South Carolina - Personal Emergency Response System — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-10

The South Carolina Department of Health and Human Services (SCDHHS) directly enrolls vendors to provide Personal Emergency Response System (PERS) installation and monitoring across multiple 1915(c) waivers, including the Community Choices (CC) and Community Supports (CS) waivers. The state divides this service into two distinct billable components: PERS Installation and PERS Monitoring, both of which require the provider to maintain 24-hour response capabilities for waiver participants who live alone or are at risk of falls.

Because South Carolina does not issue a distinct facility or agency license for PERS through the Department of Health and Environmental Control (DHEC), the structural precondition for entry is securing an active Medicaid provider agreement through the SCDHHS Provider Enrollment Web Portal. For services delivered to participants in the Intellectual Disability/Related Disabilities (ID/RD) or Head and Spinal Cord Injury (HASCI) waivers, providers must also meet vendor qualifications established and monitored by the South Carolina Department of Disabilities and Special Needs (SCDDSN).

1. Service Definition and Scope

In South Carolina, the Personal Emergency Response System (PERS) is defined as an electronic device that enables waiver participants to secure help in an emergency. The service is explicitly non-habilitative and is designed to increase independence and community integration for individuals who live alone or are alone for significant parts of the day.

The service is divided into a one-time installation component and an ongoing monthly monitoring component. Providers must ensure that the device connects to a 24-hour call center or designated responder and must replace malfunctioning units within 24 hours of notification.

• Service Components: Divided into PERS Installation and PERS Monitoring.
• Target Population: Individuals ages 65 or older, and individuals with physical or developmental disabilities who meet nursing facility or ICF/IID level of care.
• Waiver Availability: Covered under the Community Choices (CC), Community Supports (CS), ID/RD, and HASCI waivers.
• Response Requirement: Must provide 24/7 response to device signals.
• Maintenance Standard: Malfunctioning devices must be replaced within 24 hours of notification.
• Setting Limitations: Cannot be authorized for participants receiving Residential Habilitation or living in provider-controlled settings without a specific transition plan.

2. Regulatory and Oversight Agencies

SCDHHS serves as the State Medicaid Agency and retains administrative authority over all HCBS waivers in South Carolina. It directly operates the Community Choices waiver and manages the provider enrollment process.

SCDDSN operates the ID/RD, Community Supports, and HASCI waivers under an administrative contract with SCDHHS. SCDDSN utilizes a contracted Quality Improvement Organization (QIO) to conduct annual compliance reviews for its network providers.

• Administrative Authority: South Carolina Department of Health and Human Services (SCDHHS) (https://www.scdhhs.gov).
• Operating Authority (DD Waivers): South Carolina Department of Disabilities and Special Needs (SCDDSN) (https://ddsn.sc.gov).
• Enrollment Portal: SCDHHS Provider Enrollment Web Portal (https://providerservices.scdhhs.gov/ProviderEnrollmentWeb).
• Quality Assurance: SCDHHS Office of Waivers and Facility Services conducts periodic QA reviews.
• Compliance Monitoring: SCDDSN contracted QIO performs annual licensing and certification reviews.

3. Gatekeeping Prerequisites: Who Can Even Apply

South Carolina does not require a Certificate of Need (CON) or a specific DHEC facility license to operate as a PERS provider. There are no closed networks or moratoria currently blocking new PERS vendor applications.

The primary structural prerequisite is that the applicant must be a legally established business entity capable of obtaining a National Provider Identifier (NPI) and an Employer Identification Number (EIN). For SCDDSN-operated waivers, the provider must be approved as a qualified vendor by SCDDSN before rendering services to those specific waiver populations.

• Certificate of Need: Not required for PERS providers in South Carolina.
• DHEC Licensure: Genuinely none exists; PERS is not a licensed facility type in SC.
• Business Registration: Must have a valid EIN and be registered to do business in South Carolina.
• NPI Requirement: Must obtain a National Provider Identifier (NPI) prior to Medicaid enrollment.
• SCDDSN Vendor Approval: Required as a prerequisite for serving participants in the ID/RD, CS, and HASCI waivers.
• Managed Care Contracting: Not strictly required for fee-for-service waiver enrollment, but necessary if serving Healthy Connections PRIME members.

4. Licensure and Certification Requirements

Because South Carolina does not have a distinct statutory license for PERS agencies, providers are approved through the Medicaid enrollment and waiver certification process rather than a traditional DHEC licensure track.

Providers must continuously meet the standards outlined in the SCDHHS Home and Community Based Services Provider Manual. This includes maintaining the technical infrastructure to support 24/7 monitoring and adhering to HCBS Settings Rule requirements where applicable.

• State License: No specific DHEC license exists for PERS.
• Certification Standard: Must meet qualifications outlined in the SCDHHS HCBS Provider Manual.
• Technical Capability: Must demonstrate the ability to maintain 24/7 call center operations.
• HCBS Settings Compliance: Must comply with 42 CFR 441.301(c)(4) regarding community integration.
• Out-of-State Providers: May enroll if they hold equivalent business licenses in their home state and meet SC Medicaid standards.

5. Medicaid Provider Enrollment

Prospective PERS providers must submit an application through the SCDHHS Provider Enrollment Web Portal. The process includes screening, verification of business credentials, and execution of the Medicaid provider agreement.

PERS providers typically enroll as atypical providers or standard vendors depending on their exact corporate structure. The enrollment process requires submission of the entity's EIN, NPI, and a completed W-9.

• Application System: SCDHHS Provider Enrollment Web Portal.
• Provider Type: Enrolled as an Organization/Vendor.
• Required Identifiers: Must submit Employer Identification Number (EIN) and NPI.
• Screening Process: Subject to standard Medicaid provider screening, including exclusion database checks.
• Agreement Execution: Must sign the South Carolina Medicaid Provider Agreement.
• Revalidation: Required to revalidate enrollment periodically as directed by SCDHHS.

6. Staffing, Training and Background Checks

While PERS is primarily an equipment and monitoring service, the staff responsible for installation and call center operations must meet basic competency and background check requirements. Relatives, legal guardians, or legally responsible individuals cannot be paid to provide PERS.

Installers must be trained to instruct the participant on how to use the device. Call center staff must be trained in emergency response protocols and universal precautions.

• Background Checks: All personnel interacting with participants must pass state and national criminal background checks.
• Exclusion Checks: Must verify staff are not on the OIG List of Excluded Individuals/Entities (LEIE).
• Installer Training: Must be capable of providing instruction to the participant on device usage.
• Call Center Staffing: Must maintain sufficient staffing to ensure 24/7 response capabilities.
• Prohibited Providers: Cannot be provided by a relative, Legal Guardian, or Legally Responsible Individual.
• Ongoing Training: Must complete DHHS or SCDDSN trainings upon request.

7. Documentation, Policies and Records

PERS providers must maintain comprehensive records demonstrating service delivery and equipment maintenance. All services must be documented in the participant's Person-Centered Plan (PCP) prior to installation.

Providers are required to keep logs of monthly device testing and must update the participant's list of responders and contact names at least twice a year.

• Delivery Verification: Must obtain the participant's or authorized representative's signature verifying receipt of the PERS unit.
• Testing Logs: Must document monthly testing of the PERS device.
• Responder Updates: Must update the list of responders and contact names at least twice a year.
• Maintenance Records: Must log all equipment malfunctions and document replacement within 24 hours.
• Record Retention: Must retain all service and billing records for a minimum of five years.
• Person-Centered Plan: Services must align with the authorized PCP generated by the waiver case manager.

8. Billing, Rates and Claims

PERS is reimbursed through the South Carolina Medicaid MMIS using specific procedure codes for installation and monthly monitoring. Services must be prior-authorized by the participant's waiver case manager.

Providers cannot charge Medicaid more than their customary charge to the general public. If a vendor offers a discount to a specific demographic (e.g., senior citizens), that same discount must be applied to Medicaid participants in that group.

• Billing System: Claims are submitted through the SCDHHS Web Tool or via EDI to the MMIS.
• Installation Code: Billed as a one-time installation fee (procedure code specified in the HCBS manual).
• Monitoring Code: Billed as a monthly rental/monitoring fee.
• Prior Authorization: Required from the waiver case manager before services can be billed.
• Rate Limitation: Cannot charge Medicaid more than the rate offered to the general public.
• Budget Limits: Must be purchased within the participant's annual individual waiver budget amount.

9. Approval Sequence and Timeline

The approval sequence begins with establishing the business entity and obtaining an NPI. The provider then submits the Medicaid enrollment application through the SCDHHS portal.

Once the application is submitted, SCDHHS conducts its screening and verification process. If applying to serve SCDDSN waiver participants, the provider must concurrently or subsequently complete the SCDDSN vendor approval process.

• Step 1: Obtain EIN and NPI for the business entity.
• Step 2: Submit application via the SCDHHS Provider Enrollment Web Portal.
• Step 3: Undergo SCDHHS screening and background checks (typically 30-60 days).
• Step 4: Receive official notification of Medicaid enrollment and provider number.
• Step 5: (If applicable) Complete SCDDSN vendor qualification review.
• Step 6: Receive authorizations from case managers and begin service delivery.

10. Common Denials and Survey Findings

Medicaid enrollment applications for PERS are most frequently delayed or denied due to incomplete documentation, such as missing W-9 forms or mismatched EIN/NPI data. Failure to respond to requests for additional information within the specified timeframe will result in application rejection.

During QA reviews, common findings include failure to document monthly device testing, failure to update responder lists bi-annually, and failure to replace malfunctioning units within the required 24-hour window.

• Enrollment Denial: Mismatched tax information or failure to provide a valid NPI.
• Application Rejection: Failure to respond to SCDHHS requests for clarification within 30 days.
• Survey Finding: Missing participant signatures verifying initial receipt of the PERS unit.
• Survey Finding: Lack of documentation proving monthly testing of the devices.
• Survey Finding: Outdated responder contact lists (not updated twice a year).
• Contract Action: Failure to replace broken devices within 24 hours of notification.

11. Key Contacts and Resources

Providers should utilize the SCDHHS Provider Service Center for questions regarding enrollment and billing. The SCDHHS website hosts the HCBS Provider Manual and official Medicaid bulletins.

For providers seeking to serve the ID/RD, CS, or HASCI waivers, the SCDDSN website provides directives, standards, and vendor qualification information.

• SCDHHS Provider Enrollment: https://providerservices.scdhhs.gov/ProviderEnrollmentWeb
• SCDHHS Provider Service Center: (888) 289-0709
• SCDHHS Main Website: https://www.scdhhs.gov
• SCDDSN Main Website: https://ddsn.sc.gov
• HCBS Provider Manual: Available via the SCDHHS provider portal and publications library.
• Healthy Connections PRIME: Information available via SCDHHS for managed care contracting.

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