![\"The](\"https:\/\/www.europesays.com\/us\/wp-content\/uploads\/2025\/10\/VTD-Bratt-hospital-4-1200x900.jpg\")
The Brattleboro Memorial Hospital campus on Belmont Avenue. Photo by Kevin O\u2019Connor\/VTDigger<\/p>\nThe Brattleboro Memorial Hospital campus on Belmont Avenue. Photo by Kevin O\u2019Connor\/VTDigger<\/p>\n
BRATTLEBORO \u2014 Ask administrators at Brattleboro Memorial Hospital about a multimillion-dollar operating budget shortfall and they\u2019ll point to everything from too many unpaid patient bills to their own staff\u2019s rising health insurance costs.<\/p>\n
\u201cWe fully recognize that we are in a very bad financial condition,\u201d one hospital official said at an Aug. 6 budget review hearing. \u201cWe need to increase cash and decrease our payables and receivables.\u201d<\/p>\n
Vermont health care regulators, for their part, cite a bigger problem: fiscal figures they say don\u2019t add up.<\/p>\n
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\t\t\t\t\t\t\t\t \u201cBMH has not accurately or completely answered many questions,\u201d the state\u2019s Green Mountain Care Board wrote in an Oct. 1 decision<\/a> on hospital spending. \u201cThis missing, incomplete and inaccurate information makes it challenging to understand BMH\u2019s current financial position.\u201d<\/p>\n No one, for example, can pinpoint the exact sum of the shortfall attached to the $119 million annual budget that ended Sept. 30. At a Sept. 3 hearing, the board said hospital filings were projecting a deficit of $2.8 million and, at the same time, reporting a year-to-date loss of $10.8 million.<\/p>\n Regulators, expressing fears that \u201cthe hospital may be at risk of a sudden solvency crisis,\u201d have told Brattleboro leaders to resubmit \u201ccorrected and accurate\u201d budget numbers or risk becoming the first Vermont health care facility to receive outside intervention under a new state law<\/a>.<\/p>\n As administrators revise their math, the hospital\u2019s more than 500 staffers and 45,000 residents in its service area are questioning both the budget and this month\u2019s unexplained leave of absence<\/a> of CEO Christopher Dougherty.<\/p>\n Dougherty has referred all inquiries to the hospital\u2019s communications office, which isn\u2019t elaborating \u201cout of respect for Chris\u2019s privacy,\u201d it has emailed corporators.\u00a0<\/p>\n The hospital also is limiting comment on its finances, saying only that administrators are cooperating with regulators. But the extent of the challenge can be gleaned from Green Mountain Care Board records, reports and recordings full of red ink.<\/p>\n \u2018Significant financial challenges\u2019<\/p>\n The hospital, one of Brattleboro\u2019s three largest employers, hasn\u2019t reported a positive operating margin since 2020, according to board figures. But regulators didn\u2019t initially see that as a red flag, as Vermont\u2019s 13 other community hospitals also faced budget problems during the Covid-19 pandemic and a subsequent boom in patients that drove up spending<\/a>.<\/p>\n Brattleboro, which ranks eighth in the state for net patient revenue, isn\u2019t as large as Burlington\u2019s University of Vermont Medical Center, Rutland Regional Medical Center or Berlin\u2019s Central Vermont Medical Center, all which can offer more profitable subspecialties. On the flip side, Brattleboro\u2019s 61-bed count isn\u2019t small enough to be one of the state\u2019s eight \u201ccritical access hospitals\u201d<\/a> (up to 25 beds in a rural location) that qualify for federal support.<\/p>\n Brattleboro\u2019s financial plight became public in May<\/a>, when the hospital warned it had four months to find $4 million in reductions and new revenue to balance its budget by Sept. 30.<\/p>\n \u201cLike rural hospitals here in Vermont and across the nation, BMH faces significant financial challenges that have been imposed on us in large measure by both the state and federal governments,\u201d Dougherty wrote in the email to community supporters.<\/p>\n The not-for-profit pointed to its status as the state\u2019s only Medicare dependent hospital, meaning at least 60% of its admissions are Medicare patients age 65 or older. Brattleboro\u2019s Medicare reimbursements for professional services have declined by almost 3% annually, Dougherty wrote. At the same time, the hospital is paying $600,000 a month in Vermont health care provider taxes \u2014 charged to facilities statewide \u2014 to help fund Medicaid expenditures for people with limited incomes.<\/p>\n \u201cWhile part of that money comes back to us,\u201d Dougherty wrote of the provider taxes, \u201cthe state recently reduced the percentage of annual return to less than 10%.\u201d<\/p>\n \u2018System inefficiencies\u2019<\/p>\n State regulators see the numbers differently. In last year\u2019s budget decision, they noted that Brattleboro Memorial Hospital\u2019s low Medicare payment-to-cost ratio, clinical productivity data and higher-than-average wait times indicated \u201csystem inefficiencies\u201d<\/a> that could be reduced through better management of expenses.<\/p>\n Hospital administrators went on to launch a hiring freeze and let go of six administrators<\/a> in hopes of lowering its staff count from 543 last spring to 513 this fall. The hospital also recently won selection to a Centers for Medicare & Medicaid Services\u2019 Rural Community Hospital Demonstration<\/a> project that helps with financial reimbursements.\u00a0<\/p>\n But during the state\u2019s annual budget hearings in August, hospital administrators detailed an even longer list of troubles. Unpaid patient bills had risen as high as $50 million after the arrival of Covid-19 and a 2024 cyberattack on its electronic claims processor. And costs had increased for everything from a self-funded employee health benefit plan to salaries of travel nurses and other contract workers.<\/p>\n As for the future, administrators told the board the hospital could lose nearly $4 million a year if the federal government doesn\u2019t extend a subsidy provided to Medicare-dependent and low-volume facilities. Another $700,000 is at risk annually if the hospital is dropped from a national drug pricing program called 340B that offers financial help.\u00a0<\/p>\n
\n\t\t\t\t\t\t\t\t\t\t\t\t![\"Brattleboro](\"https:\/\/www.europesays.com\/us\/wp-content\/uploads\/2025\/10\/VTD-Bratt-hospital-2-1200x900.jpg\")
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