HomeCareAtlas Team · Updated November 2026
Researched from primary state regulatory sources.
How to Start a Home Care Agency in South Carolina
Starting a home care agency in South Carolina costs roughly $40,000 - $75,000 and takes 60-120 Days. Here's every step, fee, and deadline — sourced directly from South Carolina Department of Public Health (SC DPH, Bureau of Health Facilities Licensing).
South Carolina licenses non-medical home care under the In-Home Care Providers Act (S.C. Code 44-70-10 and after) and Regulation 60-122. DPH took over this job from DHEC on July 1, 2024. The rule was renumbered from 61-122 to 60-122 in 2025. Its content was updated in May 2026. Any business that gives or arranges in-home care for pay needs this license. The first license costs $1,000. Renewal is $800 a year. Your main office must be in South Carolina, in a commercial or unzoned area.
To start a non-medical home care agency in South Carolina, you need a In-Home Care Provider License from the South Carolina Department of Public Health (SC DPH, Bureau of Health Facilities Licensing). The application fee is $1,000 ($1,000 first license ($800 yearly renewal)), the process takes approximately 60-120 days, and total startup costs range from $40,000 - $75,000. You need an In-Home Care Provider License from SC DPH ($1,000, then $800 a year). Every caregiver needs a criminal background check and a drug test before starting.
- License Required
- Yes — In-Home Care Provider License
- Regulatory Body
- South Carolina Department of Public Health (SC DPH, Bureau of Health Facilities Licensing)
- Application Fee
- $1,000 ($1,000 first license ($800 yearly renewal))
- Timeline
- 60-120 Days (our estimate, application to license)
- Total Startup Cost
- $40,000 - $75,000
- Key Requirement
- You need an In-Home Care Provider License from SC DPH ($1,000, then $800 a year). Every caregiver needs a criminal background check and a drug test before starting.
- Last Verified
- November 2026 against South Carolina Department of Public Health (SC DPH, Bureau of Health Facilities Licensing) regulations
$1,000 First License ($800 Yearly Renewal)
Source: Reg. 60-122 §103.I · Checked Oct 2026
Our Estimate, Application to License
This is our best guess. Check with the South Carolina Department of Public Health (SC DPH, Bureau of Health Facilities Licensing).
Residents Age 70+
Competitive Market
How South Carolina compares to neighboring states
| State | License Fee | Timeline | Startup Cost |
|---|---|---|---|
| South Carolina ← | $1,000 | 60-120 Days | $40,000 - $75,000 |
| North Carolina | $510 | 8-14 Weeks | $50,000 - $90,000 |
| Georgia | $550 | 2-4 Months | $30,000 - $65,000 |
South Carolina Licensing Overview
The South Carolina Department of Public Health (SC DPH, Bureau of Health Facilities Licensing) oversees all non-medical agencies.South Carolina licenses non-medical home care under the In-Home Care Providers Act (S.C. Code 44-70-10 and after) and Regulation 60-122. DPH took over this job from DHEC on July 1, 2024. The rule was renumbered from 61-122 to 60-122 in 2025. Its content was updated in May 2026. Any business that gives or arranges in-home care for pay needs this license. The first license costs $1,000. Renewal is $800 a year. Your main office must be in South Carolina, in a commercial or unzoned area.
In-Home Care Provider License (Regulation 60-122)
Any business that gives or arranges in-home care for pay needs this license from SC DPH. The rule is 60-122 (the old number was 61-122). A few groups are left out, like house-cleaning-only services and home health agencies (S.C. Code 44-70-20). Ask DPH if you are not sure.
SLED Background Checks + Drug Tests
Every caregiver needs a criminal background check under S.C. Code 44-70-60(B) and 44-7-2910 before they start. They also need a 5-panel drug test before hire. Random drug tests follow. Owners who sign the application need a SLED check and a drug test too.
Insurance & Workers' Comp
You need liability insurance of at least $100,000 per occurrence and $300,000 total. A surety bond for the same amount can be used in place of that insurance (Reg. 60-122 §302.A). You also need coverage that pays clients for losses, and workers' comp (S.C. Code 42-5-10).
A Real Office in a Business Zone
Your main office must be in South Carolina. It must be in a commercial or unzoned area. Get a county or city zoning permit, or a letter if the area is unzoned (Reg. 60-122 §103.D). Extra locations must be registered with DPH first.
Estimated Startup Costs (2026)
Budget for $40,000 - $75,000 to ensure 3-6 months of runway.
| Category | Low Est. | High Est. |
|---|---|---|
| DPH first license fee ($800 yearly renewal) | $1,000 | $1,000 |
| Business formation (LLC with Secretary of State) | $110 | $500 |
| Liability insurance (min $100K/$300K) — estimate | $1,500 | $4,000 |
| Professional liability insurance (estimate) | $800 | $2,500 |
| Workers' comp insurance (estimate) | $800 | $2,500 |
| SLED background checks & drug tests (first staff) | $300 | $1,200 |
| Policies & procedures | $1,500 | $4,000 |
| Office space & zoning permit | $1,500 | $5,000 |
| Training program | $500 | $2,000 |
| Technology & software | $1,000 | $3,000 |
| Marketing & branding | $2,000 | $8,000 |
| Working capital (3-6 months) | $15,000 | $35,000 |
We map every cost and file your South Carolina license for you.
South Carolina In-Home Care Provider Licensing Timeline
1-2 Weeks
Register your business & pick your services
Register your LLC or corporation with the South Carolina Secretary of State. Get your EIN from the IRS and set up state tax accounts. List the services you will offer. Your name cannot match or look like another licensed provider. Franchise locations must add their area to the name (Reg. 60-122 §103.E).
1-3 Weeks
Find an office in the right zone
Rent an office in South Carolina in a commercial or unzoned area. Get a county or city zoning permit. If the area has no zoning, get a letter from the county or city saying you can run a provider there (Reg. 60-122 §103.D).
3-4 Weeks
Write policies & procedures
Write a full policy manual. Cover client rights, care plans, fees, emergencies, hiring, training, random drug tests, abuse and incident reports, and records. It must follow the In-Home Care Providers Act and Regulation 60-122. Review your policies at least every two years.
2-3 Weeks
Get insurance, background checks & drug tests
Get liability insurance (at least $100,000/$300,000) or a surety bond in its place. Add coverage that pays clients for losses, and workers' comp. Each owner who signs the application needs a SLED name-based check from the last 90 days. They also need a 5-panel drug test taken within 30 days before DPH gets the application.
1-2 Weeks
Send your application to SC DPH
Email your application to [email protected] (DPH's preferred way). Or mail it to the Bureau of Health Facilities Licensing, P.O. Box 2046, West Columbia, SC 29171. Pay the $1,000 fee through the DPH payment portal and include proof of payment. Attach insurance proof, owner checks, drug test results, and your random drug test policy. Questions: 803-545-4370 (DPH form 1307).
6-12 Weeks
DPH review & license
DPH reviews your file against S.C. Code 44-70 and Regulation 60-122. DPH can inspect at any time without notice. Fix any problems fast. Once approved, you get your license. Renew every year for $800. A late renewal costs $200 more.
2-4 Weeks
Hire staff, train, and open
Hire caregivers who are 18 or older. Finish background checks, drug tests, and health self-checks before any client contact. Give the required training first. Set up scheduling, billing, and records. Get to know hospitals, rehab centers, and senior communities.
We can do all of them for you in South Carolina.
New 2026 Legal Mandates
In-Home Care Providers Act (S.C. Code 44-70-10 and after)
Ongoing - The state law for in-home care providers. It sets the license rule, background checks and drug tests (44-70-60), and random drug tests (44-70-70).
Regulation 60-122 (Standards for Licensing In-Home Care Providers)
Updated 2026 - The DPH rule for in-home care. It was numbered 61-122 under DHEC. It was renumbered in 2025 and updated in May 2026. It covers fees, insurance, staff, training, records, reports, and fines.
Caregiver Background Checks (S.C. Code 44-70-60 and 44-7-2910)
Ongoing - Every caregiver must pass a criminal background check before starting work. Also check the Sex Offender Registry and the Nurse Aide Registry. Some crimes bar hiring. These include abuse of a vulnerable adult, violent crimes, and theft or drug crimes in the last 10 years (Reg. 60-122 §405).
Drug Tests Before Hire and at Random (S.C. Code 44-70-60 and 44-70-70)
Ongoing - Caregivers need a 5-panel drug test before hire. Owners who signed the application and caregivers get random drug tests after that. Your policies must say how you pick people for random tests.
Training Before Client Contact and Every Year
Ongoing - Caregivers must be trained before client contact and at least once a year (Reg. 60-122 §404). Topics: first aid, dementia or disability care as needed, privacy, records, ethics, lifting and transfers, infection control, and abuse prevention. There is no set hour count. Keep signed training records.
Insurance Minimums (Reg. 60-122 §302)
Ongoing - Liability insurance of at least $100,000 per occurrence and $300,000 total. A surety bond can be used in place of the liability insurance. Plus coverage that pays clients for losses, and workers' comp under S.C. Code 42-5-10.
Report Serious Incidents Fast (Reg. 60-122 §501)
Ongoing - Report broken bones, hospital stays or deaths from an incident, crimes against a client by a caregiver, and abuse, neglect, or exploitation by a caregiver. Tell the client's responsible party and DPH within 24 hours or the next business day. Send DPH a written report within 5 days.
Fines for Breaking the Rules
Ongoing - DPH can fine you $100 to $5,000 for each violation (Reg. 60-122). DPH can also deny, suspend, or revoke your license.
HIPAA Compliance
Ongoing - Follow federal health privacy rules if they apply to you. Train staff and keep client records safe.
Our South Carolina licensing team tracks the law so you do not have to.
Caregiver Mandates
Important Warning
South Carolina has many retirees, and the 65+ group is growing fast. Build ties with hospital discharge planners early. That is how you get steady referrals.
- Criminal Background Check: Every caregiver must pass a criminal background check under S.C. Code 44-70-60(B) and 44-7-2910 before work. Also check the Sex Offender Registry and the Nurse Aide Registry.
- Drug Test Before Hire, Random Tests After: A 5-panel drug test (cannabis, cocaine, amphetamines, opiates, PCP) taken no more than 30 days before the job offer. The result must be negative. Random tests continue after hire.
- Age 18 or Older: Caregivers must be at least 18. They must be able to read, write, and talk with clients and supervisors. If they drive clients, keep their license, insurance, and driving record on file.
- Training Before Client Contact and Yearly: First aid, dementia or disability care as needed, privacy, records, ethics, safe lifting, infection control, and abuse prevention. Both the trainer and the caregiver sign the record.
- Health Self-Check: Before first client contact, each caregiver fills out a health self-check. It lists diseases that spread, like flu, TB, and hepatitis. A nurse, the administrator, or HR reviews and signs it.
Regional Billing Snapshots
*Regional rates vary by specialized care needs (Dementia, Parkinson's) and local competition.*
We launch South Carolina home care agencies start to finish.
Regional Market Opportunities
South Carolina has about 1.17 million adults 65 and older, about 21% of the state. That group grew about 20% from 2020 to 2025, the 5th fastest of any state (Census, July 2025). The middle pay for home health and personal care aides is $14.48 an hour (BLS OEWS May 2025, series OEUS450000000000031112008). The billing rates below are our estimates. Real rates depend on the area and who pays.
Charleston Metro
Many retirees. MUSC is a major medical center here.
Key: Get to know MUSC and other hospital discharge planners.
Myrtle Beach / Grand Strand
A popular place to retire on the coast. Many private-pay clients. Summer visitors add demand.
Key: Plan staff for busy seasons.
Hilton Head / Beaufort
Well-off retirement communities. Many clients pay privately.
Key: Do not start your prices too low here.
Greenville-Spartanburg (Upstate)
A growing area with a strong job market and a growing number of older adults.
Key: A good place to start if the coast feels crowded.
Columbia Metro
The state capital. Many government retirees and a large university.
Key: A steady second market.
Rural SC
Real need, but hiring and long drives are hard, especially in the Pee Dee and Midlands.
Key: Grow into rural areas after your first market is steady.
Cost of care in South Carolina
What agencies charge clients vs. what caregivers earn in South Carolina. The difference is the agency's gross margin per billable hour — before overhead like insurance, admin, marketing, and compliance costs.
$30.5
Avg. hourly rate charged to clients
$18.51
Avg. caregiver hourly wage
$11.99
Gross margin per hour
39%
Gross margin %
What this means for agency owners
In South Carolina, agencies keep roughly $11.99 per billable hour after paying the caregiver. That's a 39% gross margin.
This is a typical margin for the industry. You will need to manage overhead carefully, but profitability is achievable with good operations.
Sources: Avg. hourly rate from CareYaya and CareScout 2025 surveys (averaged). Caregiver wage from Care.com. Gross margin is before overhead costs like insurance, admin, marketing, and compliance.
South Carolina Medicaid Programs
Community Choices Waiver
South Carolina's Medicaid home and community waiver for seniors and adults with disabilities. It pays for personal care and companion care, among other services. The SC Department of Health and Human Services (SCDHHS) runs it.
Agency Angle: Medicaid is a separate step from your DPH license. You enroll with SCDHHS. The waiver brings steady clients, but it has its own rules for paperwork, EVV, and billing.
Becoming a Provider
Essential 2026 Tech Stack for Owners
Tiles outlined in teal are areas HomeCareAtlas covers in our platform.
South Carolina Licensing FAQ
Do I need a license to start a home care agency in South Carolina?
Yes. Any business that gives or arranges in-home care for pay needs an In-Home Care Provider License from SC DPH. The law is the In-Home Care Providers Act (S.C. Code 44-70-10). The rule is Regulation 60-122. A few groups are left out, like house-cleaning-only services. Ask DPH at [email protected] if you are not sure.
How much does the license cost?
The first license costs $1,000. Renewal is $800 a year. A late renewal adds $200. Our estimate for total startup costs is $40,000 - $75,000. That covers insurance, background checks, policies, an office, and cash to run.
How long does licensing take?
Our estimate is 60-120 days from a complete application to license. DPH does not publish a set timeline. A complete file, done background checks, and drug test results help.
What background checks are required?
Caregivers need a criminal background check under S.C. Code 44-70-60(B) and 44-7-2910 before any client contact. Also check the Sex Offender Registry and Nurse Aide Registry. Owners who sign the application need a SLED name-based check from the last 90 days.
Are drug tests required?
Yes. Caregivers need a 5-panel drug test before hire. Owners who sign the application need one too. After that, both get random drug tests. Your policies must say how you run random tests.
What insurance is required? Is a bond required?
You need liability insurance of at least $100,000 per occurrence and $300,000 total. A surety bond is not required. You may use one in place of the liability insurance (Reg. 60-122 §302.A). You also need coverage that pays clients for losses, and workers' comp.
Is South Carolina a good market for home care?
South Carolina has about 1.17 million adults 65 and older, about 21% of the state. That group grew about 20% from 2020 to 2025, the 5th fastest of any state (Census, July 2025). The coast and the Upstate have many retirees.
What are the biggest mistakes to avoid?
Skipping a caregiver check or drug test. Using old policy templates instead of the May 2026 rule. Renting an office in the wrong zone. And waiting too long to meet hospital discharge planners.
Starting in a Nearby State?
Licensing requirements vary a lot between states. Compare your options:
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Home care agencies in South Carolina
Want to see the competition up close? Look at who is already open, city by city.
- Home care agencies in Greenville
- Home care agencies in Columbia
- Home care agencies in Rock Hill
- Home care agencies in Anderson
- Home care agencies in Bluffton
Looking for care for a family member? Find agencies near you
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Where our numbers come from
We check each fact against South Carolina's own rules. Tap a source to read it yourself.
- License needed?YesS.C. Code §44-70-30· Nov 2026
- Who oversees itSouth Carolina Department of Public Health (SC DPH, Bureau of Health Facilities Licensing)S.C. Code §44-70-10 et seq.; DPH In-Home Care Providers page· Oct 2026
- License nameIn-Home Care Provider LicenseReg. 60-122· Oct 2026
- The rulesS.C. Code Regs. 60-122Reg. 60-122 (formerly 61-122)· Oct 2026
- First license fee$1,000Reg. 60-122 §103.I· Oct 2026
- License lasts1 yearReg. 60-122 §103.I; S.C. Code §44-70-30· Oct 2026
- BondNone required (a surety bond may be used instead of the $100,000/$300,000 liability insurance)Reg. 60-122 §302.A· Oct 2026
- Owner/manager trainingNo state minimumReg. 60-122 §401· Oct 2026
- Caregiver trainingNo state minimumReg. 60-122 §404· Oct 2026
- Background checksSLED state criminal record check before hire (plus an FBI check after hire if SC residency for the past 12 months can't be verified), and a 5-panel drug test before hire with random testingS.C. Code §§44-70-60(B), 44-70-70, 44-7-2910; Reg. 60-122 §402· Nov 2026
- How long it takes60-120 DaysBest guess — not confirmed yet
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This guide is for informational purposes only and does not constitute legal, regulatory, or business advice. Licensing requirements, fees, and regulations change frequently. Always verify current requirements with your state's licensing agency before making business decisions. HomeCareAtlas is not responsible for the accuracy or completeness of this information.
Researched and reviewed by
John Helmy, Founder of HomeCareAtlasBuilding tools and resources to help home care agency owners navigate licensing, compliance, and growth.