Greenville Senior AdvisorWho licenses nursing homes in Greenville, South Carolina?
The S.C. Department of Public Health's Healthcare Quality office licenses every nursing home in South Carolina, and as the state survey agency it also conducts the federal inspections that let a home participate in Medicare and Medicaid; DPH lists 34 licensed nursing homes in the four counties with 3,764 licensed beds; CMS rates 33 of them, 15 with four or five stars overall (Care Compare data as of October 1, 2026).
A DPH license is required to operate. CMS certification is separate and optional in principle, but almost every Upstate nursing home is certified because Medicare and Medicaid pay for most nursing home days. The one licensed home in our four counties without a CMS match is a small health care center on a Clemson retirement campus; it appears on our roster but has no CMS ratings.
How are nursing homes inspected in South Carolina?
Certified nursing homes receive unannounced standard health inspections roughly every year, plus complaint investigations, conducted by DPH surveyors under federal rules; the results, including every deficiency cited, are published on CMS Care Compare.
CMS turns three years of inspection results, staffing data and quality measures into star ratings from one to five. The health inspection rating carries the most weight in the overall rating. A home with repeated serious problems can be placed in CMS's Special Focus Facility program, which means more frequent inspections; our nursing home pages note any home CMS lists in that program.
What do CMS star ratings measure, and what do they miss?
CMS's overall star rating combines health inspection results, nurse staffing hours from payroll data and quality measures such as falls, pressure ulcers and rehospitalizations; it does not measure food, activities, how a particular unit feels at night, or how well a home communicates with families.
Use the stars to build a short list and to ask pointed questions, not as a final verdict. A four-star home with high nursing turnover and a recent abuse citation can be a worse fit than a three-star home with steady staff. Our pages show each home's staffing hours and turnover next to the four-county median so those differences are visible.
Can South Carolina fine or sanction a nursing home on its own?
Yes. Besides federal penalties imposed through CMS, DPH can take state enforcement action against a licensed nursing home, and those administrative and consent orders appear in DPH's monthly Healthcare Quality enforcement reports.
In May 2026, for example, DPH's report included a consent order against the operator of Brushy Creek Post Acute in Greer. Federal fines and payment denials appear separately on Care Compare. Our nursing home pages list both: CMS's three-year penalty count and any DPH order we found since January 2025.
How do nursing homes and CRCFs share a campus in the Upstate?
Several Upstate retirement communities hold both a DPH nursing home license and a CRCF license at the same address, letting residents move between assisted living and nursing care, or go to rehab and come back, without changing communities.
On our directory, campus partners are noted on each facility page. Continuing care retirement communities often require an entrance fee and give priority access to their own nursing beds. Ask whether nursing beds are reserved for current residents, what happens if no bed is open, and how monthly fees change when a resident moves from one license to the other.
At a glance
| For a South Carolina nursing home | For a South Carolina CRCF | |
|---|---|---|
| License | DPH nursing home license | DPH CRCF license |
| Federal oversight | CMS certification and annual-cycle inspections | No federal oversight |
| Public ratings | CMS star ratings on Care Compare | No ratings of any kind |
| Long-stay Medicaid | Healthy Connections Medicaid pays for eligible residents | OSS or Community Choices in participating CRCFs |
Sources include S.C. Code Regs. 60-84, DPH Healthcare Quality and SCDHHS pages and bulletins, CareScout, CMS and VA rate tables as cited above; see our editorial standards.
