Columbia Senior AdvisorWhich South Carolina counties does Columbia Senior Advisor cover?
Six Midlands counties: Richland, Lexington, Kershaw, Fairfield, Saluda and Calhoun, the core of the Columbia metropolitan area, all licensed by the same state agency and all part of South Carolina's Healthy Connections Medicaid program.
| County | Population | 65+ | 85+ | Median age | Senior CRCFs | Nursing homes |
|---|---|---|---|---|---|---|
| Richland County | 434,956 | 72,777 | 6,654 | 36.7 | 37 | 13 |
| Lexington County | 317,588 | 61,136 | 6,039 | 40.4 | 19 | 9 |
| Kershaw County | 73,166 | 14,892 | 1,294 | 41.3 | 4 | 2 |
| Fairfield County | 20,340 | 5,947 | 492 | 51.3 | 0 | 2 |
| Saluda County | 19,680 | 4,729 | 529 | 44.5 | 2 | 1 |
| Calhoun County | 14,188 | 3,872 | 366 | 48.6 | 2 | 1 |
U.S. Census Bureau, Vintage 2025 county population estimates by age (July 1, 2025); S.C. DPH data as of November 6, 2026.
Do all six counties share one aging agency?
No. Richland, Lexington and Fairfield counties are served by the Central Midlands Council of Governments Area Agency on Aging, Kershaw by Santee-Lynches, Calhoun by Lower Savannah and Saluda by Upper Savannah.
The split decides which regional ombudsman handles a complaint and which office assesses someone for in-home services. Newberry County shares the Central Midlands region but sits outside our directory.
Which Midlands county has the oldest population?
Fairfield County: 29.2% of residents were 65 or older in 2025 Census estimates, with a median age of 51.3, against 27.3% in Calhoun, 24.0% in Saluda, 20.4% in Kershaw, 19.3% in Lexington and 16.7% in Richland County.
Fairfield also has no hospital and no assisted living on DPH's roster, so many Fairfield families weigh the two Ridgeway nursing homes against options in Northeast Columbia and Blythewood.
Where is most of the region's licensed senior care?
In Richland and Lexington counties: Columbia, West Columbia and Lexington hold most of the six counties' senior CRCFs, nursing homes, home health agencies, hospices and in-home care agencies, while Kershaw has a solid cluster around Camden and the outer counties a handful each.
Each county page lists every licensed facility and the straight-line distance from the county seat to the nearest hospitals and to downtown Columbia.
How many older adults live in the six counties?
Census Bureau estimates put 163,353 residents aged 65 and older in the six counties on July 1, 2025, including 15,374 aged 85 and older, the group most likely to need daily help.
Richland and Lexington hold most of those older residents in raw numbers, but Fairfield, Calhoun and Saluda have much higher shares of residents 65 and older, which is why families there so often look toward Columbia, Lexington or Camden.
Side by side
| Shared by all six counties | Different from county to county | |
|---|---|---|
| Rules | DPH licensing (Regulation 60-84) and SCDHHS Medicaid rules | Area Agency on Aging and ombudsman office |
| Hotlines | DPH 1-800-922-6735, DSS APS 1-888-227-3487 | Local aging agency phone |
| PACE | Available in Richland, Lexington and Calhoun | Available in Kershaw, Fairfield or Saluda |
| Costs | The same South Carolina CareScout medians | Actual quotes |
