2022-11-15T16:01:04-06:00 2021-12-31 010523282 Berry Dunn McNeil & Parker LLC 2211 Congress St Portland ME 04102 990 2021-01-01 030107360 Brattleboro Retreat BRAT 8022577785 1 Anna Marsh Lane Brattleboro VT 05302 Linda Rossi CEO 8022577785 2022-11-14 1 Linda Rossi 999009999 Joseph R Byrne P01289281 2077752387 2022-11-14 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z Linda Rossi 1 Anna Marsh Lane Brattleboro VT 05302 67018798 0 X www.brattlebororetreat.org X 1834 VT Offering a continuum of care including Inpatient, Partial Hospitalization, Residential and Outpatient Treatment for Children, Adolescents, Adults, and Older Adults throughout the Northeast. 12 11 616 12 2066 0 16184144 20923754 52962587 44084665 202829 86451 -16654 370169 69332906 65465039 7350 0 0 0 46748551 37359612 0 0 0 24220451 22634045 70976352 59993657 -1643446 5471382 45056083 45190535 27213457 21872622 17842626 23317913 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, psychological trauma and addiction. 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 47225236 43942929 Offering a full continuum of care including inpatient and partial hospitalization, residential care for children and adolescents, intensive outpatient services for adults (including treatment for opiate addiction), and traditional outpatient treatment for children, adolescents adults and older adults from throughout the Northeast. Patient Days: Inpatient 18,950, Partial 4,176, Residential 2,294, Outpatient - 20,373 241487 444315 Vermont Board of Education Approved school serving children and adolescents in inpatient, residential, and partial hospitalization programs. The curriculum meets the educational, clinical, and behavioral needs of our students as well as the requirements of Vermont's educational standards. Patient School Days 905. 47466723 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 52 0 1 616 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 12 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 VT X William King 8022583716 1 Anna Marsh Lane Brattleboro VT 05301 Louis Josephson CEO 40.00 0.00 X X 429117 0 43793 Thomas Huebner Board Chair 1.00 0.00 X X 0 0 0 Elizabeth Catlin Vice Chair 1.00 0.00 X X 0 0 0 Adam Grinold Secretary 1.00 0.00 X X 0 0 0 Joshua Davis Asst Secretary 1.00 0.00 X X 0 0 0 Christopher Turley Acting Treasurer 1.00 0.00 X X 0 0 0 Drew Pate Trustee 1.00 0.00 X 0 0 0 Joseph Pyle Trustee 1.00 0.00 X 0 0 0 Judi Fox Trustee 1.00 0.00 X 0 0 0 Justin Johnson Trustee 1.00 0.00 X 0 0 0 Kate O'Connor Trustee 1.00 0.00 X 0 0 0 Kenneth Becker Trustee 1.00 0.00 X 0 0 0 Tonia Wheeler Past Trustee 1.00 0.00 X 0 0 0 Beth L Chague Past CFO 40.00 0.00 X 113887 0 9857 Steven Van Loh Vice President Finance 40.00 0.00 X 51241 0 4618 Lisa Lambert Staff Psychiatrist 40.00 0.00 X 439600 0 12126 Guarav Chawla Chief Medical Officer 40.00 0.00 X 400840 0 36093 Karl Jeffries Sr Medical Director 40.00 0.00 X 288480 0 42208 Elizabeth H Joseph Staff Psychiatrist 40.00 0.00 X 268961 0 28398 Tracey Krasnow Unit Chief 40.00 0.00 X 258379 0 34913 2250505 0 212006 53 0 1 0 Sodexo PO Box 360170 Pittsburgh PA 152516170 Food/Housekeeping services 3436577 AHSA LLC PO Box 928 Edmond OK 730831928 Travel nurse provider 3048449 Schroeder Consulting 6630 Fonder Dr Parker CO 80134 Process consultant 1364155 Avant Healthcare PO Box 744554 Atlanta GA 303744554 Travel nurse provider 1008899 Locumtenens PO Box 405547 Atlanta GA 303845547 Travel doctor provider 799275 17 18546407 2377347 20923754 Patient Service Revenue 622200 89016976 89016976 Miscellaneous 900099 1081781 957530 2066 122185 MSO Revenue 622200 570539 570539 Contractual/Char. Adj. 622200 -46584631 -46584631 44084665 85474 85474 167342 99752 67590 67590 67590 1454984 1454007 977 977 977 Joint Venture Earnings 900099 302579 302579 302579 65465039 44262993 2066 276226 X 652514 652514 28642959 24784218 3858741 410338 355216 55122 5554188 4726757 827431 2099613 1771632 327981 437240 437240 90450 90450 23579 23579 12007843 9585556 2422287 69232 69232 65502 22751 42751 1728149 11815 1716334 14591 10035 4556 429119 242096 187023 1754605 967467 787138 796025 796025 Provider Tax 2552822 2552822 Miscellaneous Expenses 1624347 604358 1019989 Meals 626074 621508 4566 Medical Supplies 414467 414467 59993657 47466723 12526934 0 X 1708410 2603533 5155635 9925163 711923 1027878 7699649 2890283 150075 150075 630185 1222576 65013612 43101713 22585319 21911899 3672832 3807383 188551 492049 2553504 1159696 45056083 45190535 10354793 10024175 10371906 9532832 57605 356221 6429153 1959394 27213457 21872622 X 10058073 19822573 7784553 3495340 17842626 23317913 45056083 45190535 5471382 3905 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 12353 12353 0 Part II-B, Line 1: Line 1b relates to a portion of MSO VP's salary in the amount of $4,851. Line 1i includes the portion of AHA and VAHHS dues related to lobbying. 3686428 -49619 3636809 4965555 -1279127 3686428 7094433 389087 2517965 4965555 7046470 47963 7094433 6856675 191951 2156 7046470 1.00000 0.00000 0.00000 0 0 120033 120033 51136658 31992641 19144017 10965763 9206500 1759263 2791158 1902572 888586 21911899 Bank Overdraft 263629 Deferred Compensation Obligation 559820 Deferred Provider Relief Funds 73330 Medicare Accelerated Payments 1062615 1959394 65568696 3905 99752 103657 65465039 0 65465039 60093409 99752 99752 59993657 0 59993657 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 99,752. Part XII, Line 2d - Other Adjustments: Rental Expenses 99,752. 1 1 1 X 1 X 1 1 1 0 1 1 2681668 2681668 0.04470 26976485 14511344 12465141 0.20780 29658153 14511344 15146809 0.25250 240105 240105 0.00400 15730817 9187060 6543757 0.10910 15970922 9187060 6783862 0.11310 45629075 23698404 21930671 0.36560 1 0 7192464 15948262 -8755798 X 1 1 1 1 Brattleboro Retreat 1 Anna Marsh Lane Brattleboro VT 05301 www.brattlebororetreat.org 921 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 200.000000000000 300.000000000000 X X 1 1 X X X 1 X https://www.brattlebororetreat.org/financial-assistance X https://www.brattlebororetreat.org/financial-assistance X https://www.brattlebororetreat.org/financial-assistance X X X X 1 X 0 X X X X 1 X 0 0 Brattleboro Retreat Part V, Section B, Line 5: Because of its diverse and extensive service area, the Retreat defines its service area at both the county and state levels, and assesses the health needs of both areas. This gives planners a detailed understanding of the needs of the local populations as well as Vermont as a whole. The Community Health Needs Assessment (CHNA) was therefore divided into two phases: Phase I for Windham County and Phase II for the state of Vermont.For Phase I (Windham County), the Retreat partnered with Grace Cottage Hospital and Brattleboro Memorial Hospital to gather and assess both quantitative and qualitative data. The three health care organizations developed a steering committee, made up of representatives from each of the hospitals as well as from the Vermont Department of Health, Brattleboro Office, to guide the qualitative research and collect and analyze the quantitative data. The Windham County CHNA Steering Committee planned and conducted qualitative research, which included a countywide survey and a focus group on health care needs of minority and underserved populations. During the research process, the Steering Committee consulted with Vermont Agency of Human Services District Leadership Team and the Clinical Planning Group of the Vermont Blueprint for Health-Brattleboro Service Area.In Phase II (statewide), the Retreat gathered and assessed quantitative and qualitative data on mental health and addiction in the state of Vermont. Additionally, qualitative data was collected from community stakeholders across the state of Vermont through an online survey that was widely distributed across the state. During this phase of research, the Retreat consulted with the Vermont Department of Health, the Brattleboro Retreat's Consumer Advisory Council as well as a range of Retreat staff members, including clinical and administrative staff.Once the qualitative and quantitative data were collected and analyzed, planners reviewed the community health needs that emerged as a result of conducting the assessment. They carefully assessed each need, identified the major themes and developed broader priority areas to encompass these needs. Planners carried out this process by focusing only on needs and priority areas that fall within the mission and scope of the Brattleboro Retreat, namely in mental health and addiction treatment, as well as within the Retreat's capacity to make an impact. Planners also worked to identify needs that were supported by quantitative research data OR were identified in the community input process, through either of the surveys or the focus group. Once the planners identified some potential priority areas, they shared the results of the needs assessment as well as the recommended priority areas with the Brattleboro Retreat's Consumer Advisory Council and a group of Retreat staff members that included both clinical and administrative staff from various departments. Brattleboro Retreat Part V, Section B, Line 6a: Brattleboro Memorial Hospital, Grace Cottage Hospital and Brattleboro Retreat Brattleboro Retreat Part V, Section B, Line 11: See attached implementation strategy. Part II, Community Building Activities: Retreat Trails-Nine mile recreational trail network open to the public for non-motorized recreational activities. Part III, Line 4: See Pages 9-11 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 2021, the Brattleboro Retreat served 2,258 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 2021, the Brattleboro Retreat served 1,689 individuals in our outpatient programs. Two hundred and sixty two (262) children were served across all programs. Thirteen (13) 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 (wound care, for example) 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 regular appearances and/or memberships with the Brattleboro Select Board, Building a Better Brattleboro, 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 ongoing collaborations with other community organizations including Brattleboro Memorial Hospital, Grace Cottage Hospital, Health Care and Rehabilitation Services (HCRS), Rescue Inc., the Brattleboro Police Dept., and area schools.In addition to its regular treatment and professional education services, the Brattleboro Retreat offers numerous programs to the community free of charge, 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 2021 the Brattleboro Retreat spent approximately $1M on capital improvements. The depreciation schedule was $1.8M. 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 42,222. The state of Vermont has an estimated population of 623,989. (U.S. Census estimate, July 1, 2019).The Retreat plays a vital role as a large provider of mental health and substance abuse services in New England. It provides 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, the Retreat provides an array of ambulatory services to people in the local area. These services include outpatient counseling as well as partial hospital and intensive outpatient mental health and substance use disorder treatment.The Brattleboro Retreat is the only mental health and addiction 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. The surrounding states have similar arrays of services: a few free-standing psychiatric hospitals, such as Providence Behavioral Healthcare Hospital in Holyoke, MA, and some medical hospitals operating psychiatric units. 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. As a regional specialty hospital, the Retreat draws patients from a large and diverse catchment area: across Vermont and throughout the greater New England area and beyond. 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 all other New England States and beyond. Massachusetts, with an estimated population in 2019 of 6,892,503 is the second largest sending state. The Retreat is located just 8 miles from the Massachusetts border with interstate access to the western part of the state, including the cities of Northampton, Holyoke, and Springfield. 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 $60,076. Eleven percent of Vermonters live in poverty and 4.9 percent of Vermonters are without health insurance. In 2019, 74 percent of the Retreat's funding came from public sources-22 percent from Medicare and 51 percent from Medicaid/State programs. Part VI, Line 5: AL-ANON-weekly use of Central Conference RoomAA-weekly use of CafeteriaMidwinter Lunch Series-a series of 4 hour-long educational programs. Held annually in February, the series is free and open to staff, community providers, and the public. Topics are related to mental health and substance abuse in children, adolescents, and adults.Community Wellness Workshops-presented by the Brattleboro Retreat; these include wellness programs, ongoing classes, and support groups, many of which are free, for all members of the community. Cafeteria & Conference Room-both facilities are used for meetings by groups including: Brattleboro Area Development Committee, Brattleboro Area Chamber of Commerce, Early Education Services, Brattleboro Area Human Resources Network, Windham Regional Commission, Local Emergency Planning Committee (LEPC), Brattleboro Area Hospice, Brattleboro Early Educators Cooperative, Brattleboro Area Human Resources Network, Windham County Consortium on Substance Use (COSU), Safe Driving Program, Windham Southeast Supervisory Union, Windham Central Supervisory Union, NFI Vermont, Center for Health & Learning, Green Mountain Care Board, Blue Cross Blue Shield of Vermont, Al Anon, Alcoholics Anonymous, and United Way of Windham County.Relay for Life-the hospital's "Retreat Feat" team participates in this local event to raise funds and awareness in the fight against cancer. Part VI, Line 6: Vermont Assoc. for Mental Health-provides advocacy for the mental health community in Vermont: Vermont Program for Quality in Healthcare-provides advocacy for access to health-care services in Vermont. X 1 0 0 0 0 0 0 0 0 Louis Josephson CEO 406202 0 0 0 22915 0 8700 0 35093 0 472910 0 0 0 Lisa Lambert Staff Psychiatrist 439600 0 0 0 0 0 8700 0 3426 0 451726 0 0 0 Guarav Chawla Chief Medical Officer 400840 0 0 0 0 0 0 0 36093 0 436933 0 0 0 Karl Jeffries Sr Medical Director 288480 0 0 0 0 0 8700 0 33508 0 330688 0 0 0 Elizabeth H Joseph Staff Psychiatrist 268961 0 0 0 0 0 2741 0 25657 0 297359 0 0 0 Tracey Krasnow Unit Chief 258379 0 0 0 0 0 7950 0 26963 0 293292 0 0 0 Beth L Chague Past CFO 61864 0 0 0 52023 0 0 0 9857 0 123744 0 0 0 Part I, Line 4a During 2021, Beth Chague, Past CFO, received a severance payment of $38,464. A Vermont Educational and Health Buildings Financing Agency 237154467 2015-07-15 11245000 Refund Series 2011A Bonds 0 0 0 A 1674608 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 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 Chief 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 219,387. Management and general expenses 0. Fundraising expenses 0. Total expenses 219,387. Contract Services: Program service expenses 9,296,480. Management and general expenses 1,044,871. Fundraising expenses 0. Total expenses 10,341,351. Purchased Services: Program service expenses 64,109. Management and general expenses 0. Fundraising expenses 0. Total expenses 64,109. Consulting Fees: Program service expenses 0. Management and general expenses 1,377,416. Fundraising expenses 0. Total expenses 1,377,416. Collection Fees: Program service expenses 5,580. Management and general expenses 0. Fundraising expenses 0. Total expenses 5,580. 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 303498 536906 0 1 0.50000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0