Columbia Senior AdvisorBy Columbia Senior Advisor Care Team · September 8, 2026
Lexington County has 19 senior-serving assisted living facilities on DPH's roster and 9 licensed nursing homes. The town of Lexington and West Columbia hold most of them; Irmo, Chapin, Gaston and Batesburg-Leesville add a handful each.
Why Lexington County is its own search
Lexington County grew faster than almost anywhere in South Carolina over the past two decades, and senior housing followed the rooftops. Families who live around Lake Murray, along Sunset Boulevard or in Red Bank rarely want a parent on the far side of the Congaree, and they do not have to: the county now has a full range of licensed care of its own.
It also has an older population than Richland County. Census estimates put 19.3% of Lexington County residents at 65 or older in 2025, against 16.7% in Richland, with a median age of 40.4.
Every senior-serving CRCF in the county
This is the full list from DPH's license file, grouped by postal city:
| Facility | Postal city | Licensed beds | Secured Alzheimer's unit |
|---|---|---|---|
| Generations of Batesburg | Batesburg-Leesville | 88 | No |
| Generations of Chapin | Chapin | 56 | No |
| Highlands Senior Living Gaston | Gaston | 92 | No |
| Harbison Shores | Irmo | 82 | Yes |
| Generations of Irmo | Irmo | 78 | Yes |
| Wellmore of Lexington | Lexington | 174 | Yes |
| Oakleaf Village of Lexington | Lexington | 100 | No |
| Presbyterian Communities of South Carolina-Columbia | Lexington | 91 | Yes |
| Lakeside Place Senior Living | Lexington | 90 | Yes |
| Spring Oak Lexington | Lexington | 90 | No |
| Legacy of Lexington | Lexington | 49 | No |
| Lexington Memory Care | Lexington | 48 | Yes |
| New Light Community Care | Lexington | 14 | No |
| Pines at Columbia | West Columbia | 90 | No |
| Colonial Gardens Alzheimer's Special Care Center | West Columbia | 66 | No |
| SC Episcopal Home at Still Hopes (CRCF) | West Columbia | 48 | Yes |
| Laurel Crest | West Columbia | 26 | Yes |
| Lighthouse Residential Care Facility | West Columbia | 10 | No |
| Southern Heritage | West Columbia | 10 | No |
Source: S.C. DPH Find a Facility license data as of November 6, 2026. Some Columbia-address buildings in the 29210 and 29212 ZIP codes also sit in Lexington County; our Columbia area pages cover them.
What sets the county apart
Three things. First, Lexington Medical Center in West Columbia is the second-largest hospital in the Midlands, and its extended care nursing home in Lexington is one of the region's biggest. Second, the county has the Midlands' only licensed inpatient hospice house, in Lexington. Third, several continuing care campuses, Episcopal and Presbyterian among them, combine independent living, assisted living and nursing care at one address, which can spare a resident a second move.
The trade-off is traffic. U.S. 378 and Interstate 20 can turn a six-mile trip into half an hour at rush hour, so test the drive at the time of day you would actually visit.
Nursing homes in Lexington County
If nursing care is needed instead, these are the county's licensed nursing homes with CMS's overall rating where CMS publishes one:
| Nursing home | City | Licensed beds | CMS overall |
|---|---|---|---|
| Laurel Crest Retirement Community | West Columbia | 12 | Not rated by CMS |
| Lexington Medical Center Extended Care | Lexington | 388 | 2 of 5 |
| Millennium Post Acute Rehabilitation | West Columbia | 132 | 2 of 5 |
| NHC Healthcare Lexington | West Columbia | 170 | 4 of 5 |
| Opus Post Acute Rehabilitation | West Columbia | 98 | 3 of 5 |
| Presbyterian Communities of South Carolina-Columbia | Lexington | 44 | 5 of 5 |
| Retreat at Wellmore of Lexington | Lexington | 60 | 1 of 5 |
| Seven Oaks Rehabilitation and Healthcare Center | Columbia | 108 | 1 of 5 |
| South Carolina Episcopal Home at Still Hope | West Columbia | 70 | 5 of 5 |
Source: CMS Care Compare Provider Information, data as of October 1, 2026.
Payment questions to ask in Lexington
Many of the newer Lexington communities are private-pay only. Before signing, ask whether the building participates in Optional State Supplementation, which in 2026 pays a participating CRCF up to $1,719 a month for a resident with net income under $1,804, or in Community Choices Residential Personal Care. If the answer is no, ask what happens when savings run out, and get the answer in writing.
Lexington County residents are in the Central Midlands aging region, so free benefits counseling and the ombudsman program come from the Central Midlands Council of Governments at (803) 376-5390, and Prisma Health SeniorCare PACE-Midlands serves the county.
Lake Murray, Gaston and the edges of the county
Lexington County is long, and its edges behave like different places. North-shore families around Chapin and Irmo look to the Lutheran campus near Chapin and to Harbison. South of Interstate 20, Gaston and Swansea are rural, and families there often weigh a mid-sized building in Gaston against options in Lexington or Cayce. At the western end, Batesburg-Leesville is closer to Saluda than to the State House, and its residents often think in terms of Lexington Medical Center's distance rather than Columbia's.
Our town pages for Lexington, West Columbia, Irmo, Chapin and Batesburg-Leesville list every licensed option with its distance from the town's center, which makes it easier to compare a building eight miles away on a two-lane road with one fifteen miles away on the interstate.
What to look for on a Lexington tour
Many Lexington communities opened in the last fifteen years, so buildings look new and amenities are generous. Look past the lobby. Ask how long the administrator and the director of nursing services have been in place, how many residents need two-person help, and how the building staffs its secured unit at night. Ask to see the most recent DPH inspection report, which the facility must keep and which DPH releases on written request.
Finally, ask how prices have changed over the last three years. A building that raised rates sharply after a change of ownership may do it again; one with steady increases near the cost of living gives you a more predictable budget.
Frequently asked questions
How many assisted living facilities are in Lexington County, SC?
DPH's data lists 19 senior-serving community residential care facilities in Lexington County, plus some Columbia-address buildings that sit inside the county line.
Is there memory care in Lexington, SC?
Yes. 8 Lexington County CRCFs carry DPH's secured Alzheimer's unit flag.
Where is the nearest hospice house to Lexington?
In Lexington itself: the Midlands' only licensed inpatient hospice house is there.
Which aging agency serves Lexington County?
The Central Midlands Council of Governments Area Agency on Aging in Columbia.
Is West Columbia part of Lexington County?
Yes. West Columbia, Cayce, Irmo (partly), Chapin and Batesburg-Leesville are all in Lexington County.
Which Lexington County nursing home is the largest?
Lexington Medical Center Extended Care in Lexington, with 388 licensed beds on DPH's roster.
