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S 496

A JOINT RESOLUTION TO APPROVE REGULATIONS OF THE DEPARTMENT OF LABOR, LICENSING AND REGULATION - SOUTH CAROLINA REAL ESTATE APPRAISERS BOARD, RELATING TO SOUTH CAROLINA REAL ESTATE APPRAISERS BOARD, DESIGNATED AS

2025-2026 Regular Session

Nursing homes must have licensed admins and medical directors certify budgets and staffing meet residents’ care needs or face licensing penalties and limits on admitting new reside

Recommitted to Committee on Labor, Commerce and Industry
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Bill Summary · S 496

Summary — S. 496 (2025): Clarifying responsibility for policy and budgetary decision‑making in nursing homes

Status: Introduced Feb 10, 2025; Passed Senate Mar 11, 2025; Delivered to House and referred to Labor. Hearing scheduled Sept 16, 2025.
Primary sponsors (per bill text): Senator John C. Velis; co-petitioner James B. Eldridge. (Note: an alternate sponsor list was provided separately and appears inconsistent with the official bill text.)

Purpose

The bill requires nursing home administrators and the facility medical director to formally certify that a facility’s budget and staffing are sufficient to meet the “care needs” of current residents, and it creates new enforcement tools and potential civil/criminal liability when facilities operate with insufficient budgets.

Key provisions

  • Adds new subsections to chapter 112 §115:

    • Administrator certification (new §115(f)): At the start of the facility’s fiscal year, the licensed nursing home administrator (or acting administrator) must certify, under “pains and penalties of perjury,” that the facility’s budget and staffing are sufficient to meet regular operational needs, including the care needs of all current residents. The certification must be countersigned by the facility’s medical director in accordance with CMS Operations Manual 100-07 §483(i).
    • Definition of “care needs”: the total of programs, services, staffing, dietary, recreational, rehabilitative, medical equipment and apportioned housing/management costs identified in each resident’s care plan.
    • Administrator discipline and admissions prohibition (new §115(g)): If an administrator refuses to sign the sufficiency affidavit, the Board of Registration of Nursing Home Administrators must suspend the licensee and may take further discipline. Corporate approval of a budget does not excuse an administrator’s refusal to sign. Facilities lacking a signed affidavit may not accept new residents until the affidavit is filed to DPH’s satisfaction.

  • Adds new sections to chapter 111:

    • §72CC: If the Department of Public Health (DPH) determines a facility’s budget is insufficient, after a public hearing DPH may impose sanctions up to license revocation or receivership. DPH must promulgate implementing regulations.
    • §72DD: Adverse events tied (directly or indirectly) to operating with an insufficient budget may be attributed as responsibility of the administrator and/or medical director when an affidavit is signed; where no affidavit exists, owners of record may be held civilly and criminally liable.

  • Regulatory timeline: DPH must develop implementing regulations by July 1, 2027.

Who is affected

  • Nursing home administrators (licensure, certification duties, potential suspension/discipline)
  • Facility medical directors (required countersignature; potential liability)
  • Nursing home owners/operators and corporate management (potential responsibility and liability if operation without proper affidavits)
  • Residents (intended benefit: budgets/staffing adequate to meet care plans)
  • Department of Public Health and Board of Registration of Nursing Home Administrators (new enforcement and rulemaking duties)

Potential impact and considerations

  • Increases formal accountability for administrators, medical directors and owners regarding adequacy of budgets/staffing.
  • Creates a bar to admitting new residents if a sufficiency affidavit is not on file, which could affect facility revenue and access to care.
  • Raises risk of civil and criminal exposure for adverse events linked to underfunding.
  • Transfers some decision‑point authority and legal exposure from corporate officers to on‑site licensed professionals, potentially prompting disputes between administrators and corporate management.
  • Imposes regulatory work on DPH to define standards and enforcement procedures by the July 1, 2027 deadline.

Compiled from official sources — confirm details with the bill’s official record.

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