Charleston Senior AdvisorWho licenses and inspects nursing homes around Charleston?
DPH's Healthcare Quality office licenses every South Carolina nursing home and, acting as the state survey agency, performs the federal inspections that allow a home to bill Medicare and Medicaid; DPH lists 19 licensed nursing homes in the three counties with 2,115 licensed beds, and CMS rates 18 of them, 9 at four or five stars overall (Care Compare data as of October 1, 2026).
A DPH license is what makes operating legal. CMS certification is technically separate, but nearly every Lowcountry nursing home is certified because Medicare and Medicaid pay for most nursing home days. A home that is licensed but not matched to CMS data appears on our roster without star ratings.
How are certified nursing homes inspected?
Each certified home gets an unannounced standard health inspection roughly once a year plus complaint investigations, carried out by DPH surveyors under federal rules, and every deficiency cited is published on CMS Care Compare.
CMS combines three years of inspection results with staffing data and quality measures to produce ratings from one to five stars, with health inspections weighted most heavily. Homes with persistent serious problems can be placed in CMS's Special Focus Facility program and inspected more often; our pages note any Lowcountry home on that list.
What do CMS star ratings capture, and what do they leave out?
The overall rating blends health inspection results, nurse staffing hours from payroll records and quality measures such as falls, pressure injuries and rehospitalizations; it says nothing about food, activities, how a hall feels at night or how well a home communicates with families.
Use the stars to narrow the list and to sharpen questions, not as the final word. A four-star home with high turnover and a recent abuse citation can be a worse fit than a three-star home with a stable night crew. Each of our nursing home pages puts staffing hours and turnover beside the tri-county middle value so those differences show.
Can DPH penalize a nursing home separately from CMS?
Yes. Alongside federal fines and payment denials imposed through CMS, DPH can take its own enforcement action against a licensed nursing home, and those administrative and consent orders appear in its monthly Healthcare Quality enforcement reports.
Federal penalties appear on Care Compare for a three-year window; state orders appear only in DPH's reports. Our nursing home pages show both: CMS's penalty count and any DPH order we matched since January 2025.
Do any Lowcountry campuses combine nursing care and assisted living?
Yes. Several retirement campuses in the tri-county area hold both a DPH nursing home license and a CRCF license at the same address, which lets residents move between assisted living and nursing care, or go to rehab and return, without leaving the community.
Our facility pages flag those shared addresses. Continuing care campuses often charge an entrance fee and give their own residents first claim on nursing beds. Ask whether the nursing beds are reserved for residents, what happens if none is open, and how the monthly fee changes when a resident moves from one license to the other.
Side by side
| A nursing home's record includes | A nursing home's record does not include | |
|---|---|---|
| License | A DPH nursing home license and bed count | A CRCF license (that is separate) |
| Federal data | CMS stars, inspections, staffing and fines | Ratings invented by websites |
| State data | DPH administrative and consent orders | Every complaint ever made |
| Emergency rules | Federal emergency preparedness requirements (42 CFR 483.73) | A guarantee residents stay put in a storm |
Sources: S.C. Code Regs. 60-84, DPH Healthcare Quality, SCDHHS bulletins and charts, CareScout, CMS and VA rate tables, as cited in each answer. See our editorial standards.
