CLTC South Carolina: How Community Long Term Care Works and How to Start Intake

What CLTC Is and Why It's the Gateway to Funded Home Care

Community Long Term Care (CLTC) is a division within the South Carolina Department of Health and Human Services (SCDHHS) that manages the state's home and community-based services for adults who need a nursing facility level of care but want to remain at home. CLTC is the operational backbone of the Community Choices (CC) Waiver — the state's primary Medicaid program for funding in-home care.

Every family seeking Medicaid-funded home care in South Carolina passes through CLTC. The division handles three critical functions: centralized intake (putting your parent on the waiver interest list), clinical assessments (determining whether your parent qualifies medically), and ongoing case management (coordinating services after enrollment).

Understanding how CLTC operates — its referral process, its area office structure, and its timeline — is the difference between an application that moves efficiently and one that stalls for months because the family missed a documentation step.

The Intake Process: Phoenix Portal and Phone Referral

CLTC referrals enter through a centralized system called Phoenix. There are two ways to initiate a referral:

Phone: Call the CLTC Centralized Intake office at (888) 971-1637. An intake specialist will gather your parent's demographic information, Medicare and Medicaid card numbers, Social Security number, and a summary of their functional limitations. This call places your parent on the CC Waiver interest list.

Phoenix public portal: Submit an electronic referral through the SCDHHS website. The portal collects the same information as the phone intake but lets you submit it outside of business hours.

The intake specialist will evaluate immediate safety risks and document your parent's limitations with activities of daily living (ADLs) — bathing, dressing, toileting, eating, transferring, and mobility. This initial screening does not determine eligibility; it creates the referral record and establishes your parent's position on the interest list.

After intake, the referral is assigned to the CLTC Area Office that covers your parent's county of residence. Assignment should happen within one business day.

CLTC Area Offices: Where Your Case Is Managed

CLTC operates through regional area offices that correspond to the state's geographic service regions. Your parent's case will be managed by the office covering their county:

• Greenville Office (Area 1 — Upstate): (864) 242-2211
• Anderson Office (Area 1): (864) 224-9452
• Greenwood Office (Area 2 — Upper Savannah): (864) 223-8622
• Rock Hill Office (Area 3 — Catawba): (803) 560-6457
• Columbia Office (Area 5 — Central Midlands): (803) 764-8319
• Orangeburg Office (Area 6 — Lower Savannah): (803) 536-0122
• Sumter Office (Area 7 — Santee-Lynches): (803) 567-3110
• Florence Office (Area 8 — Pee Dee): (843) 667-8718

These offices handle the clinical assessment, level-of-care determination, and case management for everyone in their service area. High-density areas like Greenville, Columbia, and Charleston process more cases but also have higher demand.

The Clinical Assessment: Form 1718

When your parent's position on the interest list reaches the top — or if an emergency clinical slot becomes available — a CLTC Nurse Consultant from the regional area office will schedule an in-home clinical assessment.

The nurse uses SC DHHS Form 1718 (the South Carolina Long Term Care Assessment Form) to evaluate your parent's:

• Cognitive status — memory loss, judgment impairment, disorientation
• Physical function — ability to perform ADLs independently, mobility limitations, fall history
• Medical diagnoses — chronic conditions requiring ongoing management
• Medication regimen — complexity and self-administration ability
• Behavioral concerns — wandering, aggression, resistance to care

To meet the state's Nursing Facility Level of Care (NFLOC) standard, the assessment must document that your parent requires hands-on assistance with at least two ADLs or needs a minimum of eight hours of daily skilled nursing care. If your parent has intellectual disabilities or mental illness, they must also be screened under the Pre-Admission Screening and Resident Review (PASRR) Level I tool.

The assessment must be scheduled and completed within 10 business days of the case being assigned to the local area office. After the initial nurse completes the assessment, a second CLTC Nurse Consultant in the same office must review and authorize the level-of-care determination within three business days.

What to Prepare Before the CLTC Assessment

The in-home assessment goes faster and produces a more accurate result when you prepare these materials in advance:

1. A current physical exam — your parent's primary physician should have completed one within the past 12 months and be prepared to sign clinical documentation supporting the NFLOC determination
2. A complete medication list — every prescription, dose, frequency, and the prescribing physician
3. Documentation of ADL limitations — specific examples of what your parent can and cannot do independently (not "she needs help" but "she cannot transfer from bed to wheelchair without two-person assist")
4. Recent hospitalization records — if applicable, discharge summaries and any skilled home health orders
5. A log of behavioral incidents — if your parent wanders, has fallen, or resists care, document dates and specifics

The nurse assessor is trained to document what they observe during the visit, but they can only evaluate what is presented. If your parent has a "good day" during the assessment and appears more functional than usual, your prepared documentation provides the context they need.

After Approval: The Service Plan

If the NFLOC determination is approved and your parent also meets all financial eligibility criteria ($2,982 monthly income cap, $2,000 asset limit for a single applicant), the case is transferred in Phoenix to active waiver status. A state case manager must then develop the Initial Service Plan within seven business days.

The service plan specifies:

• Which services your parent will receive (personal care, companion care, adult day care, home modifications, etc.)
• How many hours per week of each service
• Which providers will deliver the services (you choose from an approved provider list)

The selected Waiver Case Manager must formally accept the referral in Phoenix within 48 business hours. After that, services begin — though finding available providers in rural areas can add additional days.

The clinical Form 1718 must be re-evaluated every 12 months to maintain waiver eligibility. Miss the annual review and services can be suspended until a new assessment is completed.

The Reality of the Interest List

As of January 2025, the Community Choices Waiver interest list contained over 23,000 individuals. Because the CC Waiver is a capped program — not an entitlement like traditional Medicaid — there are a fixed number of slots available statewide. When a slot opens (because a participant moves to a nursing facility, passes away, or loses eligibility), the next person on the interest list is offered intake.

This means the CLTC intake call is the most time-sensitive step for families. Every day you delay calling (888) 971-1637 is a day your parent moves further back in the queue. Families who coordinate a same-day intake call while simultaneously arranging private-pay bridging care have the strongest long-term position.

The South Carolina Home Care Coordination Guide includes a waiver intake worksheet pre-filled with every data point the CLTC intake specialist will request, plus a home safety assessment form designed to align with the Form 1718 evaluation criteria — so the in-home assessment captures the full picture of your parent's care needs.

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