SC Ranks Last

This story first appeared in the SC Daily Gazette. A mew report published by the U.S. Senate Special Committee on Aging shows a lack of investigation and enforcement by regulatory agencies over the long-term care industry. Vulnerable adults are being abused and neglected and the government does nothing to deter the conduct.

The report mentions South Carolina as one of the worst in the United States. They bring receipts. For example, a nurse reported missing narcotics at Condor Health nursing home; a serious safety issue. The state’s public health agency was called to investigate, but due to staffing shortages [or lack of care], it took state inspectors four months to respond. Meanwhile, at least three more complaints, including one instance where a patient was injured.

Statewide, there are about 190 nursing homes. South Carolina has the lowest ratio in the nation –one inspector for every 11 homes. However, DHEC has just one active inspection team that travels the entire state. By federal law, each team of five must include a registered nurse, and that division of the state Department of Health and Environmental Control has just one nurse with the necessary credentials.

As a result, routine inspections required under federal law, as well as complaints requiring investigation, go without investigation or resolution.

Federal law requires routine inspections for nursing homes every 16 months. As of Sept. 30, 2023, one-third of the Palmetto State’s 191 nursing homes went uninspected within the required time period, department spokesman said.

Nursing homes must meet certain safety standards to receive taxpayer funding. States are responsible for inspecting facilities to make sure they qualify. These routine reviews should ensure residents are healthy, safe and not neglected. Advocates say on-time inspections would likely prevent many of the issues that lead to complaints. These lags open up residents to abuse and neglect.

At the same time, federal regulators have upped inspection requirements for nursing homes while federal funding to help pay for inspectors has remained stagnant for nearly four decades.  South Carolina had the largest staffing gap by far.

The state’s budgeted ratio of one state-employed inspector for every 11.8 nursing homes was roughly double the rate of several states with a similar number of facilities.

Compare that to a ratio of one inspector per 5.9 homes in Mississippi, 5.7 in Nebraska and 3.1 in Connecticut. In the southeast, Alabama was at 4.5 nursing homes per inspector, Georgia was at 6.5 and North Carolina had 4.4.

Map of nursing home surveyor vacancy rates.

 States are struggling to hire nursing home inspectors to conduct federally-mandated reviews, according to a congressional report published Friday, May 19, 2023. A map shows South Carolina as one of seven states with a large percentage of unfilled inspector jobs. Even if it were fully staffed, the state Department of Health and Environmental Control would still be last in the nation. Courtesy of the U.S. Senate Committee on Aging



South Carolina has one of the most significant projected nursing shortages, resulting in the need for 10,400 more nurses to meet demand through 2030, according to a study by the University of South Carolina

AARP also ranked South Carolina among the nation’s worst for long-term care support. Its report, released in September, takes into account the number of nursing homes in a state, as well as their affordability, quality, support for caregivers outside of facilities and how often people in facilities interact with those outside.

SC Daily Gazette is part of States Newsroom, a national nonprofit news organization.