How memory care is regulated in South Carolina

Is memory care a separate license in South Carolina?

No. A CRCF or nursing home that runs a secured dementia program is described in Regulation 60-84 as having an Alzheimer's Special Care Unit or Program, and DPH's licensing data carries a yes-or-no flag for it; there is no stand-alone memory care license.

Section 101.F defines the unit as a facility, or part of one, offering a secure, special program for residents with probable Alzheimer's disease or a related dementia, designed to prevent or limit their access outside the designated area, and promoted as specialized dementia care. On DPH's licensing data (as of November 6, 2026), 21 of the 56 senior-serving CRCFs in Charleston, Berkeley and Dorchester counties carry an Alzheimer's special care unit flag, 4 more report Alzheimer's care without a unit, and 1 of the 19 licensed nursing homes carry an Alzheimer's flag.

That flag is the best way to tell a secured program from a brochure phrase. “Memory care neighborhood” has no legal meaning by itself; the DPH flag does.

What must a Charleston memory care program disclose?

South Carolina's Alzheimer's Special Care Disclosure Act (S.C. Code 44-36-510 and following) requires any facility that offers or advertises special care for Alzheimer's disease or related dementia to explain in writing what makes that care special, so families can compare programs side by side.

Expect the disclosure to cover the program's philosophy, how residents are admitted, moved and discharged, care planning, staffing and dementia training, the physical setting and its security, the daily activity program and any charges above the basic assisted living rate. Regulation 60-84 also requires each CRCF's written policies to describe specialized services it offers, including an Alzheimer's unit (Section 401). Ask for the disclosure before you tour West Ashley, Mount Pleasant or Summerville programs, then hold each one to what it wrote.

How many staff must be on a secured dementia unit?

The general CRCF floor is all South Carolina requires: one staff member or direct-care volunteer for every eight residents, or fraction of eight, during peak hours, one for every 30 during non-peak hours, and someone awake and dressed at all times (Regulation 60-84, Section 503.B).

Those numbers apply to the whole building, not to the unit. A 30-bed secured wing inside a 120-bed community could legally share its overnight coverage with the rest of the building unless the operator staffs it separately. Ask how many people are physically inside the secured doors at 2 a.m., whether they are employees or agency staff, and who watches the hallway while that person helps someone in the bathroom. In multi-story buildings over 10 beds, a staff member must be available on every floor where residents are (Section 503.B.3).

What dementia training does the regulation require?

Before working with residents and at least once a year, CRCF staff must be trained in caring for residents with the conditions the facility accepts, including dementia, cognitive disability and aggressive or inappropriate behavior, covering communication methods such as cueing and mirroring, behavior management, safety and activities (Regulation 60-84, Section 504.A.5).

No minimum number of hours is set. Ask how many hours the program actually gives, who teaches it and whether night and weekend staff attend the same sessions. Ask too how staff respond to sundowning and exit-seeking without reaching for medication first, because behaviors, more than the diagnosis, decide how long someone can stay.

When must a memory care resident move to a nursing home?

A CRCF may not keep someone with serious aggressive or inappropriate behavior it cannot manage, someone totally dependent in every daily activity for more than 14 consecutive days, or someone who needs a licensed nurse's continuous daily attention, and it must arrange a transfer within 30 days once its care no longer meets the resident's needs (Regulation 60-84, Sections 801.D and 801.F).

A dementia diagnosis is not, by itself, a reason to discharge. Many residents remain in a secured unit into the late stages with hospice brought in. The 14-day dependency rule is the one families most often run into: if a resident is still totally dependent on the 15th day and not improving, the facility has to start a transfer plan. A few Lowcountry nursing homes also carry an Alzheimer's flag; see the memory care roster.