Ventilator Care and Critical Airways


About Us


Hospital for Special Care provides highly specialized care for patients living with complex and often catastrophic medical conditions. We are the primary provider of care for both adult and pediatric patients who qualify for Medicaid and require a long-term acute care hospital level of care.


Approximately 80 percent of our total inpatient days rely on Medicaid reimbursement, including nearly 100 percent of our pediatric patient stays


Each day we care for 65-70 patients dependent on or in process of weaning from a ventilator


Every day at least seven pediatric patients with critical airways require 1:1 observation 24/7

The complex care our patients require demands a different set of clinical competencies than other care environments. Recruitment and retention of a skilled licensed and unlicensed patient care workforce remains our greatest challenge, continues to impact access to care, and drive labor costs to unsustainable levels. The state’s targeted investment in specialized care, including enhanced rates for child inpatient psychiatric/autism care and ventilator beds in chronic disease hospitals, has slowed the financial losses that undermine our fiscal stability but have not been sufficient to sustain access to care.


We recognize and appreciate Connecticut’s investment in supporting the growth of academic and workforce development programs to expand the health care workforce, and we expect the return on those investments to be substantial – but they will take time, years even, to fully mature.

Our patients, however, need care today and most have nowhere else to turn.

Our Priority

We’ve made difficult decisions in order to prioritize the safety of patients currently in our care. Two minutes can be the difference between life and death for a pediatric patient with a critical airway.  These patients require one-to-one observation every minute of the day and night.  We cannot admit a child who requires this level of care unless we can be certain we can staff and pay for that observation for 21 shifts per child per week.


We acknowledge that these decisions have negative impacts for the patients we cannot admit and for the state healthcare system as a whole:

  • Reduction in our capacity has impacted pediatric and adult patients who require our level of care and have no other alternatives
  • Pediatric referrals we cannot accept stay in acute care for prolonged periods or may be sent to out of state facilities, increasing the burden on the patient’s family and the cost to the state for their care
  • These challenges will lead to continued and even greater reductions in access to care for Medicaid patients as we take necessary steps to ensure patient safety remains the top priority.  We need your assistance to sustain patient safety, and quality, and to keep our beds pediatric and adult beds open. 


We Need Your Support


We cannot do it alone and ask respectfully for your support and assistance.  With your support, we can return our focus to expanding access to care for the highly specialized patient populations we serve and training the health care workforce of tomorrow.  Specifically, we need your action to:

  1. Adopt the enhanced chronic disease hospital Medicaid rate for ventilator beds as a permanent rate change
  2. Adopt a matching, permanent $500 per day chronic disease hospital Medicaid rate enhancement for pediatric critical airway beds
  3. Establish a rate-setting process to adequately fund and sustain the safety net Hospital for Special Care has created in partnership with the State of Connecticut for our most vulnerable residents, ensuring that health care professionals who choose to care for Medicaid patients can earn equitable wages and benefits