South Carolina License Reinstatement

Author: A. Ant, CADC-II, Licensing & Accreditation Expert

Disclaimer: This content is provided for general informational purposes only and should not be construed as legal, regulatory, or licensing advice. Requirements change frequently. Consult qualified professionals for guidance specific to your situation.

South Carolina’s licensing statute uses the word “reinstated” in exactly one situation, and it is the fastest way back the law offers. When the South Carolina Department of Public Health (DPH) suspends a facility’s license on an emergency basis because conditions threaten patients, S.C. Code 44-7-320(A)(3) sets a five-day clock: “Within five calendar days of the suspension a preliminary hearing must be held to determine if the immediate threatening conditions or practices continue to exist. If they do not, the license must be immediately reinstated.” A facility that fixes the threatening condition before that hearing, and can prove it, has a statutory right to get its license back. That doesn’t close the matter, though, because the same subsection lets DPH keep pursuing permanent revocation whether or not the license is reinstated. Every other path out of trouble runs through a correction plan, an appeal, or a fresh application.

Appeals work differently since spring. The Governor signed 2026 Act No. 146 (H.4189) on May 15, 2026, the act took effect on that signature, and it rewrote both 44-7-320(B) and the general DPH appeal statute, 44-1-60. Any guide or policy binder written before then describes steps that no longer apply.

DPH’s Enforcement Tools and the Way Back From Each

Statute text here comes from the S.C. Code on the Legislature’s site, which is current through the 2025 session, and from the ratified text of Act No. 146 for the 2026 changes. Rule citations are to DPH’s posted copy of R.60-93. Where we describe a likely route back, that is our reading.

The grounds for denial, suspension or revocation in 44-7-320(A)(1) include violating the licensing article or DPH’s rules, conduct or practices detrimental to the health or safety of patients, and one item specific to behavioral health. A facility can be sanctioned for “refusing to admit and treat alcoholic and substance abusers, the mentally ill, or persons with intellectual disability, whose admission or treatment has been prescribed by a physician who is a member of the facility’s medical staff.” DPH also looks backward. Under 44-7-320(A)(2), its review “is not limited to information relating to the current licensing period but includes consideration of all pertinent information regarding the facility and the applicant,” so old deficiencies can resurface in a new case.

The Appeal Path Since May 15, 2026

Under 44-7-320(B) as rewritten by Act No. 146, DPH sends its decision by certified mail, return receipt requested, and “the decision may be appealed by requesting a contested case hearing pursuant to Section 44-1-60 and the Administrative Procedures Act.” The old version of subsection (B) had its own deadline and its own hearing body. Both are gone, and the timing now comes from 44-1-60.

SECTION 100 of the same act replaced the text of 44-1-60 as well. The online Code page for 44-1-60, current only through the 2025 session, still shows the older two-step version, with a 15-day request for final review, a $100 filing fee and a review conference before any hearing. None of that appears in the 2026 text. Under 44-1-60(D)(2) as enacted by Act No. 146, a licensee who wants to contest a DPH decision may request a contested case hearing before the Administrative Law Court within “thirty calendar days after the mailing of a decision.” The count runs from mailing, not from the day someone signs for the certified letter, and a deadline that falls on a Saturday, Sunday or state holiday moves to the next day that is none of those (44-1-60(E)). Until the Code page catches up, calculate the date from the act, and calendar it the day the letter arrives.

Penalty Classes in R.60-93

The statute caps monetary penalties at “not less than one hundred nor more than five thousand dollars for each violation,” and under 44-7-320(C) each day a violation continues can count as a subsequent offense. R.60-93 §302 sorts violations into three classes. Class I covers those “that present an imminent danger to the health, safety, or well-being of the persons in the Facility,” Class II covers violations with a negative impact on patients, and Class III covers the rest. For a first offense, the rule’s schedule runs from $500 to $1,500 for Class I, $300 to $800 for Class II, and $100 to $300 for Class III, and the ranges climb with each repeat. Class I reaches a flat $5,000 at the fourth offense, Class II at the fifth and Class III at the sixth. Section 302.D lets DPH use that schedule or set the amount directly under 44-7-320(C).

The penalty matters most at renewal. Under 44-7-320(D), a penalty left unpaid for 30 days is itself grounds to suspend, revoke or refuse to renew, and “A license must not be issued, reissued, or renewed until all penalties finally assessed against a person or facility have been paid.” R.60-93 §102.N adds that a facility “under consideration for, or undergoing, enforcement actions by the Department” cannot renew at all. A dispute over a fine can therefore hold the whole license hostage if it runs past the expiration date.

Lapses That Turn a Licensee Into an Applicant

Several situations in R.60-93 have nothing to do with sanctions but end in the same place, filing as if the facility were new:

• Late renewal. Miss the expiration date and the renewal picks up a late charge, the larger of $75 or a quarter of the license fee, and a facility that still hasn’t paid 30 days after expiration is unlicensed (§102.M). We read that to require a new application.
• Closure longer than a year. “If the Facility is closed for a period longer than one (1) year, and there is a desire to re-open, the Facility shall re-apply to the Department for licensure” (§607.C), and the reapplication is held to current construction standards.
• Change of controlling interest. A sale or a shift in controlling interest needs a new license application before the change, even when the corporation or partnership keeps its name and identity (§102.P).

Zero census has its own rule. Under §608, once a facility has gone 90 days or more without patients, it must tell DPH in writing no later than the 100th calendar day after the last active patient left, and DPH may decide to inspect before anyone new is admitted. The license fee is still due while census sits at zero, and a facility with no patients for more than a year must reapply for licensure under the requirements in force at that time, construction standards for a new facility included.

Reinstating a Lapsed Controlled Substances Registration

A facility’s state drug registration has its own reinstatement process, run by the DPH Bureau of Drug Control rather than the licensing bureau. If a South Carolina Controlled Substances Registration lapses, the Bureau says “a new application must be submitted with a payment of the registration fee plus a $100 penalty fee,” and “Processing time is approximately 12-15 business days.” Until it is reinstated, providers “are not authorized to prescribe, administer, possess or dispense controlled substances.” For a residential program with medical withdrawal management or buprenorphine patients, two to three weeks without a registration can stop medical care entirely. Questions go to (803) 896-0636 or bdc@dph.sc.gov.

Psychiatric Hospitals and Crisis Stabilization Units

Section 44-7-320 sits in the article that licenses every facility on the 44-7-260 list, hospitals and crisis stabilization unit facilities included, so in our reading the same grounds, penalty range, emergency suspension procedure and post-2026 appeal route apply to a psychiatric hospital licensed under R.60-16 and to a crisis unit under R.60-125. The day-to-day standards those facilities are held to are covered in South Carolina Mental Health Inpatient Licensing. In our reading, outpatient mental health practices hold no DPH facility license to lose, as South Carolina Mental Health Outpatient Licensing explains, so their exposure runs through the individual professional licenses instead.

No Waiting Period, and No Accreditation Shortcut

We found no provision in R.60-93 or 44-7-320 that bars a revoked licensee from reapplying for a set time. That cuts both ways. A new application can go in once the problem is fixed, but 44-7-320(A)(2) lets DPH weigh the full history of the facility and the applicant when it decides. Accreditation won’t speed anything up either. R.60-93 grants no deemed status, waiver or reduced inspection for CARF, Joint Commission or COA accreditation, so a returning facility goes through the same pre-licensure inspection as anyone else.

Getting Ready for the Contested Case Hearing

From what we’ve seen, the strongest position at a contested case hearing, and in any settlement talks with DPH before it, comes from a file that answers DPH’s own findings line by line. For each cited standard, show the rule section, the change made, the date it took effect and the evidence, such as revised policies, training sign-in sheets, new staffing schedules or a fresh chart audit. If any finding involved an incident DPH should have heard about within 24 hours under §601 of R.60-93, document when and how it was reported, because late reporting tends to become its own citation. Bring proof that every assessed penalty has been paid or is formally contested. For the rules a reopened residence or clinic must meet, see South Carolina Drug and Alcohol Inpatient Treatment Licensing, South Carolina Drug and Alcohol Outpatient Treatment Licensing, and the state overview at South Carolina Behavioral Health Licensing. The Bureau of Health Facilities Licensing can be reached at 803-545-4370.

Frequently Asked Questions

Holding a DPH enforcement letter with the 30-day appeal clock already running? Contact us.

Sources

• S.C. Code Title 44, Chapter 7, sections 44-7-260 and 44-7-320: State Certification of Need and Health Facility Licensure Act (checked October 18, 2026)
• 2026 Act No. 146 (H.4189): Ratified act text, including 44-1-60 (SECTION 100) and 44-7-320(B) (SECTION 129) (checked October 18, 2026)
• S.C. Code Title 44, Chapter 1, section 44-1-60 as printed through the 2025 session (superseded by Act No. 146): Department of Public Health (checked October 18, 2026)
• DPH, Regulation 60-93, sections 101 to 608: Standards for Licensing Facilities for Chemically Dependent or Addicted Persons, unofficial copy (PDF) (checked October 18, 2026)
• S.C. Code of State Regulations, Chapter 60 (official): Chapter 60, including R.60-93 history note (PDF) (checked October 18, 2026)
• DPH: Facilities for Chemically Dependent or Addicted Persons (checked October 18, 2026)
• DPH: Hospital Licensure (checked October 18, 2026)
• DPH, Regulation 60-125: Crisis Stabilization Unit Facilities (PDF) (checked October 18, 2026)
• DPH, Bureau of Drug Control: Drug Control, register and verify (checked October 18, 2026)