2020-11-16T13:50:02-06:00 2019-12-31 010523282 Berry Dunn McNeil & Parker LLC PO Box 1100 Portland ME 041041100 990 2019-01-01 030107360 Brattleboro Retreat BRAT 8022577785 1 Anna Marsh Lane Brattleboro VT 05302 Louis Josephson PhD President & CEO 8022577785 2020-11-13 1 Joseph R Byrne P01289281 2077752387 2020-11-13 69.49.157.66 2020-11-13 11:49:39 ES P E991ED1B9E004569FFEC626FB244167D6F1D0D75 B12F49522033FB8D1B7BDF64743817F7E8159EF1 2019 2021-01-29 14:40:06Z Louis Josephson PhD 1 Anna Marsh Lane Brattleboro VT 05302 83658200 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 11 892 12 409812 0 6240314 458146 71771130 72682931 184592 234624 39288 138638 78235324 73514339 40157 45077 0 0 50229456 51993541 0 0 0 23527573 26918945 73797186 78957563 4438138 -5443224 48334026 42993541 23786014 23646782 24548012 19346759 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 62508449 45077 69508859 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 - 36,066, Partial - 8,123, Residential - 4,911, Outpatient - 19,547 225160 225263 Continuing education program providing up to 23 workshops and seminars throughout the year for physicians, nurses, social workers, psychologists, therapists, drug and alcohol counselors, and other healthcare professionals. 2465080 3055780 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 8,208. 65198689 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 121 0 1 892 1 1 1 0 0 0 0 1 1 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 0 1 1 0 VT X Ann Walsh 8022583737 1 Anna Marsh Lane Brattleboro VT 05301 Elizabeth Catlin Board Chair 1.00 0.00 X X 0 0 0 Justin Johnson Vice Chair 1.00 0.00 X X 0 0 0 Adam Grinold Secretary 1.00 0.00 X X 0 0 0 Joseph Pyle Assistant Secretary 1.00 0.00 X X 0 0 0 Christopher Turley Acting Treasurer 1.00 0.00 X X 0 0 0 Kenneth Becker Trustee 1.00 0.00 X 0 0 0 Kate O'Connor Trustee 1.00 0.00 X 0 0 0 Drew Pate MD Trustee 1.00 0.00 X 0 0 0 Thomas Huebner Trustee 1.00 0.00 X 0 0 0 Tonia Wheeler Trustee 1.00 0.00 X 0 0 0 Josh Davis Trustee 1.00 0.00 X 0 0 0 Tammy Richards Past Secretary 1.00 0.00 X X 0 0 0 Louis Josephson CEO 40.00 0.00 X X 420599 0 49187 Arthur Nichols Past CFO 36.00 0.00 X 236565 0 30441 David Burke CFO 40.00 0.00 X 10258 0 0 Karl Jeffries Staff Physician 40.00 0.00 X 272360 0 41062 Peter B Kassis Staff Physician 40.00 0.00 X 265203 0 41437 Tracey Kasnow Staff Physician 40.00 0.00 X 245888 0 45488 Lisa Lambert Staff Physician 40.00 0.00 X 462954 0 2811 Simha Ravven Chief Medical Officer 36.00 0.00 X 290982 0 17089 2204809 0 227515 73 0 1 0 AHSA LLC PO Box 1928 Edmond OK 730831928 Contract Labor 4404330 Sodexo PO Box 360170 Pittsburgh PA 152516170 Cafe/Dietary/Housekeeping 3653411 Locumtenenscom PO Box 405547 Atlanta GA 303845547 Contract Labor 1908810 Barton Associates PO Box 417844 Boston MA 022417844 Contract Labor 1233383 Avant Healthcare Professionals PO Box 744554 Atlanta GA 303744554 Contract Labor 1088437 17 75480 92528 290138 19699 458146 Patient Service Revenue 622200 165993536 165993536 Miscellaneous 900099 1977745 1140382 409812 427551 MSO Revenue 622200 1011147 1011147 Contractual/Char. Adj. 622200 -96299497 -96299497 72682931 216271 216271 149900 110823 39077 39077 39077 10015220 10462 10003410 3919 11810 6543 18353 18353 18299 75480 25709 -7410 -7410 Joint Venture Earnings 900099 106971 106971 106971 73514339 71952539 409812 693842 X 45077 45077 747050 747050 40625874 35557447 5068427 696544 607024 89520 7038970 6115433 923537 2885103 2481718 403385 402598 402598 67704 67704 21408 21408 14384759 12685483 1699276 100136 100136 186158 51470 134688 1333811 1333811 95017 59129 35888 506790 275288 231502 1813182 999766 813416 829367 829367 Miscellaneous Expenses 3269829 1618278 1651551 Provider Tax 2482916 2482916 Meals 1172417 1137440 34977 Medical Supplies 252853 252853 78957563 65198689 13758874 0 X 840348 40510 1198933 931768 12494731 10903566 228242 174390 622127 720249 58865499 39581376 18228262 19284123 11818736 8333383 682531 797023 2220116 1808529 48334026 42993541 9541449 8627740 11170671 11185977 1131708 597584 1942186 3235481 23786014 23646782 X 18440367 13459897 6107645 5886862 24548012 19346759 48334026 42993541 -5443224 241971 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 0 0 1 25725 25725 0 Part II-B, Line 1: Line 1b relates to a portion of MSO VP's salary in the amount of 15,557. Line 1i includes the portion of AHA and VAHHS dues related to lobbying. 7094433 389087 2517965 4965555 7046470 47963 7094433 6856675 191951 2156 7046470 9664963 192287 3000575 6856675 10806727 58236 1200000 9664963 1.00000 0.00000 0.00000 0 0 120033 120033 44091450 29569554 14521896 10094348 8243251 1851097 4559668 1768571 2791097 19284123 Bank Overdraft 2472597 Deferred Compensation Obligation 512884 Insurance Claim Payable 250000 3235481 73900542 241971 7700 136532 386203 73514339 0 73514339 79101795 7700 136532 144232 78957563 0 78957563 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 110,823. Fundraising Expenses 25,709. Part XII, Line 2d - Other Adjustments: Rental Expenses 110,823. Fundraising Expenses 25,709. Ride for Heros 44895 40551 4344 500 6835 Golf Tournament 48884 34929 13955 330 6807 4708 5007 1522 93779 75480 18299 330 7307 4708 5007 8357 25709 -7410 1 1 1 X 1 X 1 1 1 0 1 1 2686735 2686735 0.03400 37891345 36791738 1099607 0.01390 40578080 36791738 3786342 0.04790 41192 41192 0.00050 248066 7100 240966 0.00310 20210913 15613693 4597220 0.05820 45077 45077 0.00060 20545248 15620793 4924455 0.06240 61123328 52412531 8710797 0.11030 1 0 0 10035065 14942613 -4907548 X 1 1 1 1 Brattleboro Retreat 1 Anna Marsh Lane Brattleboro VT 05301 www.brattlebororetreat.org 889 X Brattleboro Retreat 1 0 0 1 X X X X X X X X X 18 1 1 0 1 X www.brattlebororetreat.org/info X 1 18 1 www.brattlebororetreat.org/info 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 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: Based on the data collected in the 2018 CHNA, the Brattleboro Retreat identified three (3) priority areas in which to focus its efforts for the upcoming 2019-2021 reporting period:1. Cooperate with regional providers as part of the Accountable Communities for Health by helping individuals and families receive more timely and effective mental health/addiction treatment and aftercare support through enhanced inter-agency collaboration.2. Increase accessibility to the Retreat's programs and services by improving the cultural competencies of providers and removing barriers that challenge vulnerable populations and people who have been historically underserved by the mental health and addiction treatment system.3. Reduce barriers to treatment and promote fact-based knowledge about mental illness and addiction among healthcare providers and the general public by increasing educational initiatives and supporting campaigns to decrease stigma.In 2019, planners at the Brattleboro Retreat, in consultation with various staff members from across the hospital and the Brattleboro Retreat's Consumer Advisory Committee, delivered on the below items, that are part of the three-year action plan to address these priority areas.CHNA Implementation Plan 2019-2021 (2019 Activities)#1. Cooperate with regional providers as part of the Accountable Communities for Health by helping individuals and families receive more timely and effective mental health/addiction treatment and aftercare support through enhanced inter-agency collaboration.- Continued to staff an office of mental health professionals within the main facility of Blue Cross Blue Shield Vermont (BCBSVT) in Barre, VT. The individuals who staff this office (called Vermont Collaborative Care or VCC) help BCBSVT subscribers integrate mental health care and medical health care.- Continued to provide collaborative office rounds with area pediatric and family practices to facilitate problem solving on psychiatric and addiction cases.- Continued to participate in the Windham County Consortium on Substance Use (COSU)- a group of regional agencies tasked with studying and intervening in the opioid epidemic.#2. Increase accessibility to the Retreat's programs and services by improving the cultural competencies of providers and removing barriers that challenge vulnerable populations and people who have been historically underserved by the mental health and addiction treatment system.- Offered a continuing education workshop on 4/18/2019 that focused on culturally diverse patient populations entitled Improving Provider Communication and Shared Decision Making with Multi-Cultural Clients, with speaker Margarita Alegria, Ph.D.- Continued to provide on-site clinical services at Groundworks Collaborative, Brattleboro's temporary shelter for homeless men, women, and children. This is a service that began in 2015.- Further refined and expanded the scope of the hospital's cultural competency online training module and assigned it to all newly-hired staff during orientation and annually for all Retreat staff.#3: Reduce barriers to treatment and promote fact-based knowledge about mental illness and addiction among healthcare providers and the general public by increasing educational initiatives and supporting campaigns to decrease stigma.- Continued to support our Stand Up to Stigma community awareness campaign through community events, advertising, website, promotional items, etc.- Offered nine all-day, one half-day, and one two-day continuing education workshops in the spring of 2019. Combined with 11 full-day, and one half-day continuing education workshops in the fall of 2019 for a total of 23 for the year.- Continued hosting and participating in a Consumer Advocacy Group that meets on a monthly basis with Retreat clinicians and administrators. Goal is to ensure that Retreat programs and services are meeting the needs of consumers and are being delivered in ways that accommodate the perspectives and experiences of patients.- Dr. Geoff Kane participated as a panelist with representatives from Brattleboro Memorial Hospital, Turning Point of Windham County, among others at a community forum of approximately 175 people. This forum was held at the Brattleboro Fire Station on Thursday, June 20th and was focused on the opioid crisis facing the town of Brattleboro. - Participated on a pilot project with Strolling of the Heifers (SOTH) Apprenticeship Program and Groundworks Collaborative to provide therapeutic support for SOTH in their annual jobs training program.- Launched Rapid Access to MAT (medication assisted treatment) with Brattleboro Memorial Hospital (BMH), and Turning Point of Windham County to help people in active withdrawal from opioids receive MAT quickly while at the BMH emergency department.- Partnered with Brattleboro Museum and Arts Center (BMAC), Turning Point, Groundworks Collaborative, and other organizations in the community, to honor the courage of those in recovery through Michael Poster's "If she has a pulse, she has a chance" documentary photography exhibit (at BMAC, Oct. 5, 2018-Jan. 7, 2019).- Brattleboro Retreat continued its partnership with the Ticket to Work program (America Works) in 2019 with the ongoing goal of helping clients who are recovering from opioid addiction to search for and secure employment.- Continued participation with Project CARE, a community coalition led by the Brattleboro Police Department that includes Habit Opco, Brattleboro Memorial Hospital, Turning Point, HCRS, and Groundworks. The goal of this coalition is to improve community relations with local law enforcement and to explore ways to better integrate the police in efforts to get help for people psychiatric and addiction issues.- Brattleboro Retreat marched in the annual Strolling of the Heifers parade with NAMI Vermont in June 2019 with staff and community volunteers sharing the Stand Up to Stigma campaign message.- Produced two new "Keep Talking" video broadcasts on Brattleboro Community Television in 2019: o "Step Families: Meeting the Challenges" o "Kids and Cannabis - Changing Perceptions, Myths, and Risks"-Published three Op-Eds and/or educational pieces in local and regional newspapers: o "Calling All Mental Health Professionals: Border Crisis Requires Action on Behalf of Children," by Louis Josephson, Ph.D., VT Digger, July 11, 2019; Bennington Banner, July 12, 2019, Brattleboro Reformer, July 13, 2019, Rutland Herald, July 20, 2019 o "An IOP Exclusively For Addiction Issues: Spotlight on the Retreat's Starting Now Program," by Kurt White, LADC, LISCW, September 10, 2019 o"We lament changes to healthcare too," by Louis Josephson, PhD. Letter to the Editor in Brattleboro Reformer, September 8, 2019The Brattleboro Retreat's criteria for prioritizing and addressing community health needs was based on the following: an identified priority or concern in community input process; consistent with quantitative research data; within the Brattleboro Retreat's capacity to impact; consistent with the Brattleboro Retreat's mission; and a need where community partners exist. Some needs emerged in the research findings that the Brattleboro Retreat has not prioritized in this health needs assessment.In Phase I of the CHNA, BMH and Grace Cottage Hospital identified a number of medical health needs in their CHNA. Given that the Retreat is a specialty mental health and addictions treatment hospital that does not provide medical services to the general public, the Retreat will not address these medical health needs. Through qualitative research with the communities served, the Retreat learned that a number of socioeconomic challenges exist for the community, including the need for more employment opportunities, affordable housing, public transportation and social services. These socioeconomic needs do not fall within the mission or programs of the Retreat; however, the Retreat supports several initiatives aimed at increasing economic and educational opportunities in the community. The Brattleboro Retreat is active in Southeastern Vermont Economic Development Strategies (SeVEDS), The Brattleboro Area Chamber of Commerce, and The Rotary Club of Brattleboro. The Retreat is also an active supporter of United Way of Windham County and matches employee contributions dollar for dollar in the United Way Employee Giving Campaign. Additionally, the Brattleboro Retreat partners with schools and universities to offer training and internships to students pursuing clinical degrees. Part V, Section B, Line 11 Continued In October, 2017, the Windham County CHNA Steering Committee formed and began meeting to work on the 2018 Community Health Needs Assessment that will cover 2019-2021. The group met eight times. Data collection for Phase 1 (Windham County) took place between the months of November, 2017 and May, 2018. The 2018 Windham County CHNA Steering Committee planned and conducted qualitative research, which included a county-wide survey and outreach to organizations in the community on health care needs of minority and underserved populations. The resident surveys were available through the month of March 2018. The findings were presented at the Southeastern Vermont Accountable Communities for Health meeting in September 2018 to a number of human service organizations in Windham County who attended the meeting.In Phase II (statewide) of the 2018 CHNA, the Brattleboro Retreat gathered and assessed quantitative and qualitative data on mental health and addiction in the state of Vermont and consulted with the Vermont Department of Health. The Retreat conducted an online survey, which was distributed widely across the state to various stakeholder groups and to the general public. 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 Care.Planners 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 within the Retreat's capacity to make an impact. In the first quarter of 2019, planners at the Brattleboro Retreat developed a three-year action plan to address our identified priority areas. 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 8-9 of audited financial statements for footnote disclosure.In 2019, the Retreat adopted FASB Accounting Standards Update (ASU) No. 2014-09, Revenue from Contracts with Customers (Topic 606), which supersedes accounting standards that currently exist under Generally Accepted Accounting Principles and provides a single revenue model to address revenue recognition to be applied by all companies. Under the new standard, companies recognize revenue when a customer obtains control of promised goods or services in an amount that reflects the consideration to which the company expects to be entitled in exchange for those goods and services. ASU No. 2014-09 also requires companies to disclose additional information, including the nature, amount, timing, and uncertainty of revenue and cash flows arising from contracts with customers. The Retreat adopted this ASU for the year ended December 31, 2019 and elected the modified retrospective method; therefore, the financial statements and related notes have been presented accordingly.As a result of the adoption of the rules described above, the Retreat isrecording $0 of bad debt expense for 2019. 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 2019, the Brattleboro Retreat served 4,540 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 2019, the Brattleboro Retreat served 2,427 individuals in our outpatient programs. Six hundred and eighteen (618) children were served across all programs. Fifty-five (55) children were served in our residential programs and 84 children in our school 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 in 2019. 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.2019 marked the third and final year of the Retreat's 2017-2019 strategic plan entitled Setting a New Standard. This three-year plan outlines a host of strategic initiatives organized under four main categories: Focus on Clinical Excellence; Achieve Financial Stability; Increase Accountability; and Reimagine our Historic Campus.Summary of Strategic Plan Progress in 2019:1."Focus on Clinical Excellence" 2019 Summary of Achievements: -Aligned clinical workflows in concert with EHR optimization project-Enhanced patient-centered nursing practice-Rolled out Nurse Residency Program to support onboarding of recently graduated RNs-Advanced further use of evidence-based practices and integrated in more patient programs-Optimized Pharmacy operations-Launched mandatory training for all staff on restrictions of plastic items on inpatient units-Further refined curriculum/methodology for educating clinical staff-Strengthened and updated structure of Quality Assurance program-Assessed impact and future scope of tele-psychiatry program/virtual care-Commenced roll-out of "Redesign with Patients in Mind" (RPM), a project to completely re-engineer the Retreat's Admissions Department and admissions process in order to provide patients and referral sources with streamlined, patient-focuses admissions procedures and more efficient assignment to appropriate levels of care.2."Achieve Financial Stability" 2019 Summary of Achievements:-Negotiated an increase in Medicaid rates with the state of Vermont-Commenced implementation of consultant recommendations to improve revenue cycle as part of the RPM project-Signed three-year collective bargaining agreement with union employees-Continued to execute bed expansion project in partnership with the state-Streamlined systems for ordering/purchasing supplies and materials.3."Increase Accountability" 2019 Summary of Achievements: -Redesign performance appraisal system-Upgraded and re-launched ADP-Published and observed quarterly schedule of Employee Town Hall informational meetings-Published eight informational articles for staff written by the CEO-Improved cyber security measures-Improved IT infrastructure.4."Reimagine our Historic Campus" 2019 Summary of Achievements-Made progress on construction of a new 12-bed Level I adult inpatient unit on the first floor of the hospital's Linden Lodge building.-Explored USDA capital financing options for improvement of buildings and grounds.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 2019 the Brattleboro Retreat spent approximately $2,666,031 on capital improvements. The depreciation schedule was $1,813,181. As a private not-for- profit organization, copies of the strategic plan are not publicly available. Questions regarding any strategic planning issues or opportunities for public input may be addressed to Konstantin von Krusenstiern, vice president of Development and Communications. For more information, please contact: Konstantin von Krusenstiern, Vice President of Development & CommunicationsBrattleboro Retreat1 Anna Marsh Lane, P.O. Box 803Brattleboro, VT 05301(802) 258-4366 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 abuse 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. Brattleboro Last Night, Strolling of the Heifers, and Harris Hill Ski Jump Event-all make use of the Retreat facility for these annual events (campus grounds, parking, tents, Facilities & Security Staff, etc.)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. 1 United Way of Windham County 1 Holstein Place Brattleboro VT 05302 036003074 501(c)(3) 18178 Organizational Support Hinsdale Historical Society 609 Brattleboro Road Hinsdale NH 03451 237162909 501(c)(3) 6000 Organizational Support 2 0 Part I, Line 2: Grants and other assistance payments are made only to 501(c)(3) organizations or governmental entities. Therefore, additional monitoring is not deemed necessary. X 0 0 0 0 0 0 0 1 0 Louis Josephson CEO 381199 0 25000 0 14400 0 8400 0 40787 0 469786 0 0 0 Arthur Nichols Past CFO 213072 0 0 0 23493 0 0 0 30441 0 267006 0 0 0 Karl Jeffries Staff Physician 268816 0 0 0 3544 0 8400 0 32662 0 313422 0 0 0 Peter B Kassis Staff Physician 265203 0 0 0 0 0 1904 0 39533 0 306640 0 0 0 Tracey Kasnow Staff Physician 229334 0 0 0 16554 0 7619 0 37869 0 291376 0 0 0 Lisa Lambert Staff Physician 462900 0 50 0 4 0 1705 0 1106 0 465765 0 0 0 Simha Ravven Chief Medical Officer 290642 0 0 0 340 0 0 0 17089 0 308071 0 0 0 Part I, Line 7 Lisa Lambert received a $50 service award and Louis Josephson received $25,000 bonus for meeting criteria established by the board of directors. A Vermont Educational and Health Buildings Financing Agency 237154467 2015-07-15 11245000 Refund Series 2011A Bonds 0 0 0 A 11245000 97745 11147255 2015 1 0 1 1 A 0 0 0 0 0 0 0 A 0 1 1 0 0 0 0 0 0 A 1 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 322,559. Management and general expenses 0. Fundraising expenses 0. Total expenses 322,559. Contract Services: Program service expenses 12,208,425. Management and general expenses 806,190. Fundraising expenses 0. Total expenses 13,014,615. Purchased Services: Program service expenses 96,484. Management and general expenses 0. Fundraising expenses 0. Total expenses 96,484. Consulting Fees: Program service expenses 0. Management and general expenses 893,086. Fundraising expenses 0. Total expenses 893,086. Collection Fees: Program service expenses 58,015. Management and general expenses 0. Fundraising expenses 0. Total expenses 58,015. 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 119176 875081 0 1 0.50000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0