🔒Durand returns to CT from Rhode Island to lead New Britain’s Hospital for Special Care; reimbursement rates, worker burnout among key challenges

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When Lynn Ricci, the longtime president and CEO of New Britain-based Hospital for Special Care (HFSC), announced in June last year that she planned to retire, the hospital began a national search for her replacement.

HFSC hired Chicago-based executive search firm WittKieffer to help find its next chief executive. After that nationwide hunt, they found Ricci’s successor — practically in the hospital’s backyard.

Meet Crista F. Durand, a Connecticut native born and raised in Putnam, and a die-hard New England Patriots fan.

Since 2014, Durand, 54, had served as president of Newport Hospital, a 129-bed community care provider in Rhode Island that is part of the Brown University Health System. Before that, she served as vice president of strategic planning, marketing and business development at Lawrence + Memorial Hospital in New London.

When Durand’s appointment was announced in February, Diane Chace, chair of the Hospital for Special Care board, said she was confident Durand would “further our commitment to our mission.”

For her part, Durand believes she was selected because she possesses a trifecta of skills.

“I was a hospital chief financial officer, a chief strategy officer and a CEO,” she said during a recent interview with Hartford Business Journal. “So, I deeply understand the financial aspects of a hospital-operations strategy, and I’m a seasoned CEO.”

She added that her Connecticut roots were also a plus.

Durand, who officially assumed her CEO role on March 3, is still settling into her job, but already has set goals for the 236-bed hospital located on 32 acres on Corbin Avenue in New Britain.

But unlike the facilities she has worked for in the past, this hospital is, well, special. It’s one of only two long-term, acute-care hospitals in the state; Gaylord Hospital in Wallingford is the other.

Two additional facilities are in the works, one in Danbury and another in Waterbury, which will double competition in the state.

That, combined with concerns over possible cuts to Medicaid reimbursement rates, offers significant challenges for HFSC’s new leader.

85% Medicaid

Founded in 1941, Hospital for Special Care is an independent, not-for-profit healthcare facility.

According to its most recent tax filing, for the fiscal year ended March 2024, the hospital reported revenue of $136 million, expenses of $131 million and net income of just under $4.8 million.

In addition, an analysis by ProPublica.org found that 95% of the hospital’s revenue, or $129.3 million, was from program services, while 2.6% ($3.5 million) was investment income and 0.9% ($1.26 million) was from donations.

Durand, though, says the hospital has historically struggled financially because 85% of its reimbursement revenue is from Medicaid — the government program administered by the state that provides health coverage for low-income individuals.

“I’ve worked in hospital systems that have had a high government payer mix, but 85% is unheard of,” she said.

The hospital’s staff of about 1,300 cares for patients that range in age from infants to the elderly.

It has eight areas of focus, including autism, brain injury, cardiac, complex pediatric, neuromuscular, pulmonary and spinal cord injury care, as well as therapy and rehabilitation.

“We have very sick, complicated patients,” Durand said. “For some patients, it’s a hospital. For others, it’s a home.”

HFSC’s patients run the gamut from those suffering from paralysis, a traumatic brain injury or Alzheimer’s/dementia, to individuals with muscular dystrophy or amyotrophic lateral sclerosis (ALS).

Durand noted that HFSC is the fourth-largest long-term care hospital among the 330 that operate in the U.S., and is one of just two nationwide that provides long-term acute care for children.

Of its 236 beds, 48, or about 20%, are for kids. That includes 28 beds for chronic, long-term care pediatric patients, and 20 for the hospital’s inpatient autism program.

“The fact that we treat kids that are really sick, I think, really sets us apart,” she said.

Goals and challenges

In accepting the leadership role at Hospital for Special Care, Durand said she was not given any specific goals by the organization’s board.

But, after nearly two months on the job, she has developed some of her own.

“My observations are that we’re steeped in history and culture,” she said. “We’ve got a phenomenal reputation and brand. So, one of my early goals would be to formalize our physician recruitment process. I think that’s something I’d like to do in time.”

She also wants to develop a strategic plan.

“I think that’s super important, and to continue to elevate our quality and brand, those are some of the short-term goals,” she said.

Longer term, she intends to develop a three-year strategic plan, which would include having “annual work plans to continue to drive our financial performance, our operational performance and our quality and community involvement,” she said.

As for challenges, Durand cited what she considers to be at the top of the list.

“The biggest challenge is that health care is hard, right?” she said. “When you look at it from an industry perspective, there’s a lot of residual PTSD from COVID. I think the biggest challenge is the workforce. Not only shortages, but development.”

To address that, she wants to incorporate and leverage artificial intelligence into everyday care.

“Leverage technology, have a digital ‘front door,’ … and create and inspire the next generation of healthcare workers, leaders and clinicians,” she said.

Also on her challenges list, not surprisingly, is reimbursement rates. According to the Connecticut Hospital Association, hospitals in the state receive reimbursement from Medicaid for only about 62% of what it costs to provide care to those patients. The reimbursement rate for Medicare is 74%.

As a result, Connecticut hospitals in 2023 incurred losses of $1.43 billion in Medicaid and $1.38 billion in Medicare, according to the CHA.

“We’re being nipped and tucked anywhere you face it,” Durand said. “So, whether you’re a hospital in Connecticut, or you’re a hospital somewhere else in the country, reimbursement is definitely a challenge.”

A third concern she cited is burnout, though she said she doesn’t like that word.

“Whether it’s physician burnout, clinical burnout, you could be working in the finance department and be burned out,” Durand said. “These jobs require a lot of emotional and physical stamina. Regulations are constantly evolving, whether it’s Medicare, Medicaid or the commercial side of the business. It’s a constant grind and it takes a lot of grit.”

The key, she added, is to “adapt and overcome. It takes a certain kind of individual that wants to work in the healthcare environment today.”

What she doesn’t consider a significant challenge, though, are the two new long-term care facilities being developed in Danbury and Waterbury.

“I’ve always thought competition is good because it helps you elevate your brand and what you do,” she said.

The two new hospitals also will be much smaller than HFSC, with each having about 40 beds.

Infectious enthusiasm

Durand certainly has enthusiasm for her work, something that Chief Nursing Officer Anne Wojskowicz describes as “infectious.”

While she enjoys working in health care, serving on the medical side was never really a goal, Durand said.

Growing up in Putnam, the daughter of two teachers, Durand earned a degree in finance and financial management from Salve Regina University in Rhode Island, and an MBA from Nichols College in Dudley, Massachusetts.

She returned to Connecticut and took her first healthcare job in home and hospice care, and then moved on to Day Kimball Hospital in her hometown, where she worked her way up to chief financial officer and senior vice president.

Now living in Newington with her husband, Steve, who works in manufacturing, Durand says they are “empty-nesters” since their two grown sons are now on their own.

Asked about her experience at Newport Hospital, she said a highlight was raising $1.2 million in 15 minutes with the help of former Patriots receiver Julian Edelman.

Yet, that was not her most surprising revelation. Since she has worked in hospital administration in both Connecticut and Rhode Island, she offered an observation about each state’s certificate of need (CON) application process that likely would startle health officials here.

In Connecticut, hospitals need to file a certificate of need — and get it approved by the Office of Health Strategy — in order to add certain expensive equipment, a new facility or conduct a merger or acquisition, among other things.

While health administrators and others in the state have complained about the length of time a CON approval takes in Connecticut, Durand said Rhode Island’s method is worse.

“It’s a much more arduous process, really,” she said. “So, in Rhode Island you have to file what’s called a letter of intent 45 days before, to let the state know. You can only submit a CON in January or June, with these very specific dates.”

“In Connecticut, it’s a rolling process, which is much, much better,” she added. “You can submit a CON at any time. So, I think that Rhode Island can learn a little bit from Connecticut.”