Anderson Company Runs Most of State Veteran Nursing Homes

Jessica Holdman/S.C. Daily Gazette

Caring for South Carolina’s elderly veterans has been one Upstate company’s focus for nearly three decades. A recent state contract will further extend that streak.

Anderson-headquartered HMR Veterans Services operates four of South Carolina’s six nursing homes for veterans.

The company started with the Richard M. Campbell Veterans Nursing Home, located in Anderson and named for the brother of the late former Gov. Carroll Campbell: U.S. Army Sgt. Richard Campbell was killed in action in May 1968 in Vietnam.

HMR has run Campbell’s namesake home since 1998 and will continue to do so through at least February 2033, along with Veterans Victory House in Walterboro. HMR has held contracts on the Lowcountry home since 2007.

For its services at the two homes, HMR will receive an estimated $375 million over seven years, paid by state and federal taxes.

HMR was the lowest bidder of three finalists for contracts starting March 1. In the first year, its rate of $333 per bed per day compared to the high bid of $425 per bed per day, according to documents provided to the SC Daily Gazette in a public records request.

Contracts for two other homes HMR runs — one in Gaffney and one in Florence — are out for bid now.

Outside the Palmetto State, HMR also runs all five of Alabama’s veterans homes and six out of 10 in Texas.

That brings the company’s total to 15 homes with 3,000 employees across three states.

SC’s investment in veterans

For all six homes in South Carolina, taxpayers spend about $80 million annually to collectively care for roughly 800 veterans, according to Heyward Hilliard, director of veterans’ homes for the South Carolina Department of Veterans’ Affairs.

In a state with 400,000 veterans, the homes always have a waiting list, he said.

Future expansions, including new homes planned for Orangeburg and Horry counties and a replacement of a Columbia home with a newer facility planned for Lexington County, will eventually increase capacity to more than 1,080 veterans.

Gov. Henry McMaster has backed these veterans’ homes in his budget recommendations. That includes a 2024 call for the Legislature to set aside $41 million for the state’s share of the future Lexington facility and $8 million for renovations at existing homes. The Legislature’s final budget last year matched that request.

“The governor believes veterans bring great value to South Carolina,” said his spokesman, Brandon Charochak. “We’re a military friendly state and part of the reason for that are state veterans’ homes.”

The construction timeline of those new homes depends on congressional spending, since federal taxes cover 65% of the cost. South Carolina must kick in the other 35%. Total funding could be five years away, Hilliard said.

A focus on veterans

Operating homes for veterans is the only thing HMR does, which makes the company unique nationwide, Russell Keogler, vice president of corporate operations, told the SC Daily Gazette.

“There are competitors out there, but their main focus is on traditional nursing homes,” Keogler said. “For us, this is all we do and all we do every day.”

That gives HMR an advantage when it comes to meeting the unique needs of veterans, according to Keogler.

HMR has specialists on hand to treat illnesses more common to veterans, such as post-traumatic stress disorder. As Vietnam and Korean War veterans are aging, they are also facing more health complications from exposure to toxins, such as Agent Orange used during the war to remove trees and foliage in the dense jungle battlegrounds.

The House’s chief budget writer, Ways and Means Chairman Bruce Bannister, said it makes sense to have specialized homes with staff to meet veteran-specific needs rather than caring for them alongside the rest of the state’s elderly population.

“South Carolina has a very long and proud history of supporting veterans,” said the Greenville Republican. “And we like the idea of taking care of veterans after their service.”

Plus, South Carolina’s military bases are major economic drivers for the state, he said.

Veterans’ homes are just one way lawmakers seek to attract veterans to the Palmetto State or, if they’re here already, keep them and their skills in South Carolina after they retire. Under a 2022 law, military retirees pay no state income taxes on pensions earned for at least 20 years of service.

“If they knew there was a robust veterans home resource, that would be a favorable consideration when thinking about where to spend their retirement years once they’re out (of the military),” Bannister said.

A company history

Still, HMR wasn’t always just a veterans-based company.

Michael McBride, a nursing home administrator, founded it as Health Management Resources, Inc., in 1993, after leasing his first six nursing homes.

Its first veterans’ home, the Campbell facility, became part of the portfolio in 1998, seven years after it opened. That’s also when Army veteran William Biggs, the husband of freshman U.S. Rep. Sheri Biggs, joined as CEO. He had been the administrator of the home in Anderson when HMR took over the contract.

At one point, HMR had as many as 27 veteran and non-veteran facilities across five states, according to McBride’s biography on the company website. In 2010, the company sold 21 hospice, rehab and pharmacy locations to a private equity firm but held on to the veterans’ services side of the business.

McBride continues to sit on HMR’s board of directors, as does the widow of another HMR co-founder, Ed Childress.

William Biggs retired and Ladeeb Diab replaced him as CEO in May 2023. Eight months later, Biggs’ wife launched her campaign for the ruby red congressional seat being vacated by Rep. Jeff Duncan, who chose not to seek an eighth term. Sheri Biggs, a nurse practitioner, emerged the winner of a seven-way GOP primary contest in June 2024. Her 3rd District win last November sent two South Carolina women to Congress for the first time ever.

William Biggs declined to comment for this article, citing a noncompete agreement he signed upon retirement that prevents him from speaking about the company.

The congresswoman, in financial disclosures filed last month, reported more than $4 million in income in 2024 from the sale of her husband’s minority interest in HMR businesses.

Members of Congress are required to annually disclose their finances. But they’re only required to report a range of how much their assets and liabilities are worth, so the couple’s exact earnings are unknown. But she valued the capital gains from each of four HMR businesses at more than $1 million.

‘Push the envelope’

Keogler said HMR has sought to “push the envelope” in other ways as well.

For example, at the request of states it contracts with, HMR began running its own pharmacies at its homes, instead of calling in prescriptions from elsewhere.

“We can do all of our medication reviews right in house, and our pharmacists actually know the residents,” he said. “It’s no longer just filling a prescription. It’s taking care of a veteran who you see every day.”

HMR also weathered staffing shortages exacerbated by the COVID-19 pandemic. It does so through a scholarship program, paying for the education of any certified nursing assistant employed by the company who wants to pursue a higher-level licensed practical nursing degree.

“We help cover the cost of their tuition and books. We provide them a mentor to help guide them through the program, all while they can continue to work on this flexed academic schedule that builds professional growth for the individual and provides us a constant source of new nurses,” Keogler said. “I think it’s those innovative practices, which we’ve accelerated over the last two years, that really caught the attention of our state partners.”

A huge cost benefit

There are other reasons South Carolina’s more than 386,000 veterans and their families may choose a veterans home.

“It’s really camaraderie and connection,” Keogler said. “There’s a true brotherhood that exists in the service and that comes out later on in life.”

Also, there’s a huge cost benefit to families when they select a state veterans home. With military service benefits, their cost is far less than that of a traditional nursing home.

The federal government pays states a daily rate which can cover up to 50% of the homes’ operating costs. For veterans deemed at least 70% disabled due to injuries related to their military service, their cost is covered in full, Hilliard said.

The remaining costs are covered by state taxes or by the veterans themselves, said Hilliard, who was previously HMR’s executive vice president of operations. He joined the state agency in April 2024 after it took over the homes’ operations from the state mental health agency.

Above average

South Carolina also is in the minority of states — one of 13 — that pay private contractors to run all of its homes, though more states are trending that direction, Hilliard said.

While private contractors run the homes, the state public health agency and the U.S. Department of Veterans Affairs are tasked with inspecting them. And the state veterans agency employs someone on site at each home, Hilliard said.

“Our homes consistently perform at or above national averages,” he said.

Three of the four HMR-run homes in South Carolina have recently received high marks.

State and federal regulators inspected the Anderson and Walterboro homes seven times over the past four years. Some reviews were the result of complaints and required the homes to make improvements. But each received a government rating of four out of five stars.

The Gaffney home has gone through four inspections and one improvement plan in that time and has a perfect rating.

The Florence home, however, sits at a two out of five. Federal reports site shortfalls in a handful of patient treatment plans for residents with medical issues including diabetes, a feeding tube and ulcers and bedsores.

The state home in Columbia, which is run by Avalon Health Care Group rather than HMR, also has a two-star rating. The same group also runs the state’s newest veterans’ home in Sumter, which opened in January. It hasn’t been rated yet.

HMR also made headlines in 2018, when the wife of a U.S. Air Force veteran alleged her husband suffered repeat infections, hospitalizations and unexplained bruises while he was in the Walterboro home, the Independent Mail reported.

And in May 2018, HMR settled a $425,000 lawsuit involving a veteran at the Anderson home who had a latex glove lodged in his airway. He died five days later.

Hilliard, who was still working for HMR at the time, told the Independent Mail: “Health care is a very litigious environment. A settlement does not constitute an admission of liability.”

State Department of Public Health investigations around this time found 13 violations involving “policies and procedures, staff training, resident records, resident care and medication administration.” The agency fined HMR $3,600.