RESIDENTIAL CARE SERVICES PROVIDER IN SOUTH CAROLINA

SUPPORTING INDEPENDENT LIVING IN COMMUNITY-BASED HOMES FOR INDIVIDUALS WITH DISABILITIES, BEHAVIORAL NEEDS, OR AGING-RELATED SUPPORT REQUIREMENTS

Residential Care Services in South Carolina provide 24-hour support and supervision in non-institutional, home-like settings for individuals who are unable to live independently due to intellectual or developmental disabilities (IDD), behavioral health conditions, or age-related limitations. These services are authorized through Medicaid HCBS Waivers managed by the South Carolina Department of Disabilities and Special Needs (DDSN) and other specialized programs under SCDHHS.

1. GOVERNING AGENCIES

Agency: South Carolina Department of Disabilities and Special Needs (DDSN)

Role: Oversees residential supports for individuals with IDD, autism, and related conditions, including provider approval and compliance.

Agency: South Carolina Department of Health and Human Services (SCDHHS)

Role: Administers Medicaid and HCBS Waivers, funds residential habilitation and community living programs.

Agency: South Carolina Department of Health and Environmental Control (DHEC)**

Role: Licenses Community Residential Care Facilities (CRCFs) and monitors facility safety and sanitation.

Agency: Centers for Medicare & Medicaid Services (CMS)**

Role: Sets federal guidelines for residential HCBS settings and person-centered care delivery.

2. RESIDENTIAL CARE SERVICES OVERVIEW

Residential care includes structured living environments where individuals receive supervision, assistance with daily living, and community integration opportunities.

Approved providers may deliver:

• Residential Habilitation: Skill-building and ADL support in group homes or supervised apartments.

• 24-Hour Supervision & Safety Monitoring

• Medication Assistance & Health Coordination

• Meals, Transportation & Housekeeping Support

• Community Integration & Social Skill Development

• Behavioral Support (if authorized by waiver or care plan)

• Documentation: ISP progress notes, shift logs, incident reports, and Medicaid billing records.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register your business with the SC Secretary of State.

• Obtain EIN and Type 2 NPI.

• Apply for DHEC licensure if operating a Community Residential Care Facility (CRCF).

• Apply through DDSN for residential provider approval and service authorization.

• Enroll with SCDHHS as a Medicaid provider for residential habilitation.

• Maintain liability insurance, staffing plan, and emergency preparedness systems.

• Develop a Residential Care Services Policy & Procedure Manual addressing supervision, ADLs, health coordination, and participant rights.

4. SOUTH CAROLINA PROVIDER ENROLLMENT PROCESS

Step 1: Register business, obtain EIN/NPI, and apply for DHEC licensure.

Step 2: Submit provider application to DDSN for residential habilitation approval.

Step 3: Enroll with SCDHHS as a Medicaid waiver provider.

Step 4: Complete facility inspections, staffing credential checks, and program readiness reviews.

Step 5: Begin accepting residents upon service plan authorization and referral.

5. REQUIRED DOCUMENTATION

• Articles of Incorporation, EIN, and NPI

• DHEC CRCF license (if required)

• DDSN provider approval documentation

• Medicaid enrollment confirmation

• Staff background checks and training logs

• Residential Care Services Policy & Procedure Manual including:

  • Daily living support protocols

  • Medication administration and health coordination

  • Behavioral support procedures (if applicable)

  • Staff-to-client ratio standards

  • Emergency, fire safety, and infection control policies

  • Incident response, quality assurance, and documentation tools

6. STAFFING REQUIREMENTS

Role: Residential Direct Support Professional (DSP)

Requirements: High school diploma/GED, background check, CPR/First Aid, abuse prevention training.

Role: House Manager or Program Supervisor

Requirements: Supervisory experience in residential care, DDSN/Medicaid compliance training.

Role: Registered Nurse (if required by plan)

Requirements: Active SC license, assists with medication administration and health plans.

All staff must complete:

• Person-centered planning training

• HIPAA and participant rights education

• Crisis intervention and behavioral de-escalation (if applicable)

• Fire safety, emergency response, and infection control

• Ongoing in-service training and annual skills review

7. MEDICAID WAIVER PROGRAMS

Residential Care Services are authorized through:

• ID/RD Waiver – For individuals with intellectual or related developmental disabilities

• Community Supports Waiver – May cover limited residential respite

• HASCI Waiver – For individuals with head or spinal cord injuries needing residential habilitation

• CLTC (Community Long Term Care) – Includes some supervised living or group home models for seniors

• State-Only DDSN Placements – For individuals not eligible for waiver but needing residential services

8. TIMELINE TO LAUNCH

Phase: Business Registration & Policy Manual Creation

Timeline: 1–2 months

Phase: DHEC Licensing & DDSN Provider Approval

Timeline: 2–4 months

Phase: Staff Hiring, Facility Setup & Medicaid Enrollment

Timeline: 2–3 months

Phase: Begin Accepting Residents

Timeline: Once all licenses, enrollments, and inspections are approved

9. CONTACT INFORMATION

South Carolina Department of Disabilities and Special Needs (DDSN)

Website: https://ddsn.sc.gov

South Carolina Department of Health and Human Services (SCDHHS)

Website: https://www.scdhhs.gov

South Carolina Department of Health and Environmental Control (DHEC)

CRCF Licensing: https://scdhec.gov

Centers for Medicare & Medicaid Services (CMS)

Website: https://www.cms.gov

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — SOUTH CAROLINA RESIDENTIAL CARE PROVIDER

WCG provides comprehensive support to agencies establishing residential habilitation services that comply with Medicaid, DDSN, and DHEC standards.

Scope of Work:

• Facility and program licensing with DHEC and DDSN

• Medicaid provider enrollment and compliance documentation

• Residential Care Policy & Procedure Manual development

• Staff onboarding and annual training trackers

• Incident response tools and documentation systems

• Participant rights materials and emergency preparedness plans

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