BRATTLEBORO -- The Centers for Medicaid and Medicare Services has given the Brattleboro Retreat preliminary approval following a three-day visit this week to determine if the psychiatric hospital was following its own plan of correction.

Federal inspectors arrived at the Retreat Monday following a number of compliance issues earlier this year that threatened millions of dollars in federal Medicare and Medicaid payments if the hospital was found to be in violation of any federal regulations.

Wednesday afternoon Konstantin von Krusenstiern, Brattleboro Retreat vice president for strategy and development, said federal inspectors during an exit interview indicated that the hospital had made the necessary changes to its policies and services.

"The CMS surveyors indicated in their exit conference that they had no findings and that the Retreat is in compliance with CMS Conditions of Participation," von Krusenstiern stated in a press release. "The surveyors acknowledged the hard work and commitment to patients and to performance improvements by the employees at the Retreat."

CMS has 10 days to issue its final report and von Krusenstiern cautioned that the hospital would have to wait for a final determination following this week's visit.

Federal investigators visited the Brattleboro Retreat earlier this year following reports that the hospital had improperly restrained and medicated patients, and that the hospital had involved local police in violation of CMS standards.

The Retreat had to come up with new policies, which were sent to CMS, and in turn accepted by the federal agency.

The visit this week was conducted to see if the Retreat staff members were familiar with the new policies and if they were being followed.

The follow up visit was delayed three times, von Krusenstiern said, in part due to the government shut down which pushed back the federal agency's schedule.

"We wish to acknowledge the extraordinary work of our employees as they continue to be dedicated to improving the lives of the individuals who come to the Retreat for care," von Krusenstiern said. "We have engaged in a process of continuous learning and problem solving while simultaneously adjusting our processes and protocols to meet the increasingly complex needs of some of our state's most acutely ill patients."

After Tropical Storm Irene closed the State Hospital in Waterbury in August 2011 the Retreat began caring for State Hospital patients.

The Retreat opened its new $5.3 million state hospital unit in April 2013, becoming a permanent part of the new state wide mental health care system.

The Retreat has been caring for between 14 and 24 patients.

Department of Mental Health Deputy Commissioner Frank Reed said the news from Wednesday's exit interview with federal inspectors was good for the hospital and for the state.

Reed said the Retreat, as well as Rutland Regional Medical Center which has also taken on more level one patients, have both been working to provide the best care for the most challenging patients while following all federal regulations.

"They have been doing the very tough work of caring for this high risk population and it is not at all unexpected to have security events when they are under the public scrutiny the involuntary treatment provides," Reed said. "For both hospitals there has been a learning curve around the complexities of treating mental illness and all the legal and security issues that come with that."

Howard Weiss-Tisman can be reached at hwtisman@reformer.com; or 802-254-2311, ext. 279. You can follow Howard on Twitter @HowardReformer.