2024-11-04T09:42:20-06:00 2023-12-31 010523282 Berry Dunn McNeil & Parker LLC 2211 Congress St Portland ME 04102 990 2023-01-01 030107360 Brattleboro Retreat BRAT 8022577785 1 Anna Marsh Lane Brattleboro VT 05302 Jill Meschke CFO 8022577785 2024-10-29 1 1 Joseph R Byrne P01289281 2077752387 2024-10-29 2023 2024-10-15 13:58:12Z Steven Cummings 1 Anna Marsh Lane Brattleboro VT 05302 101461086 0 X www.brattlebororetreat.org X 1834 VT Offering a continuum of care including Inpatient, Partial Hospitalization, Residential and Outpatient. 13 11 570 11 0 0 18133034 581045 62446440 97284097 92698 479822 -65219 -92705 80606953 98252259 6295 500 0 0 39180038 44176354 36000 36000 36000 32684329 45867140 71906662 90079994 8700291 8172265 57546913 60411408 26049366 20503242 31497547 39908166 X Inspired by the courage of our patients, the Brattleboro Retreat is dedicated to children, adolescents and adults in their pursuit of recovery from mental illness and psychological trauma. We are committed to excellence in treatment, advocacy, education, research, and community service. We provide hope, healing, safety and privacy through a full continuum of medical and holistic services delivered by expert caregivers in a uniquely restorative Vermont setting. 0 0 72790454 500 97284097 Offering a full continuum of care including inpatient and partial hospitalization, residential care for children, intensive outpatient services for adults, and traditional outpatient treatment for children and adolescents adults.Patient Days: Inpatient: 33,235, Partial: 5,880, Residential: 2,739, Outpatient: 25,897 72790454 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 49 0 1 570 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 0 VT X Jill Meschke 8022583716 1 Anna Marsh Lane Brattleboro VT 05301 Thomas Huebner Board Chair 1.00 0.00 X X 0 0 0 Justin Johnson Vice Chair 1.00 0.00 X X 0 0 0 Jill Meschke Treasurer/Chief Financial Officer 40.00 0.00 X X 158170 0 2260 Joseph Pyle Secretary 1.00 0.00 X X 0 0 0 Judi Fox Assistant Secretary 1.00 0.00 X X 0 0 0 Wichie Artu Trustee 1.00 0.00 X 0 0 0 Elizabeth Catlin Trustee 1.00 0.00 X 0 0 0 Kristan Outwater MD Trustee 1.00 0.00 X 0 0 0 Drew Pate MD Trustee 1.00 0.00 X 0 0 0 Julie Potter Trustee 1.00 0.00 X 0 0 0 Christopher Turley Trustee 1.00 0.00 X 0 0 0 Julie Vieth MD Trustee 1.00 0.00 X 0 0 0 Linda C Rossi CEO 40.00 0.00 X X 425105 0 4177 William King Past Interim CFO 40.00 0.00 X 313062 0 0 Karl Jeffries Chief Medical Officer 40.00 0.00 X 488922 0 52838 Amelia Shillingford VP Patient Care/CNO 40.00 0.00 X 248566 0 22405 Lisa Lambert Medical Director of Inpatient Svcs. 40.00 0.00 X 475880 0 9900 Lance B Thigpen Medical Director of Outpatient Svcs. 40.00 0.00 X 273266 0 30417 Elizabeth H Joseph Staff Psychiatrist 40.00 0.00 X 284051 0 35133 Jarred C Zucker Staff Psychiatrist 40.00 0.00 X 369812 0 27122 Rachael E Kandath Staff Psychiatrist 40.00 0.00 X 272209 0 19801 3309043 0 204053 82 0 1 1 AHSA LLC PO Box 1928 Edmond OK 73083 Contract Labor - Traveling Nurses 22016856 Sodexo PO Box 360170 Pittsburgh PA 152516170 Food/Housekeeping Services 3401961 Barton Associates Inc PO Box 417844 Boston MA 022417844 Contract Labor - Physicians 1817446 Locumtenens PO Box 405547 Atlanta GA 303845547 Contract Labor - Physicians 1193806 Netsmart Technologies Inc PO Box 713519 Philadelphia PA 19171 Information Technology 969731 38 443741 137304 12058 581045 Patient Service Revenue 623990 147777123 147777123 Miscellaneous 900099 745308 559149 186159 MSO Revenue 623990 136170 136170 Contractual/Char. Adj. 623990 -51374504 -51374504 97284097 480234 480234 399392 698058 -298666 -298666 -298666 2510357 2510769 -412 -412 -412 Joint Venture Earnings 900099 205961 205961 205961 98252259 97303899 0 367315 X 500 500 1715505 812731 902774 33519894 27821219 5698675 501305 407365 93940 5975611 4845563 1130048 2464039 2001773 462266 335103 335103 186459 186459 24000 24000 36000 36000 19663 19663 33766867 27299130 6467737 44430 44430 69477 54411 15066 1945208 1690102 255106 107569 86222 21347 352128 188908 163220 2097086 1156307 940779 828867 828867 Provider Tax 2140374 2140374 Miscellaneous Expenses 1895327 1371608 523719 Medical Supplies 1043729 1043729 Meals 1010853 997215 13638 90079994 72790454 17253540 36000 X 10663329 4815764 17831624 17746318 3244359 1627760 104154 124527 945743 1143416 67875137 47068735 20460157 20806402 3358374 3586564 412356 646338 0 1576540 526817 8337779 57546913 60411408 7727161 8493432 8667978 7776603 266417 168979 9387810 4064228 26049366 20503242 X 28065471 38166969 3432076 1741197 31497547 39908166 57546913 60411408 8172265 238354 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 0 0 1 40203 40203 0 Part II-B, Line 1: Line 1b relates to a portion of MSO VP's salary in the amount of $3,233. Line 1i includes the portion of AHA and VAHHS dues related to lobbying and the portion of lobbying expense paid to MMR, a lobbying firm. 3279650 187469 3467119 3636809 -357159 3279650 3686428 -49619 3636809 4965555 -1279127 3686428 7094433 389087 2517965 4965555 1.00000 0.00000 0.00000 0 0 120033 120033 53603055 35114905 18488150 11545861 9930569 1615292 2606188 2023261 582927 20806402 Cash Surrender Value of Life Insurance Policies and Annuity Contracts 525049 Deferred Compensation 1784 Due from Third-Party Payors 7810946 8337779 Deferred Compensation Obligation 16784 Deferred Provider Relief Funds 105764 Other Long-Term Liabilities 2661507 Operating Lease Liabilities 1280173 4064228 99168782 238354 698058 936412 98232370 19663 226 19889 98252259 90758163 698058 698058 90060105 19663 226 19889 90079994 Part V, Line 4: These funds consist of assets held by a trustee under an indenture agreement and funds set aside by the Board for capital improvements, over which the Board retains control and may, at its discretion, use for other purposes such as short-term operating needs. Part XI, Line 2d - Other Adjustments: Rental Expenses 698,058. Part XI, Line 4b - Other Adjustments: Loss on Disposal of Asset 226. Part XII, Line 2d - Other Adjustments: Rental Expenses 698,058. Part XII, Line 4b - Other Adjustments: Loss on Disposal of Asset 226. X X X X X 1 Robert Szpila 140 Guilford St Brattleboro VT 05301 Fundraising Coordination 0 129299 36000 93299 129299 36000 93299 VT 1 1 1 X 250.000000000000 1 X 1 1 1 0 1 1 2410815 2410815 0.02680 2410815 2410815 0.02680 270321 400 269921 0.00300 33365224 21595399 11769825 0.13070 33635545 21595799 12039746 0.13370 36046360 21595799 14450561 0.16050 1 11954110 21403932 -9449822 X 1 1 1 1 Brattleboro Retreat 1 Anna Marsh Lane Brattleboro VT 05301 www.brattlebororetreat.org 939 X Brattleboro Retreat 1 0 0 1 X X X X X X X X X 21 1 1 0 1 X www.brattlebororetreat.org/info X 1 21 1 www.brattlebororetreat.org/info 1 0 1 X 250.000000000000 400.000000000000 X X 1 1 X X X 1 X https://www.brattlebororetreat.org/patient-financial-services X https://www.brattlebororetreat.org/patient-financial-services X https://www.brattlebororetreat.org/patient-financial-services X X X X X X 1 X 0 X X X X 1 X 0 0 Brattleboro Retreat Part V, Section B, Line 5: The Retreat conducted a collaborate Community Health Needs Assessment in partnership with Grace Cottage Family Health and Hospital, Brattleboro Memorial Hospital, and the Vermont Dept. of Health. The three health care organizations developed a steering committee which began meeting in October of 2020. The group met monthly over the next 10 months. The data collection process took place from January through June 2021. CHNA surveys were available from mid-March to mid-May 2021. The largest portion of the surveys were completed by residents attending COVID-19 vaccination clinics at Grace Cottage and Brattleboro Memorial Hospital. Windham County social service agencies, including Groundworks Collaborative, which service unhoused and housing-insecure individuals and families, also helped to distribute surveys to those individuals. Surveys were also distributed by social media. The data gathering process consisted of four primary sources of information: - Demographic, geographic, economic, and population health data gathered on Windham County residents from a variety of sources, including especially the VT Dept. Of Health online databank. - Community Health Needs Assessment survey results - Completed questionnaires submitted by social service agencies representing unique populations of Windham County residents (potentially medically underserved populations) - Group discussion and clinical experience of healthcare providers and leadership from Windham County hospitals Following collection of the qualitative and quantitative data, planners identified emerging community health needs, and flagged major themes and key findings worthy of attention in the Implementation Plan. Based on these key findings, planners at the Brattleboro Retreat established the following priorities: - Mental/Psychiatric Health - Addiction Treatment - Access to CarePlanners carried out this process by focusing only on needs and priority areas that fall within the mission and scope of the Brattleboro Retreat (i.e., mental health and addiction treatment) and that exist withing the Retreat's capacity to make an impact. The 2021 CHNA Steering Committee made significant efforts to assure that the needs and concerns of all segments of the Windham County population were heard, as described in the survey efforts above. Brattleboro Retreat Part V, Section B, Line 6a: Brattleboro Memorial Hospital and Grace Cottage Hospital Brattleboro Retreat Part V, Section B, Line 11: See attached implementation strategy. Part II, Community Building Activities: Anna Hunt Marsh founded the Brattleboro Retreat in 1834 with the hope of advancing the care and treatment of people with mental illness. She was a prominent resident of Hinsdale and the region's most successful woman at that time. The Retreat continues to honor her vision today by encouraging young people to enter the field of healthcare with the Anna Hunt Marsh Scholarship, awarded by nearby Hinsdale High School, in Hinsdale, NHAdditionally, the Retreat supports a variety of other community programs. Part III, Line 4: See Pages 8-11 of audited financial statements for footnote disclosure. Part III, Line 8: A cost to charge ratio was used to determine the amount reported on Line 6. Part III, Line 9b: Included in our debt collection policy there is a section that if a patient is known to qualify for Charity Care upon admission then the eligibility guideline is followed at the time of admission to capture that information. Part VI, Line 2: In 2023, the Brattleboro Retreat served 3,452 children, adolescents and adults in inpatient, residential, ambulatory, outpatient, and school programs.The impact of the Retreat's services upon its patients and their families and communities is often dramatic and life-saving; especially as fewer and fewer healthcare organizations choose to offer a full continuum of mental health and addiction care services. Meanwhile, the number of patients seeking treatment for mental health and substance abuse issues continues to rise throughout the region and the nation. The Retreat strives to meet this increasing demand for services by renovating and updating facilities and patient care areas and utilizing the latest in treatment modalities to improve health care outcomes for the populations served.In 2023, the Brattleboro Retreat served 1,422 individuals in our outpatient programs. Four hundred and forty-six (446) children were served across all programs. Eight (8) children were served in our residential programs.The Retreat continued to meet the need for quality psychiatric and addiction care coupled with an ongoing trend of higher inpatient acuity by strengthened its clinical expertise. This included the continued roll out of evidence-based practices throughout the hospital's programs along with an expansion of required clinical skills trainings involving both psychiatric and co-morbid medical conditions offered through the Retreat's Clinical Education department.The Retreat also continued to make important strides forward in improving its financial systems with the goal of strengthening cash flows and establishing a more predictable operating margin.Summary of Process for Openness and Public Participation:The Brattleboro Retreat keeps the community informed with appearances with the Brattleboro Select Board, Brattleboro Downtown Business Alliance, Brattleboro Development and Credit Corporation (BDCC), Brattleboro Chamber of Commerce, the Windham County Legislative Delegation, Southeastern Vermont Economic Development Strategies (SeVEDS), the Rotary Club of Brattleboro, and others. The Retreat is a member of the Brattleboro Chamber of Commerce. Additionally, there are active and ongoing collaborations with other community organizations including Brattleboro Memorial Hospital, Grace Cottage Hospital, Health Care and Rehabilitation Services (HCRS), Groundworks Collaborative, Windham County NAACP's Health Justice Committee, Rescue Inc., the Brattleboro Police Dept..In addition to its regular treatment and professional education services, the Brattleboro Retreat offers numerous programs to the community, including various lectures, forums, and special educational events. The feedback of patients, their families, and community members is of great importance to the Brattleboro Retreat.Strategic Plan & Financial Information:In 2023 the Brattleboro Retreat spent approximately $2.8M on capital improvements. The depreciation schedule was $2.1M. As a private not-for- profit organization, copies of the strategic plan are not publicly available. Part VI, Line 3: At the time of admission, patients receive counseling about their eligibility for assistance under various governmental programs as well as the organization's charity care policy. Part VI, Line 4: The Brattleboro Retreat is located in Brattleboro, Vermont, which is in the southeastern corner of Vermont-on the border with both New Hampshire and Massachusetts. Brattleboro is a small, rural town with an estimated population of 11,332. The estimated population for Windham County is 45,905 (U.S. Census, 2020). The state of Vermont has an estimated population of 643,077 . (U.S. Census estimate, 2022).The Retreat plays a vital role as a large provider of mental health services, providing a comprehensive mental health continuum of care for adults, children, and adolescents. Its inpatient services provide treatment to individuals of all ages from throughout the Northeast, accepts high numbers of Medicare and Medicaid funded patients and provides services offered by few other hospitals. In addition to its multiple adult psychiatric units, the Retreat operates the only inpatient services for children and adolescents in the State of Vermont. At the residential level of care, the Retreat also provides services to children age 6 to 14 in its Abigail Rockwell Children's Center program. In addition, the Retreat provides an array of outpatient services to people in the local area. These services include outpatient psychotherapy, medication management, as well as shorter-term intensive programs such as partial hospital and intensive outpatient levels of care. The Retreat additionally has specialty outpatient programs, offering Transcranial Magnetic Stimulation (TMS), and esketamine treatments for those with treatment-resistant depression (TRD). The Brattleboro Retreat is the only private mental health and specialty hospital in Vermont and one of the few in New England. In Vermont, there are four medical hospitals with psychiatric units. The Retreat is the largest provider of inpatient psychiatric services in the state and operates roughly the same number of psychiatric beds as the other four hospitals combined. The Retreat is also the only mental health hospital in Vermont for children and adolescents. Many area medical hospitals have downsized or eliminated their psychiatric beds in recent years, particularly those in New Hampshire. Most psychiatric units also exclusively serve adults with few inpatient programs available for children and adolescents. The Retreat is dedicated to serving this population. The relatively low population of Vermont and the greater population to the south necessitate drawing from a broad and diverse area. The Retreat's geographic location also facilitates this regional draw. While the majority of inpatient admissions to the Retreat come from the state of Vermont, patients also come from other states. The demographics of income, race, poverty etc., vary greatly across the catchment area and are therefore difficult to characterize. According to the data collected in the American Community Survey (ACS) and the Puerto Rico Community Survey (PRCS) conducted annually by the U.S. Census Bureau, the estimated median household income of Vermont residents is $73,991 (2022 data, most recent available). 10.4 percent of Vermonters live in poverty and 3 percent of Vermonters are without health insurance, according to the Vermont Household health Insurance Surbey. In 2023, 86 percent of the Retreat's funding came from public sources-34 percent from Medicare and 52 percent from Medicaid/State programs. Part VI, Line 6: Vermont Program for Quality in Healthcare-provides advocacy for access to health-care services in Vermont. X 0 1 X 0 0 0 0 0 0 0 1 0 Karl Jeffries Chief Medical Officer 443345 0 145 0 45432 0 9900 0 42938 0 541760 0 0 0 Lisa Lambert Medical Director of Inpatient Svcs. 475288 0 132 0 460 0 9900 0 0 0 485780 0 0 0 Linda C Rossi CEO 400005 0 0 0 25100 0 4177 0 0 0 429282 0 0 0 Jarred C Zucker Staff Psychiatrist 366087 0 3462 0 263 0 0 0 27122 0 396934 0 0 0 Elizabeth H Joseph Staff Psychiatrist 283425 0 0 0 626 0 8741 0 26392 0 319184 0 0 0 William King Past Interim CFO 313062 0 0 0 0 0 0 0 0 0 313062 0 0 0 Lance B Thigpen Medical Director of Outpatient Svcs. 272483 0 147 0 636 0 4203 0 26214 0 303683 0 0 0 Rachael E Kandath Staff Psychiatrist 271969 0 0 0 240 0 8229 0 11572 0 292010 0 0 0 Amelia Shillingford VP Patient Care/CNO 248365 0 0 0 201 0 7618 0 14787 0 270971 0 0 0 Jill Meschke Treasurer/Chief Financial Officer 146788 0 0 0 11382 0 0 0 2260 0 160430 0 0 0 Part I, Line 1a During calendar year 2023, Linda Rossi, CEO, and Karl Jeffries, Chief Medical Officer each received a housing allowance which is included as part of their taxable compensation. Part I, Line 1b The Board of Directors approved the housing allowances provided by the Organization. Part I, Line 7 During 2023 Karl Jeffries, Lisa Lambert, Jarred Zucker, and Lance Thigpen were awarded bonuses based on performance and due to lack of pay raise in the calendar year. Form 990, Part VII, Line 5: During the calendar year 2023, Brattleboro Retreat paid Mazars USA LLP, an unrelated organization, $313,062 for services provided by William King as Interim CFO. Brattleboro Retreat is not able to determine the compensation paid to William King, only the amount paid to Mazars USA LLP. A Vermont Educational and Health Buildings Financing Agency 237154467 2015-07-15 11245000 Refund Series 2011A Bonds 0 0 0 A 3452300 11245000 97745 11147255 2015 1 0 1 1 A 0 0 0 0 0 0 0 A 0 0 0 1 0 0 0 0 0 A 1 Date Rebate Computation Performed Issuer Name: Vermont Educational and Health Buildings Financing Agency Date the Rebate Computation was Performed: 12/20/2021 Form 990, Part VI, Section B, line 11b The Governing Body will receive the prepared 990 electronically for their review and approval prior to filing the return, followed by a presentation at their next full board meeting. Form 990, Part VI, Section B, line 12c A. The Brattleboro Retreat accepts the responsibility for the provision of optimum care and services to its patient population, and therefore must protect the integrity of clinical decision making and the provision of treatment and care to all patients. B. The Brattleboro Retreat will disclose any existing or potential conflicts of interest for those who provide care, treatment and services as well as management and governance activities. C. The Brattleboro Retreat will routinely review its existing relationship and its staff's relationships, with other care providers, educational institutions and payers to ensure that all relationships are within law and regulation and to identify and determine if conflicts of interest exist. D. Regardless of any fiduciary relationship with any healthcare provider (licensed clinical practitioner, vendor, educational institution, payer, outside resource agency, etc.), the hospital and its representative staff (including medical staff), will strive to provide optimum care to patients following appropriate utilization of resources standards. Care provided to patients will not be dependent upon financial relationships or fiduciary responsibilities. a. Tests, studies, treatments or procedures deemed usual and routine in the diagnosis, management or treatment of disease processes; as standard in the healthcare community, will not be withheld from any patient (unless the patient exercises his/her patient right to refuse treatment). b. Any healthcare provider who feels there is a conflict of interest in patient management and their relationship with the facility, must contact administration and notify the Chief Executive Officer immediately. E. Discussion at the administrative level will be initiated, whereby problem resolution will be the primary goal. In the interim, the Head of the service/department with jurisdiction over the healthcare provider will arrange for coverage of the patient; until resolution has been reached. F. If resolution cannot be reached at the administrative level, the matter will be forwarded to an Executive Committee of the Governing Body, who will meet as soon as practicable, however no later than one week after notification of issue. The Governing Body's primary purpose is to assure that optimum patient care and treatment is provided, regardless of fiduciary relationships, while maintaining a fair and just review of all circumstances surrounding the issue. The determination of the Governing Body will be final. G. No contract or transaction entered into by the corporation known as the Brattleboro Retreat, shall be affected by the fact that a director, member or officer of the corporation was personally interested in the contract or transaction or was personally interested in or a director or officer of a corporation that was personally interested in the contract or transaction. H. A member of the Governing Body or a member of a committee, when called upon to cast a vote for or against a matter which personally involves such individual, shall disclose himself/herself ineligible to vote on the grounds of conflict of interest. In cases where conflict of interest is not clearly apparent, or when such conflict is not declared by a person who in the opinion of other members has potential conflict, the conflict of interest issue may be brought before the body who will vote on such issue to determine whether or not a conflict of interest exists. I. Should there become known, at any time, a conflict of interest between any member of the Governing Body, medical staff, hospital personnel or other healthcare providers and the hospital or any of its agents, the individual(s) may excuse himself/herself from discussions and/or determinations with the identified healthcare provider(s). J. All members of the Governing Body, medical staff and hospital personnel have the responsibility and obligation, if there is such a time as it is discovered; that due to a fiduciary relationship, care of any patient may be compromised or may not be delivered within the known standard of care; to notify the Chief Executive Officer of the Brattleboro Retreat immediately upon identification of this issue. Form 990, Part VI, Section B, line 15 The Board Compensation Committee reviews comparative data for the CEO. The CEO does review benchmarking/comparative data for VPs and other key employees. Form 990, Part VI, Section C, line 19 All governing documents, conflict of interest policy, and audited financial statements are available upon request. Form 990, Part IX, line 11g Clinical Services: Program service expenses 383,879. Management and general expenses 88,678. Fundraising expenses 0. Total expenses 472,557. Contract Services: Program service expenses 26,896,625. Management and general expenses 6,187,191. Fundraising expenses 0. Total expenses 33,083,816. Consulting Fees: Program service expenses 18,626. Management and general expenses 191,868. Fundraising expenses 0. Total expenses 210,494. Form 990, Part X, Line 10; Land, Building, and Equipment Section 1.263(a)-3(n) Election: Brattleboro Retreat 1 Anna Marsh Lane Brattleboro, VT 05302 EIN 03-0107360 Brattleboro Retreat is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n). Form 990, Part VI, Line 16: Brattleboro Retreat invested in the Vermont Collaborative Care, LLC with Catamount Insurance Services, Inc. which is a wholly-owned subsidiary of Blue Cross and Blue Shield of Vermont, a non-for-profit organization. Vermont Collaborative Care LLC PO Box 186 Montpelier VT 056010186 462187169 Care Management Services VT Brattleboro Retreat Related 233982 671215 0 1 0.50000 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0