Podcast Summary: Leading Organizations That Matter
Episode 105: Renee McInnes—Passion for the Mission
Host: Rey Spadoni
Guest: Renee McInnes, CEO, Croi Health
Release Date: April 21, 2026
Episode Overview
This episode spotlights the passion and perseverance behind leading a nonprofit healthcare organization through an era of rapid change and increasing challenges. Rey Spadoni welcomes Renee McInnes, CEO of Croi Health, for an in-depth discussion on leadership, branding, industry transformation, and staying true to a mission-driven ethos in home health and hospice care. The conversation delivers insights useful for aspiring leaders, nonprofit professionals, and anyone invested in the healthcare sector.
Key Discussion Points
Renee McInnes—Background and Entry into Leadership
[00:53]
- Renee reflects on her long career as a nurse, previously spending years in both hospital and home healthcare settings.
- She’s been CEO of Croi Health (formerly NVNA and Hospice) for almost 11 years, deeply rooted in the mission of community-based care.
Quote:
“I am a nurse and have been in home health care for quite some time. I don't really want to say how many years, but many, many... And so I've been the CEO here for almost 11 years now. And yeah, it's been great. Health care is crazy, but yeah.” (Renee, [00:53])
The Power and Pitfalls of Rebranding
[01:45]
- Croi Health’s dramatic rebranding from Norwell Visiting Nurse/NVNA and Hospice aimed to reflect expanded services and regional growth (now serving 27 towns).
- The Gaelic word “Croi” (meaning “heart”) was chosen to embody the organization’s values and future flexibility.
- Community concerns included whether the organization’s ownership or mission had changed, prompting strategic communication efforts.
Quote:
“With all that you do, you really should rebrand in terms of, you know, the future state... [The new name] enables us to really also expand. We don't know what are we doing future. Future state.” (Renee, [02:45])
Lessons Learned:
- Any name change is a major leadership challenge.
- Communicating with internal and external stakeholders early and often is vital.
- Expect ongoing questions and be ready to repeatedly clarify continuity of mission and ownership.
Homecare Industry Insights and Distinctions
[07:19]
- Croi Health provides certified home health, hospice, and palliative care—distinct from “private duty” or unskilled home care.
- Reimbursement is strictly linked to physician-ordered “skilled care”; services range from post-surgery therapy and safety assessments to end-of-life and chronic disease management.
- There’s significant public confusion surrounding terms like palliative care and hospice.
Quote:
“If you're going to need services that are reimbursed by either Medicare or another commercial payer... there has to be what is considered a skilled care. And that can mean anywhere from...you need a nurse or physical therapy, occupational therapy at home...” (Renee, [07:19])
Evolution and Challenges in Home Health
[10:28]
- Patients are sicker now at discharge than in past decades, requiring more complex home care.
- Regulatory and reimbursement changes have reduced available “wraparound” services, making organizational sustainability more difficult.
- Sector now must coordinate closely with hospitals and rehab facilities to achieve successful patient outcomes.
Quote:
“People are much, much sicker now than they were back in the 90s... we were able to provide way more wraparound services than the payment structure allows today.” (Renee, [10:28])
Trends Impacting the Sector
[12:56]
- Medicare Advantage plans now dominate, but pay at rates unsustainable for providers—sometimes 52% below direct costs.
- Payment models often misalign with quality and continuity of care goals.
- Growing need among dually eligible (Medicare/Medicaid) patients, paired with a serious caregiver shortage.
- Technology is helpful, but not a full solution—especially for vulnerable populations.
Quote:
“Medicare Advantage is crippling our industry... The way our health care system is designed and the way the payment models are designed is counterintuitive... the incentives...don’t make sense in terms of quality of care.” (Renee, [12:56])
The Role of Artificial Intelligence
[16:02]
- AI is seen as both an opportunity and a risk.
- Major interest in AI-driven efficiencies for clinician documentation and workflow.
- Caution around data security and HIPAA regulations.
- Croi Health is researching but taking a watchful, not hasty, approach.
Quote:
“I think it’s relevant for sure, Ray. I think where there’s opportunity is within...our electronic medical record and documentation. Like how do we improve the documentation time for the clinicians so they can spend more time seeing patients and not so much time documenting...?” (Renee, [16:02])
Medicare Advantage: The Buyers' Beware Challenge
[18:21, 22:30]
- Patients attracted by low up-front cost and extra benefits of Medicare Advantage may experience barriers when seriously ill.
- Out-of-network costs, access challenges, and reduced network participation by providers all pose risks.
- Renee urges consumers to consider what will happen “when you get sick”—not just when healthy.
Quote:
“You have to look at the out of network cost. What's going to happen when you get sick and you want to go to the Brigham or Mass General...We see access to care issues for patients.” (Renee, [20:48])
Competing With the Goliaths: Fundraising, Quality, and Differentiation
[25:26]
- Croi Health competes by:
- Robust fundraising (especially for a residential hospice house serving the underinsured).
- Emphasizing transparent, authentic leadership and connection to the community.
- Focusing on high patient satisfaction and quality ratings.
- Developing specialized, mission-driven programs (e.g., primary palliative care in the home).
- Building partnerships rather than pursuing mergers/acquisitions.
Quote:
“When you're doing this kind of work, you need...to be authentic and you have to be transparent...You have to be passionate about and believe in the mission.” (Renee, [26:48])
Leadership Realities and Resilience
[31:08]
- Sleepless nights are part of the CEO experience—balancing patient care, staff satisfaction, and financial viability creates constant tension.
- Fundraising brings new pressures—a personal sense of responsibility to donors and the community.
- The goal as a nonprofit CEO is often just to “break even” while sustaining community impact.
Quote:
“There are many sleepless nights... You worry about...employee retention... patient engagement, patient satisfaction... how are you going to break even? That's all you're looking to do, right? ... It's really hard. It's really, really hard.” (Renee, [31:38])
Advice for Aspiring Nonprofit Leaders
[33:40]
- Develop “content expertise;” know the work intimately.
- Be able to detect red flags and validate your trust in systems and people.
- Value authenticity and recognize the impact of your title on others’ comfort and candor.
- Understand your deeper motivations—mission must be front and center, not title or compensation.
- Get coaching and self-awareness support as you move up.
Quote:
“You need...content expertise, being aware of the landmines, developing a discerning eye...You need a coach...If it's for the title, if it's for the money, don't do it. It's got to be that you really have a passion for the mission.” (Renee, [33:40])
Passion for the Mission—The Sustaining Factor
[37:59]
- Commitment to the mission is what helps leaders and organizations survive the valleys and celebrate the peaks.
- True value is found in the stories and gratitude of the people and families served, especially in difficult moments.
Quote:
“Just as soon, you know, you feel defeated sometimes due to the structure of healthcare... Then you have some moments where you're like, wow, we are really making a huge difference.” (Renee, [37:59])
Notable Quotes
- “Sleepless nights. I hate to say it, but if you're the CEO of an organization and you don't have sleepless nights, God bless...” (Renee, [31:38])
- “If it's for the title, if it's for the money, don't do it. It's got to be that you really have a passion for the mission...” (Renee, [33:40])
- “You don’t necessarily have to own something to be part of the community... you can be a preferred affiliated partner, work together, and it’s a win, win for both.” (Renee, [30:04])
Key Timestamps
- 00:53 — Renee's personal background and experience
- 01:45 — The story and leadership lessons behind the Croi Health rebrand
- 07:19 — What skilled certified home health and hospice care entails
- 10:28 — Historical and current challenges in homecare
- 12:56 — Impact of Medicare Advantage and future industry trends
- 16:02 — How AI may affect home health care
- 22:30 — What consumers should know about Medicare Advantage
- 25:26 — Competing as a nonprofit against large for-profits
- 31:38 — Leadership worries and responsibility
- 33:40 — Advice for those aiming for top leadership positions
- 37:59 — The importance of mission in sustaining leadership
Further Information
- Learn more about Croi Health: croi.org
- Contact Renee McInnes: rmcinnes@croihealth.org
Tone and Takeaways
The episode is frank, practical, and encouraging, honoring the emotional highs and administrative lows of nonprofit healthcare leadership. Both Rey and Renee emphasize transparency, authenticity, and “passion for the mission” as foundations for long-term resilience and measurable community value.
For mission-driven leaders, aspiring executives, and anyone seeking insight into nonprofit healthcare, this episode provides an honest roadmap through challenges, change, and community impact.