2017-11-14T14:50:14-06:00 2016-12-31 010523282 Berry Dunn McNeil & Parker LLC PO Box 1100 Portland ME 041041100 990 2016-01-01 030107360 Brattleboro Retreat BRAT 8022577785 1 Anna Marsh Lane Brattleboro VT 05302 Louis Josephson PhD President & CEO 8022577785 2017-11-03 1 Barbara J McGuan CPA P00219457 2077752387 2017-11-02 69.49.157.66 2017-11-03 11:53:56 ED P 4A7A9222C8D681BBCE9F1B6E7BF5E3969F273E7D 195DD2390B87809A4F2C1BC02D65E16960466FA1 2016 2017-02-10 21:41:12Z Louis Josephson PhD 1 Anna Marsh Lane Brattleboro VT 05302 75137392 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. 13 12 934 14 415502 -3049 493488 363788 68395185 67284157 215842 74748 43743 246315 69148258 67969008 54611 52022 0 0 52543647 51650276 0 0 0 16004019 16705834 68602277 68408132 545981 -439124 46052043 46145691 23128144 23442370 22923899 22703321 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 58208114 52022 64435336 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 throughout the Northeast. Patient Days: Inpatient 38,486, Partial 9,396, Residential 9,303, Outpatient 24,975. 197407 199744 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. 1845211 2697810 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 9,108. 60250732 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 0 0 0 0 1 69 0 1 934 1 1 1 0 0 0 0 1 1 0 0 0 0 X 13 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 1 1 0 VT X Arthur Nichols 8022584312 1 Anna Marsh Lane Brattleboro VT 05301 Bette Abrams Assistant Secretary 1.00 X X 0 0 0 Michael Sarsynski Jr CFP Trustee 1.00 X 0 0 0 Robert E Simpson Jr Past President & CEO 40.00 X X 125999 0 24294 Tammy Richards Board Secretary 1.00 X X 0 0 0 Tonia Wheeler Trustee 1.00 X 0 0 0 David Dunn Esq Trustee 1.00 X 0 0 0 Daniel Normandeau Past Assistant Secretary 1.00 X X 0 0 0 Elizabeth Catlin Board Chair 1.00 X X 0 0 0 Drew Pate MD Trustee 1.00 X 0 0 0 Michael Krupa Past Trustee 1.00 X 0 0 0 Joseph Pyle Trustee 1.00 X 0 0 0 Kenneth Becker Trustee 1.00 X 0 0 0 Christopher Turley Trustee 1.00 X 0 0 0 Louis Josephson CEO 40.00 X X 376814 0 25404 Adam Grinold Trustee 1.00 X 0 0 0 Kate O'Connor Trustee 1.00 X 0 0 0 Steven Monette Treasurer/VP Finance & CFO 40.00 X 196411 0 24006 Frederick Engstrom Chief Medical Officer 40.00 X 280702 0 33354 Mark McGee Physician Unit Chief 40.00 X 249623 0 35271 Dorothea Degutis Medical Director 40.00 X 285641 0 14932 John Fanton Medical Director 40.00 X 245455 0 11624 Jennifer Fryler Unit Chief 40.00 X 238653 0 21398 1999298 0 190283 56 0 1 0 Sodexo 9801 Washingtonian Blvd Gaithersburg MD 20878 Cafe/Dietary/Housekeeping 3097060 Barton Associates PO Box 417844 Boston MA 02241 Contract Labor 790703 Locumtenenscom PO Box 405547 Atlanta GA 30384 Contract Labor 684827 Netsmart Technologies PO Box 823519 Philadelphia PA 19182 IT/Billing 659014 Medical Solutions 1010 N 102nd St Suite 300 Omaha NE 68114 Contract Labor 632322 12 91692 118962 153134 12324 363788 Patient Service Revenue 621400 175191480 175191480 Miscellaneous 900099 1738008 885263 415502 437243 MSO Revenue 621400 1318156 1318156 Provision for Bad Debts 621400 -2181717 -2181717 Contractual/Char. Adj. 621400 -108781770 -108781770 67284157 284140 284140 246212 152388 93824 93824 93824 6792978 7002370 -209392 -209392 -209392 117384 91692 13626 103758 103758 Joint Venture Earnings 900099 48733 48733 48733 67969008 66480145 415502 709573 52022 52022 772929 772929 37950373 34879787 3070586 324753 308450 16303 9837536 9281855 555681 2764685 2458426 306259 286186 286186 62856 62856 26826 26826 4797096 3476233 1320863 224916 224916 363364 58928 304436 929928 929928 109193 53183 56010 439883 439883 1824905 1824905 623227 623227 Miscellaneous Expenses 2177106 847609 1329497 Provider Tax 1986457 1986457 Medical Supplies 1567939 1567939 Meals 1285952 1236984 48968 68408132 60250732 8157400 0 X 2000 818334 1665914 1398783 10857967 14970126 253013 246369 548862 534207 54740680 34365064 21198376 20375616 9733726 6026660 733704 610694 1058481 1164902 46052043 46145691 7579912 8908144 11123506 11139227 2642500 2005000 1782226 1389999 23128144 23442370 X 22450959 22135025 235128 308766 237812 259530 22923899 22703321 46052043 46145691 -439124 218546 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 38067 38067 0 Part II-B, Line 1: Line 1b relates to a portion of MSO VP's salary in the amount of 29,048. Line 1i includes the portion of AHA and VAHHS dues related to lobbying. 9664963 192287 3000575 6856675 10806727 58236 1200000 9664963 11244417 262310 700000 10806727 10940589 492713 188885 11244417 11804134 436455 1300000 10940589 1.00000 0 0 120033 120033 43061513 25854857 17206656 9026572 6965087 2061485 2532562 1545120 987442 20375616 Uncleared Checks 267742 Deferred Compensation Obligation 701678 Due to Third-Party Payors 420579 1389999 68353568 218546 166014 384560 67969008 0 67969008 68574146 166014 166014 68408132 0 68408132 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 152,388. Fundraising Expenses 13,626. Part XII, Line 2d - Other Adjustments: Rental Expenses 152,388. Fundraising Expenses 13,626. Golf Tournament 114312 47080 67232 1190 6896 5040 Ride for Heros 94764 44612 50152 500 209076 91692 117384 1690 6896 5040 13626 103758 1 1 1 X 1 X 1 1 1 0 1 1 2078946 2078946 0.03040 31381017 26216054 5164963 0.07550 33459963 26216054 7243909 0.10590 68319 68319 0.00100 220710 3500 217210 0.00320 2149117 1637096 512021 0.00750 52022 52022 0.00080 2490168 1640596 849572 0.01250 35950131 27856650 8093481 0.11840 10480 10480 0.00020 10480 10480 0.00020 1 778748 11176884 14130453 -2953569 X 1 1 1 1 Brattleboro Retreat 1 Anna Marsh Lane Brattleboro VT 05301 www.brattlebororetreat.org 841 X Brattleboro Retreat 1 0 0 1 X X X X X X X X X 15 1 1 0 1 X http://www.brattlebororetreat.org/about/community-health-needs-assessment X 1 16 1 http://www.brattlebororetreat.org/about/community-health-needs-assessment 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 the Retreat has a diverse and extensive service area, the Retreat chose to define its service area at both the county and state levels, assessing the health needs of both areas. By assessing health status at both the county and state levels, planners gained a detailed understanding of the needs of the local populations as well as a broader assessment of Vermont. The 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 2015 CHNA, the Brattleboro Retreat identified three priority areas in which to focus its efforts for the upcoming 2016-2018 reporting period:1. Enhance care coordination activities between medical and mental health providers so that individuals and families receive more timely and effective mental health and addiction treatment and aftercare support.2. Make the Retreat's programs and services more accessible to populations that have historically been underserved by some mental health and addiction treatment providers, particularly racial/ethnic minorities, LGBTQ individuals and low-income families, by improving cultural competencies and addressing various barriers such as language and mobility.3. Increase educational initiatives, both for providers as well as for the general public, to increase understanding of and treatment for mental illness and addiction.In 2016, planners at the Brattleboro Retreat, in consultation with various staff members from across the hospital and the Brattleboro Retreat's Consumer Advisory Committee, developed a three-year action plan to address these priority areas. CHNA Implementation Plan 2016 - 2018 Priority Actions #1: Enhance care coordination activities between medical and mental health providers so that individuals and families receive more timely and effective mental health and addiction treatment and aftercare support. - Increase collaboration and support for the VT Blueprint Community Health Teams, Brattleboro Memorial Hospital, HCRS, area Suboxone prescribers, Chronic Care Initiative, and the Windham County Opiate Taskforce to enhance care coordination and improve health outcomes for the area's psychiatric and substance abuse patients. - Conduct Collaborative Office Rounds with family practices and pediatrics in the area to facilitate problem-solving on psychiatric cases. - Partner with Blue Cross Blue Shield of Vermont to provide a whole person approach to care (mental health, medical and addiction). - Host an annual networking event with area health care providers and human service agencies. - Conduct a survey to referring providers to help identify processes working well in care coordination and what needs to be improved. - Incorporate into the Brattleboro Retreat's system of care increased communications with referral sources/providers in order to improve care coordination. #2: Make the Retreat's programs and services more accessible to populations that have historically been underserved by some mental health and addiction treatment providers, particularly racial/ethnic minorities, LGBTQ individuals and low-income families, by improving cultural competencies and addressing various barriers such as language and mobility.- Offer at least one Continuing Education workshop focused on improving cultural intelligence among mental health and addiction treatment professionals. - Enhance the cultural competency modules of the clinical education online trainings. - Contribute to the body of knowledge in mental health and addiction treatment for the LGBT community through nursing research and publication. - Expand the partnership with Groundworks Collaborative, a local organization providing housing support services and temporary housing, to increase access to mental health and substance abuse services to individuals and families facing homelessness.#3: Increase educational initiatives, both for providers as well as for the general public, to increase understanding of and treatment for mental illness and addiction.- Support and participate in consumer-led activities and initiatives in Vermont.- Expand peer and consumer involvement in education and outreach initiatives at all levels of service provision.- Grow our BCTV educational series Keep Talking broadcast network both in the state of Vermont and nationwide to educate the public on various mental health and addiction related issues.- Offer at least 6 free workshops for the community each year covering the most requested mental health and addiction-related topics.- Offer at least 22 full-day Continuing Education conferences and 3 free luncheons each year to mental health professionals covering a broad range of mental health and addiction-related topics.- Submit op-eds written by Retreat clinicians to inform the public on relevant and timely mental health and addiction-related topics.- As part of Collaborative Office Rounds, present case studies to area physician practices to enhance diagnosis and treatment outcomes for patients with mental health and addiction issues. - Partner with the Six College Collaborative to develop courses and programs focused on job training for the mental health field.The Brattleboro Retreat's prioritization criteria for community health needs to be addressed were that it must be: 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, The Brattleboro Area Chamber of Commerce, The Rotary Club of Brattleboro, and The Brattleboro Sunrise Rotary Club. 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 in clinical fields. 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: Accounts receivable are stated at the amount management expects to collect from outstanding balances. Management provides for probable uncollectible amounts through a charge to earnings and a credit to a valuation allowance based on its assessment of the current status of individual accounts. Balances that are still outstanding after management has used reasonable collection efforts are written off through a charge to the valuation allowance and a credit to accounts receivable.In evaluating the collectibility of accounts receivable, the Retreat analyzes past results and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for bad debts. Data for each major payor source isregularly reviewed to evaluate the adequacy of the allowance for doubtful accounts. For receivables relating to services provided to patients having third-party coverage, the Retreat analyzes contractually due amounts and provides an allowance for doubtful accounts and a corresponding provision for bad debts. For receivables relating to self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Retreat records a provision for bad debts in the period of service based on past experience, which indicates that many patients are unable or unwilling to pay amounts for which they are financially responsible. The difference between the standard rates (or discounted rates if negotiated or eligible) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged against the allowance for doubtful accounts.During 2016, the Retreat increased its estimate from $2,256,447 to $3,499,910 in the allowance for doubtful accounts relating to self-pay patients. Such changes resulted from trends experienced in the collection of amounts from patients for which they are financially responsible and from fluctuations in outstanding account balances. 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 2016, the Brattleboro Retreat served 4,740 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, and there are fewer and fewer organizations offering such a full range of services in mental health and addiction care. 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 2016, the Brattleboro Retreat served 3,375 individuals in our outpatient programs. 697 children were served across all programs. 92 children were served in our residential programs and 146 children in our school programs.In 2016 the Brattleboro Retreat welcomed Louis Josephson, Ph.D., as its new chief executive officer in January. In response to a healthcare environment that continued to shift in 2016, and as demand for psychiatric and addiction services became more pronounced, the Retreat continued to meet the need for high quality care by strengthening its clinical expertise. This included the introduction of evidence-based practices in clinical areas throughout the hospital that required a significant investment in staff education and training. The Retreat also took steps to begin modernizing its financial systems with a particular emphasis on strengthening cash flows and establishing a more predictable operating margin. In 2016, the board of trustees of Brattleboro Retreat also embarked on a strategic planning process. The planning process took several months and involved the energy and talents of many individuals. For the planning process we gathered input from a variety of sources including our board of trustees, employees, community supporters, consumers/patients, other hospitals and providers, elected officials and government stakeholders. What we learned became the roadmap for our new strategic plan that was approved by the board in 2017.Summary of Process for Openness and Public ParticipationThe Brattleboro Retreat keeps the community informed with regular appearances and/or memberships with the Brattleboro Selectboard, Building a Better Brattleboro, Brattleboro Development and Credit Corporation, Brattleboro Chamber of Commerce, the Windham County Legislative Delegation, Brattleboro Sunrise Rotary Club, the Rotary Club of Brattleboro, and ongoing collaborations with other community organizations including Brattleboro Memorial Hospital, Grace Cottage Hospital, Health Care and Rehabilitation Services, Rescue Inc., the Brattleboro Police Department, 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 and Financial InformationThe Brattleboro Retreat spends approximately $935 thousand per year on capital improvements. The depreciation schedule generally amounts to $1.8 million. 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 are counseled as to 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 a population of 11,841. The 2016 population estimate for Windham County is 43,145. The state of Vermont has an estimated population of 624,594. (U.S. Census, 2016)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 services 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 Sister of Providence 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 a population of 6,692,824 is the second largest sending state. The Retreat is located just a few 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 2016 American Community Survey, the estimated median household income of Vermont residents is $55,176. 10.2% of Vermonters live in poverty and 5.8% of Vermonters are without health insurance. In 2016, 71.7 percent of the Retreat's funding came from public sources-24.3 percent from Medicare, 24.5 percent from adult Medicaid / State programs and 22.9% from child and adolescent residential funding or Medicaid. Part VI, Line 5: Groundworks Collaborative - Monthly use of conference room for board meeting for local homeless shelter.ALANON - Weekly use of East Conference RoomAA - Weekly use of CafeteriaMidwinter Lunch Series - A series of 4 hour long educational programs. Held annually, the series is free and opened to staff, community providers and the public. It covers topics related to mental health and substance abuse in children, adolescents and adults.Wellness in Windham Health Education Calendar and Workshops - Presented by Brattleboro Memorial Hospital, Grace Cottage Hospital and the Brattleboro Retreat, the Wellness in Windham Health Education Calendar is published and distributed biannually and includes wellness programs, ongoing classes, and support groups, many of which are free, for all members of the community. The Retreat offers 6 - 8 free community workshops per year as part of the Wellness in Windham Health Education program. Brattleboro Last Night, Strolling of the Heifers, and Brattleboro Ski Jump Event - All use our facility for annual Events. They use our grounds for the events as well as parking, tents, Facilities & Security Staff.Cafeteria & Conference Room - Facility used for meetings by Brattleboro Area Development Committee, Brattleboro Area Chamber of Commerce, Early Education Services, DUI Victim Impact, Kiwanis Club, Al Anon, Alcoholics Anonymous, and United Way of Windham County.Relay for Life - Retreat Feat team participates in local event raising funds and awareness to 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 PO Box 617 Brattleboro VT 053020617 036003074 501(c)(3) 23076 Organizational Support 1 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 Robert E Simpson Jr Past President & CEO 72613 0 52833 0 553 0 7950 0 16344 0 150293 0 0 0 Louis Josephson CEO 318232 0 0 0 58582 0 0 0 25404 0 402218 0 0 0 Steven Monette Treasurer/VP Finance & CFO 189778 0 5870 0 763 0 2901 0 21105 0 220417 0 0 0 Frederick Engstrom Chief Medical Officer 270696 0 5870 0 4136 0 10132 0 23222 0 314056 0 0 0 Mark McGee Physician Unit Chief 249325 0 0 0 298 0 7689 0 27582 0 284894 0 0 0 Dorothea Degutis Medical Director 283056 0 0 0 2585 0 7200 0 7732 0 300573 0 0 0 John Fanton Medical Director 245178 0 0 0 277 0 4800 0 6824 0 257079 0 0 0 Jennifer Fryler Unit Chief 237382 0 0 0 1271 0 7200 0 14198 0 260051 0 0 0 Part I, Line 7 The bonus payments listed in Part II were made as part of the Retreat's Variable Pay Plan. The Plan was approved by the Board of Trustees as were the payment amounts which were based on the extent to which pre-approved goals were met. The Board sets a maximum for the CEO and also a maximum as a pool for the other executives. The CEO has the discretion on how that pool is distributed to the other executives. The bonus payments were based upon 2015 goals, but were paid in calendar year 2016. 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 0 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 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.