A crowded field of contenders is seeking permission to provide home health care in the lucrative Beaufort County market.
And some of the competitors are pulling out the stops to rally community support.
Nine applicants are traversing the county seeking a prized certificate of need, the state sanction to establish a new home-health agency. Only one is likely to be issued.
Eleven applicants were in the running, but two have dropped out, according to Adam Myrick, spokesman for the S.C. Department of Health and Environmental Control, which awards the certificate.
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The competition is rooted in the state health plan, a lengthy document regularly updated to assess where new services are needed, based on factors such as the number of patients in an area and population growth.
The most recent plan, issued in November, said new home-health agencies can be approved in only three of South Carolina's 46 counties -- Beaufort, Allendale and Edgefield.
On doctors' orders, home-health agencies send registered nurses and other personnel into patients' homes to provide services such as wound care and physical, occupational and speech therapy. Currently, eight home health agencies serve Beaufort County, according to the plan, although some are licensed only for certain types of patients.
Applicants and state health officials say it's not uncommon for multiple entities to seek a certificate of need when one becomes available. For example, three applicants are battling for the chance to build a new hospital near Fort Mill, Myrick said.
The state doesn't often grant new certificates for home-health care. Beaufort County is a particularly attractive market because it has a large, growing population of residents who want to stay in their homes as they age but have few relatives nearby to help them, said Paula Tharp, an owner of Interim HealthCare of Charleston and Ridgeland.
"It's going to be a great opportunity for anybody," she said. "... The stakes are high if you really want to do this."
To differentiate themselves from their rivals, the applicants for the Beaufort County certificate are visiting places like doctors offices, hospitals and nursing homes to ask for "letters of support."
Cassandra Cranston, a sales and marketing specialist at applicant Community Home Care & Hospice of Rocky Mount, N.C., said officials from her company usually plan a three- to five-day trip to blanket an area they hope to serve.
"They will use that trip to go around to solicit the letters," she said.
The practice means local doctors likely have been bombarded with requests to sign such letters, Tharp said.
The physicians do get something for their trouble.
"I think they're getting really good lunches," Tharp said.
Contact reporter Josh McCann at twitter.com/LowCoBiz.