South Carolina Adult Protective Services: Report Elder Abuse

South Carolina Adult Protective Services (APS), in the Department of Social Services Adult Advocacy Division, investigates noncriminal reports of abuse, neglect, and exploitation of a vulnerable adult in a community setting, such as the adult’s home. S.C. Code § 43-35-10(11) defines a vulnerable adult as a person 18 or older who has a physical or mental condition which substantially impairs the person from adequately providing for their own care or protection, including impairment from the infirmities of aging. A resident of a facility is a vulnerable adult. Call 1-888-227-3487 (1-888-CARE4US) for a community report. A licensed nursing home, community residential care facility, or assisted living facility follows the Long Term Care Ombudsman path below. A facility operated or contracted by the Office of Mental Health or the Office of Intellectual and Developmental Disabilities follows the SLED path.

How to Report Elder Abuse in South Carolina

Where the adult lives decides who takes the report. The DSS how-to-report page says to call 1-888-CARE4US (1-888-227-3487) for suspected abuse, neglect, or exploitation of a vulnerable adult in a community setting such as the adult’s home. The same page sends a licensed nursing home, community residential care facility, or assisted living facility to the Long Term Care Ombudsman at 1-800-868-9095, and a residential facility contracted or operated by the Department of Mental Health or the Department of Disabilities and Special Needs to the SLED Special Victims Unit at 1-866-200-6066. S.C. Code § 43-35-25(D) uses the same split: the Vulnerable Adults Investigations Unit for a facility operated or contracted by the Office of Mental Health or the Office of Intellectual and Developmental Disabilities, the Long Term Care Ombudsman Program for other facilities, and the Adult Protective Services Program for all other settings. Call 911 if the person is in immediate danger.

Report by Phone

Call 1-888-227-3487. DSS prints that number as 1-888-CARE4US on the how-to-report page, the APS page, and the contact page. The contact page lists it as the 24/7 line for suspected abuse of a child or a vulnerable adult. The April 25, 2025 APS intake policy prints the centralized Hub as 1-800-227-3487 (1-800-CARE4US). The public pages and the policy do not use the same digits. Use the number on the public report page. A person who reports in good faith is immune from civil and criminal liability which may otherwise result from the report. In a civil or criminal proceeding, good faith is a rebuttable presumption. S.C. Code § 43-35-75. Information in investigative records must not be disclosed publicly. S.C. Code § 43-35-60. The how-to-report page does not say you can withhold your name.

Report Online

The how-to-report page links “click here” to the DSS report portal. The intake policy says an online report walks the reporter through the APS Pre-Screener and the APS Intake Tool. If the tool screens the report out, the system says it does not meet the requirements of an APS intake. A Hub supervisor still reviews every online report, whether it was screened out or not. An online report must include a phone number so the Hub can call if it needs more information. A person who will not give a phone number is sent to the Hub to report by phone. The portal is for a non-emergency report. Call 911 first if someone is in immediate danger.

Emergency Situations

Call 911 first if a vulnerable adult is in immediate danger. The how-to-report page says to call local law enforcement or 911 if you or your loved one is in immediate danger or harm. S.C. Code § 43-35-25(G) says that in an emergency, a serious injury, or a suspected sexual assault, law enforcement must be contacted immediately. APS is not the agency that takes a person into custody. A law enforcement officer may take a vulnerable adult in a life-threatening situation into protective custody under S.C. Code § 43-35-55 when the statute’s conditions are met.

What Information to Have Ready Before You Call

The how-to-report page says a community report is assessed for four elements: the adult meets the legal definition of vulnerable, there is an allegation of abuse, neglect, or exploitation, it occurred in the community, and it was at the hands of a caregiver or of the vulnerable adult. The intake policy says a report is accepted only when five criteria are met: the person is over 18, the person meets the vulnerability criteria, there is an allegation of maltreatment by a caregiver, it occurred in a community setting, and it was at the hands of a caregiver or of the adult. If a criterion is missing, the policy says the report is screened out and may be referred to another agency. Have as much of the following as you can. The policy says intake staff gather the allegation. They do not decide at intake whether the maltreatment occurred:

• The adult’s name, age, and current address
• What happened, including dates and places, and whether a caregiver or the adult is involved
• The name and relationship of the person you believe is responsible, if you know it
• The adult’s physical or mental condition, if you know it
• Names of other people who saw what happened
• A phone number if you report online. The intake policy requires one so the Hub can call back. The how-to-report page does not promise that a report can be made with no name

A person required to report under S.C. Code § 43-35-25 must report within 24 hours or the next working day. The listed professionals report when they have reason to believe a vulnerable adult has been or is likely to be abused, neglected, or exploited. Any other person who has actual knowledge that a vulnerable adult has been abused, neglected, or exploited shall report. Any other person who has reason to believe it may report.

Types of Elder Abuse APS Investigates in South Carolina

The categories below are the definitions in S.C. Code § 43-35-10. “Abuse” means physical abuse or psychological abuse. Neglect includes a caregiver’s failure and, in the absence of a caretaker, a vulnerable adult’s inability to provide for their own health or safety. Exploitation is defined separately. The chapter does not define abandonment as its own category.

• Physical abuse — Intentionally inflicting or allowing physical injury by an act or a failure to act. The statute includes slapping, hitting, kicking, biting, choking, pinching, burning, actual or attempted sexual battery as defined in Section 16-3-651, medication used outside the standards of reasonable medical practice to control behavior, and unreasonable confinement. A therapeutic procedure prescribed by a licensed physician or other qualified professional, or that is part of a written plan of care, is not physical abuse. Altercations between vulnerable adults are not physical abuse
• Psychological abuse — Deliberately subjecting a vulnerable adult to threats, harassment, or other intimidating behavior that causes fear, humiliation, degradation, agitation, confusion, or other serious emotional distress
• Neglect — The failure or omission of a caregiver to provide the care, goods, or services necessary to maintain the health or safety of a vulnerable adult, including food, clothing, medicine, shelter, supervision, and medical services, when that failure has caused or presents a substantial risk of causing physical or mental injury. Noncompliance with regulatory standards alone does not constitute neglect. Neglect also includes the inability of a vulnerable adult, in the absence of a caretaker, to provide for their own health or safety when that inability produces or could reasonably be expected to produce serious physical or psychological harm or a substantial risk of death
• Self-neglect — Not a separate label in § 43-35-10. It is the second part of the neglect definition: the inability of a vulnerable adult, with no caretaker, to provide for their own health or safety. The how-to-report page includes harm “at the hands of a caregiver or the vulnerable adult themselves”
• Exploitation — Causing or requiring activity or labor that is improper, unlawful, or against the reasonable and rational wishes of the vulnerable adult; an improper, unlawful, or unauthorized use of the adult’s funds, assets, property, power of attorney, guardianship, or conservatorship for someone else’s profit or advantage; or causing the adult to buy goods or services for someone else’s profit through undue influence, harassment, duress, force, coercion, or swindling. A written plan of care, or activity a licensed attending physician prescribes or authorizes, is not exploitation under the first clause

Warning Signs of Elder Abuse

DSS does not publish the groups below as a legal test. They are examples of what the definitions in S.C. Code § 43-35-10 can look like. They are not proof that abuse, neglect, or exploitation occurred. Use the statute for the legal definitions.

Physical Signs

• Bruises, burns, cuts, or welts that the person cannot explain
• Marks that suggest restraint at the wrists, ankles, or across the body
• Bedsores or other signs of staying in one position for a long time
• Weight loss, dehydration, or lack of food without a medical explanation the caregiver can account for

Behavioral Signs

• Withdrawal from friends, family, or usual activities
• Fear or agitation around one caregiver
• A change in mood or confusion that does not match the person’s usual condition
• Reluctance to speak while a caregiver is in the room

Financial Signs

• Withdrawals or new access to accounts that the person cannot explain
• Missing property, unpaid bills, or a lack of food or medicine despite resources to pay for them
• A sudden change to a will, power of attorney, or beneficiary
• A new person controlling the money or making financial decisions

Who Can (and Must) Report Abuse in South Carolina

A physician, nurse, dentist, optometrist, medical examiner, coroner, other medical, mental health, or allied health professional, Christian Science practitioner, religious healer, school teacher, counselor, psychologist, mental health or intellectual disability specialist, social or public assistance worker, caregiver, staff or volunteer of an adult day care center or of a facility, or law enforcement officer who has reason to believe that a vulnerable adult has been or is likely to be abused, neglected, or exploited shall report. Any other person who has actual knowledge that a vulnerable adult has been abused, neglected, or exploited shall report. S.C. Code § 43-35-25(A). Any other person who has reason to believe a vulnerable adult has been or may be abused, neglected, or exploited may report. § 43-35-25(B).

A person required to report must report within 24 hours or the next working day, in writing or orally by telephone or otherwise. The report goes to the Vulnerable Adults Investigations Unit for a facility operated or contracted by the Office of Mental Health or the Office of Intellectual and Developmental Disabilities, to the Long Term Care Ombudsman Program for other facilities, and to the Adult Protective Services Program for every other setting. S.C. Code § 43-35-25(D). If the unit or entity that receives the report does not have jurisdiction, it must forward the report not later than the next working day. § 43-35-25(E). A facility may not adopt a policy that interferes with these reporting requirements. § 43-35-25(F).

A person required to report who knowingly and wilfully fails to report abuse, neglect, or exploitation is guilty of a misdemeanor and, upon conviction, must be fined not more than $2,500 or imprisoned not more than one year. S.C. Code § 43-35-85(A). A person who, acting in good faith, reports or participates in an investigation or judicial proceeding resulting from a report is immune from civil and criminal liability which may otherwise result from that action. Good faith is a rebuttable presumption. S.C. Code § 43-35-75.

What Happens After You Report to APS in South Carolina

The April 25, 2025 intake policy says intake is a 24-hour system for receiving reports. Intake gathers information, assigns a response time, and does not investigate or make the case decision. A report that misses an acceptance criterion is screened out and may be referred elsewhere.

Step 1 — Intake Screening

The how-to-report page and the intake policy both screen for vulnerability, an allegation, a community setting, and a caregiver or the adult. The policy also requires that the person be over 18. S.C. Code § 43-35-15(C) assigns APS the noncriminal reports that occur outside the facilities the Long Term Care Ombudsman investigates. If there is reasonable suspicion of criminal conduct, APS refers the report to the Vulnerable Adults Investigations Unit. The intake policy says that referral is made immediately, and no later than 24 hours after the report is received.

Step 2 — Response Timeline

S.C. Code § 43-35-40 says that upon receiving a report, the Long Term Care Ombudsman or Adult Protective Services promptly shall initiate an investigation, or review the report within two working days for reasonable suspicion of criminal conduct. A report of those cases to local law enforcement or to the Vulnerable Adults Investigations Unit must be made within one working day of completing that review. The intake policy assigns a response time of 48 hours after the intake decision for accepted reports, and a response time of 0–2 hours when the report involves emergency protective custody. Chapter 43-35 does not set a date for finishing the investigation.

Step 3 — Investigation

An investigative entity may enter facilities as otherwise permitted by law, request records, and require cooperation. S.C. Code § 43-35-20. If consent for access cannot be obtained, the investigative entity may seek a family-court warrant under S.C. Code § 43-35-45(A). When the initial report or the investigation indicates reasonable suspicion of criminal conduct, § 43-35-15 requires a referral to the Vulnerable Adults Investigations Unit. Upon conclusion of a criminal investigation, the unit or other law enforcement refers the case to the appropriate prosecutor when further action is necessary. The intake policy says the Medicaid Fraud Control Unit of the Attorney General’s Office investigates Medicaid fraud, and that an intake report alleging Medicaid fraud in a licensed nursing home or residential care facility is referred by the intake case manager.

Step 4 — Service Plan and Outcome

Protective services are services whose objective is to protect a vulnerable adult from harm caused by the adult or by another person. S.C. Code § 43-35-10(9) says those services include evaluating the need for protective services, securing and coordinating existing services, arranging for living quarters, obtaining financial benefits to which the adult is entitled, and securing medical services, supplies, and legal services. If consent to provide services cannot be obtained and the adult is at substantial risk, or has been abused, neglected, or exploited, APS may petition the family court for an order to provide protective services. S.C. Code § 43-35-45(B). The court may order ex parte emergency protective custody without consent when it finds probable cause that abuse or neglect creates an imminent danger to the adult’s life or physical safety. Ordered services must be in the least restrictive setting available, and a noninstitutional placement must be used whenever possible. § 43-35-45(F).

A law enforcement officer, not APS acting alone, may take a vulnerable adult in a life-threatening situation into protective custody under S.C. Code § 43-35-55 when there is probable cause of imminent danger, no consent, and no time to apply for a court order. The officer takes the person to a place of safety that is not a jail and notifies APS. DSS files a petition within one business day. The family court holds a probable-cause hearing within 72 hours of that filing, excluding Saturdays, Sundays, and legal holidays.

APS vs. Long-Term Care Ombudsman — Who Handles Nursing Home Abuse in South Carolina?

Use APS, at 1-888-227-3487, for a noncriminal report in a community setting. Use the Long Term Care Ombudsman at 1-800-868-9095 for a licensed nursing home, community residential care facility, or assisted living facility. The adult-protection page says the ombudsman investigates abuse, neglect, or exploitation in those licensed settings. The ombudsman page says to call 1-800-868-9095 if you suspect abuse or neglect in a long-term care facility. The same page lists a local line, (803) 734-9900, and fax (803) 734-9886, at 1301 Gervais Street, Suite 350, Columbia, SC 29201. The ombudsman advocates for residents and helps with complaints about rights, transfer or discharge, benefits, dignity, and abuse, neglect, or exploitation. The ombudsman does not replace a report to the agency that has jurisdiction.

A facility operated or contracted by the Office of Mental Health or the Office of Intellectual and Developmental Disabilities goes to the SLED Vulnerable Adults Investigations Unit. DSS’s how-to-report page still names the Department of Mental Health and the Department of Disabilities and Special Needs and lists 1-866-200-6066 for the SLED Special Victims Unit. The adult-protection page also says those reports can be made to 1-888-CARE4US. The Department of Disabilities and Special Needs reporting page uses the same 1-866-200-6066 number for the Vulnerable Adult Investigations Unit when the adult lives in a residential setting operated or contracted by the Department of Behavioral Health and Developmental Disabilities, and it sends community settings to DSS at 1-888-CARE4US. A licensing complaint about a health facility regulated by the South Carolina Department of Public Health goes to DPH. The DPH complaint page, updated March 30, 2026, says to use the health facility complaint form or call 1-800-922-6735. The form address on that page is still hosted at apps.dhec.sc.gov. For the facility steps, use the South Carolina nursing home complaint guide.

Additional Resources in South Carolina

• South Carolina APS, for a community setting: 1-888-227-3487 (1-888-CARE4US), 24 hours a day, 7 days a week
• The April 25, 2025 APS intake policy prints a different Hub number: 1-800-227-3487 (1-800-CARE4US). The public DSS report pages print 1-888-227-3487. Use the public number
• DSS online report
• Long Term Care Ombudsman, for a licensed nursing home, community residential care facility, or assisted living facility: 1-800-868-9095
• SLED Vulnerable Adults Investigations Unit, for a covered residential facility: 1-866-200-6066
• South Carolina Department of Public Health, for a health facility licensing complaint: 1-800-922-6735
• South Carolina Department of Consumer Affairs, for identity theft or scams, as listed on the DSS how-to-report page: 1-800-922-1594
• National Elder Fraud Hotline: 1-833-FRAUD-11 (1-833-372-8311)
• Eldercare Locator (national): 1-800-677-1116
• National Center on Elder Abuse

The South Carolina nursing home complaint guide explains how to report a problem in a licensed nursing home. The form on this page is a request to speak with a lawyer. It is not a report to South Carolina APS, the Long Term Care Ombudsman, the SLED Vulnerable Adults Investigations Unit, or the Department of Public Health.