps, the licensing body, and the timeline categories that actually appear in official sources — with a citation after every factual claim.

It is not legal, tax, employment, or regulatory advice. DPH will not issue an initial license until the applicant has shown substantial compliance with the licensing standards (S.C. Code of Regulations R.60-122, checked on 2026-10-13). Nothing here promises approval, enrollment, or a calendar-day processing time. Verify every requirement on the official pages before you apply, hire, bill, or advertise.

Who licenses home care in South Carolina

For non-medical in-home care, the licensing body is DPH Healthcare Quality. DPH's In-Home Care Providers page names the current regulation as Regulation 60-122, Standards for Licensing In-Home Care Providers, the statute as the Licensure of In-Home Care Providers Act (S.C. Code § 44-70-10 et seq.), and the direct-care background-check statute as S.C. Code § 44-7-2910 et seq. (DPH, In-Home Care Providers, checked on 2026-10-13) The application form is DPH 1307. (DPH, Healthcare Facilities Licensing Forms, checked on 2026-10-13)

Healthcare licensing used to sit at the Department of Health and Environmental Control (DHEC). Under Act 60, DHEC split on July 1, 2024 into the Department of Public Health and the Department of Environmental Services. DPH's restructuring page says existing regulations stayed in effect and that DPH updates healthcare licenses at renewal. (DPH, DHEC Restructuring, checked on 2026-10-13) The 2011 statute still defines "Department" as DHEC (S.C. Code of Laws, Title 44, Chapter 70, checked on 2026-10-13), but the current text of R.60-122 defines "Department" as the South Carolina Department of Public Health. (S.C. Code of Regulations R.60-122, checked on 2026-10-13) Use DPH as the agency you contact today.

R.60-122 applies to all in-home care providers in South Carolina. It defines in-home care as help with activities of daily living or a personal rather than medical need — walking, getting in and out of bed, bathing, dressing, feeding, using the toilet, preparing special diets, and supervising self-administered medication — and not skilled care or a specific therapy for an illness or injury. (S.C. Code of Regulations R.60-122, checked on 2026-10-13) The same definition appears in S.C. Code § 44-70-20. (S.C. Code of Laws, Title 44, Chapter 70, checked on 2026-10-13)

An in-home care provider is a business that, for compensation, provides those services through employees, contractors, or paid referrals. The definition excludes home health agencies, hospices, and other entities licensed under S.C. Code § 44-7-260; agencies that provide only house cleaning; individuals hired directly by the client or the client's family; and certain churches that provide care without compensation. (S.C. Code of Regulations R.60-122, checked on 2026-10-13) (S.C. Code of Laws, Title 44, Chapter 70, checked on 2026-10-13) Skilled home health is a different license under R.60-77. (S.C. Code of Regulations R.60-77, checked on 2026-10-13) If you are still choosing a model, start with non-medical home care vs. home health.

The main steps

These are the workstreams official SC sources describe. They overlap. Licensing does not replace Medicaid enrollment, and forming a company does not replace a DPH license.

  1. Decide what you will actually offer. In-home care under R.60-122 is limited to non-medical tasks such as meals, bathing, dressing, transfers, housekeeping, errands, transportation, and medication reminders. Caregivers may not provide skilled care. (S.C. Code of Regulations R.60-122, checked on 2026-10-13) If you want nursing or therapy billed as home health, you are on the R.60-77 path instead. (S.C. Code of Regulations R.60-77, checked on 2026-10-13)
  2. Form the legal entity. The South Carolina Secretary of State administers filings for corporations, nonprofit corporations, LLCs, limited partnerships, and limited liability partnerships under Title 33. Sole proprietorships and general partnerships do not file with that office. (S.C. Secretary of State, Business Entities, checked on 2026-10-13) Ask a lawyer or CPA which entity you should use. This site does not pick one for you, and we do not quote a Secretary of State fee here because the fee depends on the form you file.
  3. Set up an in-state primary office. R.60-122 requires at least one in-state office as the primary office, in a commercially zoned or unzoned area, with a county or municipal zoning permit — or, in an unzoned area, a letter from the county or municipality saying a provider may operate from that location. Additional sites must be registered with DPH before you use them. (S.C. Code of Regulations R.60-122, checked on 2026-10-13)
  4. Put the required insurance in place. Before an initial license, the application must include evidence of (1) liability insurance or a surety bond of at least $100,000 per occurrence and $300,000 aggregate, (2) indemnity coverage for injuries and losses from the services provided, and (3) workers' compensation insurance under S.C. Code § 42-5-10 et seq. Coverage must last for the license period. (S.C. Code of Regulations R.60-122, checked on 2026-10-13) Talk through the types with a licensed broker using our insurance questions. See also startup budget categories.
  5. Complete applicant screening. The people who must sign the license application have to undergo a SLED name-based criminal records check that is not older than 90 calendar days when DPH receives it, and a five-panel drug screen taken no earlier than 30 days before DPH receives the application. Certain convictions bar a license. The same people, and later caregivers, are also subject to random drug testing. (S.C. Code of Regulations R.60-122, checked on 2026-10-13) (S.C. Code of Laws, Title 44, Chapter 70, checked on 2026-10-13)
  6. Write the policies DPH will look for. The application must include the provider's random drug-testing policy. (S.C. Code of Regulations R.60-122, checked on 2026-10-13) R.60-122 also requires written policies covering each section of the regulation, an administrator, staff records, training before client contact, client records, incident reporting, infection control, client rights, and a disaster plan. (S.C. Code of Regulations R.60-122, checked on 2026-10-13)
  7. File the DPH application and pay the license fee. Use the In-Home Care Provider application (DPH 1307) from DPH's licensure forms page. (DPH, Healthcare Facilities Licensing Forms, checked on 2026-10-13) R.60-122 sets the initial license fee at $1,000 and the annual renewal fee at $800. Fees are paid to the Department through a secured portal or specified website and are not refundable, except that a denied application may receive a partial refund based on remaining months of the licensure year. (S.C. Code of Regulations R.60-122, checked on 2026-10-13) DPH's FY 2025 Fees and Fines Report lists the same amounts, plus a $50 amendment fee, a $400 reinstatement fee for a suspended license, and a $200 late fee. (DPH, FY 2025 Fees and Fines Report, checked on 2026-10-13)
  8. Do not operate or advertise until you are licensed. No person or organization may establish, operate, maintain, or represent itself — including advertising or marketing — as an in-home care provider in South Carolina without first obtaining a license. (S.C. Code of Regulations R.60-122, checked on 2026-10-13) S.C. Code § 44-70-30 requires the provider to apply for and obtain a license that is effective for a period the department determines. (S.C. Code of Laws, Title 44, Chapter 70, checked on 2026-10-13) The license is not transferable or assignable. (S.C. Code of Laws, Title 44, Chapter 70, checked on 2026-10-13)
  9. Hire caregivers only after their own checks. Before employment as an in-home caregiver, a person must undergo a criminal record check under S.C. Code § 44-7-2910 and a drug test. (S.C. Code of Laws, Title 44, Chapter 70, checked on 2026-10-13) R.60-122 also sets minimum caregiver qualifications (including age 18, communication, and disqualifying convictions) and requires listed training before client contact and at least annually after that. (S.C. Code of Regulations R.60-122, checked on 2026-10-13) See writing a caregiver job post and hiring process.
  10. Treat Medicaid as a separate project. A DPH license is not Medicaid enrollment. SCDHHS says providers must be licensed by the appropriate body, complete an online enrollment application, and receive official notification of enrollment before participating. (SCDHHS, Become a Provider, checked on 2026-10-13) Read how Medicaid waivers work and how waiver provider enrollment generally works.

Timeline categories — what official sources actually time

R.60-122 does not publish a fixed number of days for DPH to issue an initial In-Home Care Provider license. We are not going to invent one. The regulation does give clocks for screening, renewal, and some operating tasks. Use those as categories, not as a promise of how long your file will sit.

CategoryWhat official sources say
Entity and officeFile the entity with the Secretary of State if your structure requires it, then secure the in-state primary office and zoning documentation R.60-122 requires before you apply. (S.C. Secretary of State, Business Entities, checked on 2026-10-13) (S.C. Code of Regulations R.60-122, checked on 2026-10-13)
Insurance and bondingLiability or surety ($100,000 / $300,000), indemnity, and workers' compensation evidence must accompany the initial application and stay in force for the license period. (S.C. Code of Regulations R.60-122, checked on 2026-10-13)
Applicant screening windowThe SLED check may not be older than 90 calendar days when DPH receives it. The drug screen may not be taken earlier than 30 days before DPH receives the application. (S.C. Code of Regulations R.60-122, checked on 2026-10-13)
Application and compliance reviewDPH will not issue an initial license until the applicant has demonstrated substantial compliance. The license is then valid for a period specified by the Department. R.60-122 does not state a processing-day count. (S.C. Code of Regulations R.60-122, checked on 2026-10-13) (S.C. Code of Laws, Title 44, Chapter 70, checked on 2026-10-13)
License term and renewalAnnual renewal is $800. Missing the expiration date adds a $200 late fee. Missing the renewal application, licensing fee, and late fee for 30 days after expiration renders the provider unlicensed. (S.C. Code of Regulations R.60-122, checked on 2026-10-13)
Medicaid enrollment (separate)SCDHHS enrollment is a later, separate process. An in-process online application must be submitted within 30 days or it is purged and you start over. Do not bill until you have official enrollment notification. (SCDHHS, Become a Provider, checked on 2026-10-13)
First-client operationsCaregiver training listed in R.60-122 must happen before client contact. After services start, the care services plan must be completed within seven business days. (S.C. Code of Regulations R.60-122, checked on 2026-10-13) If a payer requires electronic visit verification, see EVV basics.

Key pages on this site

The guides below are free. Use them to organize research after you have the official DPH and SCDHHS pages open.

Three things worth knowing early

  1. Licensing, Medicaid enrollment, and payer contracts are different steps. Getting one doesn't give you the others.
  2. South Carolina's definitions decide the license. Other states' blog posts, fees, and timelines do not apply here.
  3. Advisors still matter. A healthcare attorney, a CPA, and a licensed insurance broker will catch things no guide can.

Planning templates, if you want them

If you'd rather not build every checklist from a blank page, the Home Care / Medicaid Waiver Startup Pack ($199) is a download of editable templates organized around the same topics as our guides. It includes the owner ebook. It's for planning and organizing your own research. It doesn't contain state applications, and you'll still need your state's official forms and your advisors.

See what's in the Startup Pack →

Official sources used on this page

Every number and rule above was checked against the linked page or PDF on 2026-10-13. If a source changes, the official text controls.

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