2012-08-15T08:27:56-05:00 2011-12-31 010523282 Berry Dunn McNeil & Parker LLC 1000 Elm Street 15th Floor Manchester NH 03101 990 2011-01-01 030107360 Brattleboro Retreat BRAT 8022577785 1 Anna Marsh Lane Brattleboro VT 05302 Robert E Simpson Jr 8022577785 2012-08-14 1 Rachel Williamson CPA P00186614 6036697337 2012-08-14 2011 2016-02-24 21:20:13Z Robert E Simpson Jr 1 Anna Marsh Lane Brattleboro VT 05302 54403581 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. 10 9 682 0 320703 -7940 405660 436886 43954558 48006205 525213 332263 64136 84984 44949567 48860338 0 0 0 0 29551634 32427198 0 0 220451 12644765 14422131 42196399 46849329 2753168 2011009 25553231 37481218 12651115 22552076 12902116 14929142 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 38778866 48350 45446975 Offering a continuum of care including inpatient, partial hospitalization, residential and outpatient treatment for children, adolescents, adults and older adults throughout the Northeast. Patient Days: Inpatient 28,961, Partial 5,906, Residential 10,732, Outpatient 24,223. 206421 233499 Continuing education program providing up to 35 workshops and seminars throughout the year for psychiatrists, physicians, social workers, psychologists, therapists, alcohol counselors, nurses and other healthcare professionals. 1328528 1925732 Vermont accredited school serving children and adolescent inpatients, residential, and partial hospitalization. The curriculum meets the educational, clinical and behavioral needs of our students and the requirements of Vermont's educational standards. Patient School Days 10,319. 40313815 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 108 0 1 682 1 1 1 0 0 0 0 1 1 0 0 0 0 X 10 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 1 1 0 VT X Brattleboro Retreat 8022584312 1 Anna Marsh Lane Brattleboro VT 05301 Bette Abrams 1.00 X 0 0 0 Jeffrey Morse 1.00 X 0 0 0 Larry Cassidy 1.00 X X 0 0 0 Mary Faucher 1.00 X 0 0 0 Michael Sarsynski 1.00 X 0 0 0 Peter Sherlock 1.00 X X 0 0 0 Robert Simpson Jr 40.00 X X 353524 0 52329 Tammy Richards 1.00 X 0 0 0 Tonia Wheeler 1.00 X 0 0 0 Patricia O'Donnell 1.00 X 0 0 0 John Blaha 40.00 X 181744 0 18596 Vareen O'Keefe-Domaleski 40.00 X 167364 0 15842 Frederick Engstrom 40.00 X 258391 0 24844 Robyn Ostrander 40.00 X 224075 0 23595 Timothy Rowland 40.00 X 205847 0 14252 William Knorr 40.00 X 207297 0 9734 Nels Kloster 40.00 X 199937 0 22088 1798179 0 181280 28 0 1 0 Sodexo 153 Second Avenue Waltham MA 02254 Cafe/Dietary/Housekeeping/Facilities 2262664 Engleberth Construction 463 Mountain View Drive Colchester VT 05446 Construction 1141685 Lavalle Brensigner Architects 155 Dow St Suite 400 Manchester NH 03101 Architects 577755 Locumtenenscom PO Box 405547 Atlanta GA 30384 Contract Labor 357473 GPI Construction 436 Canal St Brattleboro VT 05301 Construction 324244 21 58989 179584 198313 436886 Net Patient Service Re 900099 45973270 45973270 Miscellaneous 900099 819398 819398 Net MSO Revenue 621300 531443 531443 Daycare 624410 360340 320703 39637 Conference Revenue 611710 233499 233499 88255 48596 39659 48006205 353017 353017 184909 97878 87031 87031 87031 5401313 5421073 994 -19760 -994 -20754 -20754 21251 58989 23298 -2047 -2047 48860338 47606206 320703 496543 789399 789399 25759003 23145025 2484692 129286 693891 573848 120043 3339627 2942592 397035 1845278 1608722 236556 186319 186319 54400 54400 37238 37238 5862385 5083435 736498 42452 268710 268668 42 1205325 968362 233127 3836 165776 165776 1166368 1166368 133129 39246 91886 1997 174351 92500 45010 36841 151803 151803 1354510 1354510 380066 380066 Provision for bad debts 1427195 1427195 Provider Tax 864471 864471 Equipment Rental and Ma 518594 238669 274979 4946 Dues & Subscriptions 150843 25037 124805 1001 320648 197588 123010 50 46849329 40313815 6315063 220451 67639 86387 827640 7816354 5993366 6782891 124789 158436 260622 378026 36789555 26219746 7767638 10569809 9696753 10819663 814784 869652 25553231 37481218 3314954 5137775 7320000 16180000 83678 43603 1932483 1190698 12651115 22552076 X 12849453 14816147 52663 112995 12902116 14929142 25553231 37481218 X 2011009 16017 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 10524393 1279741 11804134 9351252 750000 423141 10524393 11583990 192262 2425000 9351252 12208986 475004 1100000 11583990 1.00000 0 0 120033 120033 28494148 19885007 8609141 6633263 5163990 1469273 1542111 1170749 371362 10569809 Bank Overdraft 399904 Line of Credit 210863 Deferred Compensation Obligation 194958 Estimated Third Party Settlements 384973 1190698 48860338 46849329 2011009 148462 -132445 16017 2027026 48997531 148462 121176 269638 48727893 132445 132445 48860338 46970505 121176 121176 46849329 0 46849329 Description of Intended Use of Endowment Funds: 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 8 - Other Adjustments: Loss on early extinguishment of long-term debt -132,445. Part XII, Line 2d - Other Adjustments: Rental Expenses 97,878. Fundraising Expenses 23,298. Part XII, Line 4b - Other Adjustments: Loss on early extinguishment on long-term debt 132,445. Part XIII, Line 2d - Other Adjustments: Rental Expenses 97,878. Fundraising Expenses 23,298. Golf Tournament 71795 54234 17561 4949 7280 4880 60 Ride for Heroes 8445 4755 3690 2268 1479 2382 80240 58989 21251 7217 7280 6359 2442 23298 -2047 1 1 1 X 1 X 1 1 1 0 0 103924 103924 0.00220 20326318 20542405 -216087 0.00000 20430242 20542405 -112163 0.00220 112352 112352 0.00240 22789 22789 0.00050 44786 44786 0.00100 179927 179927 0.00390 20610169 20542405 67764 0.00610 716 716 0.00000 10285 10285 0.00020 11001 11001 0.00020 1 1427195 5858007 7538436 -1680429 X 1 1 1 1 Brattleboro Retreat

1 Anna Marsh Lane Brattleboro VT 05301

X Brattleboro Retreat 1 1 1 200.000000000000 1 300.000000000000 1 X X X X 1 1 X X X 1 X 1 X X 1 X 0 0 Part II: Retreat Trails-Nine mile recreational trail network open to the public for non-motorized recreational activities. 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 2011, the Brattleboro Retreat helped over 5,000 children, adolescents and adults (numbers that have been rising every year) through a multitude of programs, services, and facilities, offering a comprehensive continuum of care across the lifespan. The impact of the Retreats services upon its patients and their families is often dramatic and life-saving, and there are fewer and fewer organizations offering such a complete array of resources in behavioral healthcare. At the same time, the number of patients coping with mental health and substance abuse issues continues to rise throughout the region and the nation, and new methods of treating these patients are constantly being developed and refined. The Retreat has striven successfully to augment and modernize its programs and facilities to ensure that its patients benefit from the latest developments in treatment. In 2011, the Retreat saw a 1.8% increase in inpatient admissions, continuing a multi-year trend that has seen admissions increase over 50% since 2007.2010 was a year of unprecedented times. Census grew in all Retreat programs as the initiatives implemented in prior years came to fruition. Inpatient admissions grew an unprecedented 23.4%. This growth was largely the result of increasing demand for adult services and the ability of the Retreats re-designed admission process to admit people in need of care safely and efficiently. Consequently, the Retreat focused on stabilizing the gains made over the past few years and ensuring that the resources were in place to meet rising demand. This meant ensuring that all core processes to admit and treat patients were strong, that adequate resources and supports for employees were in place, facility needs are met and quality is at its highest. Approximately 45 new positions were added in 2010 and another 95 in 2011, virtually all direct care positions.The Retreat also began a new strategic planning process in the fall of 2010, setting our goals for the next three years. This process included gathering data and feedback from as many sources as possible. Key items addressed in the 2011 strategic plan were: ensuring quality servicesensuring financial stability for the futureinvesting in information technology including an electronic medical recordfacilities improvements and planning for continued growth. The Retreat anticipated opening a new 15 bed program for young adults in 2011 to meet an increasing demand for adult services. Other highlights of the Retreats plans for 2011 included:Partnering with Healthcare and Rehabilitation Services (HCRS) to open a Community Crisis Center on the Retreat campusContinuing to work with the State of Vermont on plans to replace the Vermont State Hospital Partnering with Brattleboro Memorial Hospital and Grace Cottage Hospital to be a Blue Print for Health Pilot Site as part of upcoming healthcare reformPublishing the patient Gold Book, an interactive workbook to engage patients further in their treatment.Focusing on recruitment, retention and staff training.In August, Hurricane Irene devastated much of Vermont and forced the closure of the Vermont State Hospital. In the wake of this flooding the Brattleboro Retreat joined with other hospitals and agencies across the state to accommodate displaced patients. One of the Retreats existing programs was temporarily suspended to accommodate VSH patients.As the immediate crisis subsided, the Retreat was asked by the State and by Governor Shumlin to participate in a new model of care. The Governors vision of a new system that relies less on inpatient care and provides for additional diversion beds and increased step down programs in the communities where patients live coincides with our vision and the vision of many others in the state. This is a very good vision and one the Retreat supports.Part of the proposal is a 14 bed inpatient program to be located at the Retreat. The Retreat is pleased to partner with the State to create this unit. We anticipate continued negotiations with the State to establish an Adult Intensive Program designed just for this new patient population. By the end of 2012 the program will be housed in a completely remodeled, state-of-the-art clinical space that will provide the finest in safety features and clinical supports.The Retreats response to this unexpected turn of events came at a time when we were in the midst of numerous planned changes both to our buildings and campus as well as our treatment offerings. Renovations to the childrens program and a new physical space for the Lesbian, Gay, Bisexual and Transgender (LGBT) Program continued as scheduled. The Childrens Program reopened in December and the LGBT Program is scheduled to re-open in the first quarter of 2012. Plans to open an additional inpatient program have been deferred until 2013. Renovations and the focus on enhanced treatment offerings will continue through 2012 as we build on our recent success and strive to be as bold and innovate as we can on behalf of the people who come to us for mental health and addiction treatment.The Brattleboro Retreat keeps the community informed with regular appearances and/or membership with the Brattleboro Selectboard, Building a Better Brattleboro, Brattleboro Development and Credit Corporation, Brattleboro Chamber of Commerce, the Windham County Legislative Delegation, and ongoing collaboration with other community organizations including Brattleboro Memorial Hospital, Healthcare and Rehabilitation Services, Rescue Inc., the 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, films, forums, and special educational events open to the community. The feedback of patients, their families, and community members is of great importance to the Brattleboro Retreat.The Retreat also partnered with United Way of Windham County, Brattleboro Memorial Hospital, the Alliance for Building Community and the local Agency of Human Services to jointly conduct a community needs assessment. This assessment was completed in 2009. The needs assessment included mental health and addiction treatment needs in the area, which are the services the Retreat provides. The assessment included a random phone survey, focus groups designed to be inclusive of different populations and key stakeholder interviews. A comprehensive review of existing data was also undertaken. This assessment provides useful community information for the Retreat, our partners and other agencies. The Retreat utilizes this information in an ongoing way and incorporated it into our 2010 to 2013 strategic planning process. Complete copies of the Community Needs assessment can be found at: http://unitedwaywindham.org.The Retreat also began a market survey in late 2010. This survey of mental health professionals from throughout Vermont and the other New England states provided the Retreat with additional information about unmet needs in the region. Two of the largest unmet needs were for substance abuse treatment / co-occurring disorder (substance abuse and mental illness) treatment and treatment for children and adolescents. Please see the graph below for more detailed information. The Retreat plans to meet these needs through continued expansion of adult services in 2013 and continuously enhancing child and adolescent programming.In addition, the Retreat will again partner with community groups in 2012 to complete a community needs assessment. The Retreats assessment will focus on Windham County, the State of Vermont and Western Massachusetts as the communities predominantly served by the Retreat.The Brattleboro Retreat spends approximately $1 million per year on capital improvements. The depreciation schedule generally amounts to $1.3 million. As a private not-for-profit organization, copies of the strategic plan are not publicly available. Questions regarding any strategic planning issue or opportunities for public input may be addressed to Julia Sorensen, MBA, MSW, Senior Director of Marketing, Communications and Strategic Planning.For more information, please contact:Julia Sorensen, MBA, MSWSenior Director of Marketing, Communication and Strategic PlanningBrattleboro RetreatAnna Marsh LaneP.O. Box 803Brattleboro, VT 05302(802) 258-3719 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. The town of Brattleboro is located in the southwestern corner of Vermont, on the border with both New Hampshire and Massachusetts. It is a small, rural town with a population of 12,393. Brattleboro is the population center of Windham County, which has a total population of 44,266. The State of Vermont has an estimated population of 626,431, while New England has a total population of 14,492,360. The majority of that population is located in Massachusetts, Connecticut and New Hampshire. 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. In 2011, the Retreat served patients from a total of 21 states. 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. In 2011, 58.6% of inpatient admissions to the Retreat came from the State of Vermont while the remaining 41.4% came from the New England region and beyond. Massachusetts, with a population of 6,587,536 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. This geography makes the Retreat an accessible option for people in western Massachusetts and in 2009, the Retreat became a provider for several state funded Medicaid products in Massachusetts, expanding access to the people insured in these programs. The four western Massachusetts counties: Hamden, Hampshire, Franklin and Berkshire have a combined population of 823,662 exceeding the population of the entire State of Vermont.The demographics of income, race, poverty etc. vary greatly across the catchment area and are therefore difficult to characterize. This report focuses on Vermont and Massachusetts, which combined account for over 80% of the Retreat's business.The median household income of Vermont residents is $51,841 and the average household income of Massachusetts residents is $64,509. According to the 2008 Healthcare Spending Analysis published by the Vermont Department of Banking, Insurance Securities and Healthcare Administration in 2008, 60 percent of Vermont residents were enrolled in private insurance. There were an estimated 47,286 uninsured Vermont residents in 2008 (7.6 percent of the population, compared to 9.8 percent in 2005) with the remainder being enrolled in Medicaid or Medicare. Medicaid is the primary payer of Government Health Activities, funding 91 percent ($455million) of the total for that category. About $253 million (51 percent of the total $497million) are for programs related to mental health, mental retardation, and substance abuse. (http://www.bishca.state.vt.us/sites/default/files/2008-EA-Report-FINAL.pdf) 32.4% of the Vermont population is therefore covered by Medicare or Medicaid.Massachusetts mandates health insurance coverage and provides subsidized healthcare for people earning up to 300% of the federal poverty guidelines and low cost options for people who don't have employer sponsored healthcare. According to the Massachusetts Department of Healthcare Finance and Policy (DHCFP) this has caused the rate of uninsured people to drop from 6% in 2006 to 4% in December 2009. At the same time, the rate of privately insured people has remained steady at 4.4 million or approximately 67% of the population, with the remaining 29% enrolled in public plans.In contrast, in 2011, 63.4% of the Retreat's funding came from public sources-17% from Medicare, 21.3% from adult Medicaid / state programs and 25.1% from child and adolescent residential funding or Medicaid. The Retreat is therefore treating a higher proportion of people receiving Medicare or Medicaid then the rates of public and private insurance might suggest.There are no other mental health and addiction specialty hospitals in Vermont and few in New England. In Vermont, there are four medical hospitals with psychiatric units. The Retreat operates roughly the same number of beds as the other four hospitals combined, making it the largest provider of inpatient psychiatric services in the state. 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, like Sister of Providence in Holyoke, MA and some medical hospitals operating psychiatric units. Many of those medical hospitals have downsized or eliminated their psychiatric beds in recent years. This is particularly true in New Hampshire. Most psychiatric units also serve exclusively or primarily adults, with few inpatient programs available for children and adolescents. The Retreat seeks to serve this population and has expanded its child and adolescent services in recent years. The Retreat plays a vital role as a large provider of mental health and substance abuse services in New England. It treats people from throughout the area, 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 therapy, substance abuse treatment and day treatment options.Population data is from the U.S. census QuickFacts and the Brattleboro Chamber of Commerce-accessed 7/16/2012. Part VI, Line 5: Morningside Shelter - Monthly use of conference room for board meeting for local homeless shelter.ALANON - Weekly use of East Conference Room.AA - Weekly use of cafeteria.United Way - Use of conference room.VT Community Foundation - Use of conference room.BACC Community Breakfast - Use of Education Conference room.Legislative Breakfast - Use of Education Conference room.Wellness in Windham County Series - In addition to its regular treatment and professional education services, the Brattleboro Retreat offers numerous programs to the community free of charge, including the Wellness in Windham County Series, co-sponsored with Brattleboro Memorial Hospital, Brattleboro Area Hospice and Brooks Memorial Library, and various lectures, films, forums, and special educational events open to the community. Wellness topics include; stress reduction, exercise, smoking cessation and prevention and education talks on a variety of health related topics.Collaborative Office Rounds - Training to assist identifying and effectively treating and referring children and families to appropriate services. This was developed to help support in prescribing medication and treatments due to the lack of child psychiatry in the community.Mid Winter Lunch Series - The Mid-Winter Lunch Series is a series of 4-6 hour long educational programs. Held annually, the series is free and open to staff, community providers and the public. It covers topics related to mental health and substance abuse in children, adolescents and adults.VAHHS Mental health Committee Chair - Addresses current Mental Health issues in Vermont's healthcare system.Blueprint for Health - the Vermont Blueprint for Health is a vision, a plan and a statewide partnership to improve health and the health care system for Vermonters. The Blueprint provides the information, tools, and support that Vermonters with chronic conditions need to manage their own health and that doctors need to keep their patients healthy. The Blueprint is working to change health care to a system focused on preventing illness and complications, rather than reacting to health emergencies. Part of this initiative and is working collaboratively with local acute care hospitals to create a behavioral health medical home for southeastern Vermont.Community Radio Programs - discusses Mental Health issues 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 0 0 0 0 0 0 0 0 0 Robert Simpson Jr 306335 0 47189 0 0 0 40162 0 12167 0 405853 0 0 0 John Blaha 172744 0 9000 0 0 0 7412 0 11184 0 200340 0 0 0 Vareen O'Keefe-Domaleski 158364 0 9000 0 0 0 6812 0 9030 0 183206 0 0 0 Frederick Engstrom 254166 0 4225 0 0 0 10549 0 14295 0 283235 0 0 0 Robyn Ostrander 219850 0 4225 0 0 0 9310 0 14285 0 247670 0 0 0 Timothy Rowland 205847 0 0 0 0 0 0 0 14252 0 220099 0 0 0 William Knorr 207297 0 0 0 0 0 8240 0 1494 0 217031 0 0 0 Nels Kloster 199937 0 0 0 0 0 8004 0 14084 0 222025 0 0 0 Vermont Educational Health & Buildings 237154467 924166AS0 2007-06-01 2800000 Refund Series 1997-2 Bonds & refinancing 0 0 0 Vermont Educational Health & Buildings 237154467 105540AA6 2007-06-01 4835000 Refund Series 1997-2 Bonds & refinancing 0 0 0 Vermont Educational Health & Buildings 237154467 924166DY4 2011-12-01 11300000 Refund Series 2007 Bonds & new money for capital improvements 0 0 0 2800000 2800000 43880 9800 2746320 2007 1 0 1 1 4835000 4835000 120481 16923 4697596 2007 1 0 1 1 11300000 113060 58992 2154663 1467844 7505441 2011 1 0 0 1 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 Form 990, Part VI, Section B, line 11 The Governing Body receives the prepared 990 electronically for their review followed by a presentation at their next full board meeting prior to filing the return. Form 990, Part VI, Section B, line 12c At the Annual Meeting, Board Members complete the document entitled "Brattleboro Retreat Questionnaire on Conflict of Interest". They are required to revise it during the course of the year if anything changes. 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 Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized gains on investments: 148,462. Loss on early extinguishment of long-term debt -132,445. Total to Form 990, Part XI, Line 5: 16,017. Oversight of Audit Form 990, Part XII, Line 2c: The process by which the committee oversees the review and selects the independent accountant has not changed from the prior year.