Background: A privately-owned for-profit company, GPHC provides long-term basic healthcare and short-term acute and rehabilitative healthcare in their patients/customers’ homes. GPHC currently employs 70 nurses and operates in the rural areas of three states (northern Missouri, north-east Kansas, and south-west Iowa). The GPHC nurses are assigned approximately 15-20 patients each; each patient must be visited at least once per week (some more frequently). The long-term care patients are usually given a brief check of the vitals, given weekly medicine doses, and other basic care. The short-term patients require much longer visits with much more extensive care. In both cases, the nurses must coordinate care with the patient’s doctor(s), who are usually located in urban centers. The short-term patients often require advanced medical equipment, which is leased from equipment suppliers. Given the rural market, the nurses spend much of the time on the road (they are reimbursed for fuel costs). The main competitors on the long-term care are nursing homes and the patient’s families. The main competitors on the short-term care are urban rehab centers; there are no other hospice companies in the areas GPHC currently serves. GPHC’s back-office has just two managers and one secretary. Most of GPHC’s costs are labor—although fuel costs are increasingly a concern.