Columbia Senior AdvisorWhat happens when a private-pay assisted living resident runs out of money?
It depends on the building: a CRCF that participates in Optional State Supplementation or Community Choices Residential Personal Care may let the resident stay on public help, while one that takes neither may require a move once private funds are gone.
Ask the administrator now, in writing, what happens when savings end. If the answer is a move, start looking at participating buildings while there is time to choose.
Which programs can help with care costs in the Midlands?
Optional State Supplementation (up to $1,719 a month in 2026 for residents with net income under $1,804) in participating CRCFs, the Community Choices waiver at home or in participating CRCFs, Medicaid for long-term nursing home care, PACE in Richland, Lexington and Calhoun counties, and VA pension with Aid and Attendance.
Each has its own eligibility rules. Medicaid long-term care in 2026 generally requires income up to $2,982 a month (or a qualified income trust) and countable resources of $2,000 or less for one person, with a 60-month look-back on transfers.
How far ahead should we plan?
Start when about two years of savings remain: that leaves time to apply for programs, wait for a waiver slot if there is a list, and move to a participating building on your own schedule rather than in a crisis.
Build a simple monthly budget: income in, total care cost out, and the number of months savings will last. Recheck it every six months, since fees usually rise each year.
Who can help us sort out the options for free?
The regional Area Agency on Aging (Central Midlands at (803) 376-5390 for Richland, Lexington and Fairfield), SCDHHS for Medicaid and OSS applications at (888) 549-0820, CLTC intake for Community Choices at (888) 971-1637, and county veterans affairs offices for VA pension.
An elder law attorney is worth paying for when there is a house, a spouse at home or assets near the limits. Avoid anyone charging to move assets for benefit eligibility without a license to give legal advice.
Side by side
| Planning ahead means | Waiting too long means | |
|---|---|---|
| Timing | Applying with about two years of savings left | Applying after the money is gone |
| Building | Choosing a CRCF that takes OSS or waiver residents | A forced move at the worst time |
| Records | Five years of statements gathered calmly | A rushed search for paperwork |
| Advice | An elder law consultation early | Gifts that trigger a Medicaid penalty |
Drawn from S.C. Code Regs. 60-84, DPH Healthcare Quality and SCDHHS publications, CareScout, CMS, the VA and the regional aging agencies cited in the text; our editorial standards explain how we check them.
