BRATTLEBORO -- In 2003 the Brattleboro Retreat was struggling to keep its doors open.
The psychiatric hospital was operating at less than half of its capacity and there were about 400 employees working there. Cuts to mental health insurance benefits, low Medicare reimbursements, and years of drawing off the Retreat's endowment forced Rick Palmisano, who was the CEO at the time, to go to the Legislature for help. Palmisano told lawmakers at the time that the Retreat could possibly close its doors if things did not change.
Since then the staff and administration at the Brattleboro Retreat have rebuilt the hospital and "Modern Healthcare" magazine named the Brattleboro Retreat one of the 15 largest mental health care providers in the country. Hospitals were ranked by net patient revenue based on the 2012 Centers for Medicare and Medicaid Services Hospital Cost data. This is the first time the Retreat has appeared on the list.
"The most important thing this means to us is that there is a demand for mental health care and addiction treatment in this county and the places that are growing are those that are meeting that demand," said Brattleboro Retreat President and CEO Rob Simpson. "We have been able to grow because we are providing services that people need, and as long as this trend continues we will grow to meet that need."
McLean Hospital in Belmont, Mass. was the largest non-governmental mental health care provider in 2012, according to the "Modern Healthcare" ranking, with net patient revenue of $110.3 million and a total staffed-bed count of 177.
Being included on the list of the 15 largest mental health care providers in the country also means the Retreat is in a better position to survive economic downturns and potential changes in the health care system that could affect smaller institutions.
The "Modern Healthcare" list used 2012 data and the Retreat's net patient revenue increased an additional 9 percent in 2013. More than 5,000 patients received services in 2013 across all programs, and the hospital's impatient admissions grew from 1,952 in 2006 to 3,580 in 2013, an increase of 83 percent.
"What is striking is that the Retreat has grown so much during a time of economic crisis in the United States," said Retreat Vice President for Strategy and Development Konstantin von Krusenstiern.
In 2006 the Retreat was staffed for less than 50 inpatient beds, and the Retreat's inpatient capacity is now 120 beds. With more than 800 employees on its payroll, the Retreat has nearly doubled its payroll since 2007.
Simpson said the hospital's success over the past decade has allowed it to invest in both its physical infrastructure and in its programming.
Over the past few years the Retreat has invested more than $10 million in capital improvements, including a complete remodel of the hospital's 12-bed Children's Inpatient unit, the construction of a new secure outdoor courtyard, a fully modernized pharmacy, a complete remodel of the cafeteria, new roofing on the administration and adjacent buildings, and the transformation of numerous two-season porch areas into modern, four-season clinical spaces.
A new $5 million, 14-bed unit for State Hospital patients was also recently completed with state funding.
The Retreat has introduced a number of innovative specialty programs including a 14-bed inpatient unit for emerging adults, aged 18 to 26; an outpatient Mind-Body Pain Management Clinic, as well as programs for lesbian, gay, bisexual or transgender patients and a program for uniformed professional suffering from post-traumatic stress disorder and other duty-related problems.
"If you are a small 20-bed hospital it is hard to offer specialty services," Simpson said. "Specialty care can be a part of your picture if you are large enough. Our success means we can look at other ways of providing service and going where there is a need."
Howard Weiss-Tisman can be reached at 802-254-2311, ext. 279, or firstname.lastname@example.org. Follow Howard on Twitter @HowardReformer.