Newly retired Guam hospital chief reflects on navigating the toughest years
- Admin
- Sep 30
- 4 min read
By Ron Rocky Coloma
On more than one occasion, Lillian Perez-Posadas thought about walking away. The longtime administrator of Guam Memorial Hospital remembers the nights when criticism felt overwhelming, when the financial shortfalls seemed insurmountable and when even her health made her wonder if she could continue.
“Oh, lots of moments that, you know, I feel like, OK, I just want to give up. I don't want this. I need to make sure that my health is OK,” Perez-Posadas said.
She officially retired today after serving as the hospital's CEO since 2019.
There are aspects of the job that she is happy to leave behind: “The attacks from the media, the criticisms from some of our doctors and just some untrue statements." But again, I rely on the Lord, on Almighty God's courage, His faith and His mercy to get me through.”
On her last day today, GMH medical staff and employees lined the halls to say their goodbyes.
Under her leadership, GMH navigated the unprecedented challenges of the Covid-19 pandemic, advanced accreditation and operational priorities, and advocated for education, increased nursing retention, and continued to deliver essential hospital services to the island community.
Faith and persistence guided Perez-Posadas through years of leading Guam’s only public hospital, where financial uncertainty, aging infrastructure and workforce shortages are constant realities.
“It's our only public hospital, and so my conviction is to try and do whatever I can to the best of my ability,” she said.
“Having years of experience as a registered nurse, I know and I truly understand
the clinical side of it. As nurses, we have this altruistic nature that we care for people. That was one of the driving forces that kept me in this position," she added.
One has to be thick-skinned to lead a much-maligned organization. “There were always criticisms about the care that we provide here and how the employees were,” Posadas said.
She made it a goal to rebuild trust and confidence, while also empowering staff across all levels of the hospital.
“I wanted to turn that around, to build the confidence and the trust that people can feel comfortable and safe, that when they come in here, their loved ones will be taken care of efficiently, effectively, compassionately and safely,” she said.
Perez-Posadas emphasized training and career growth, even for employees working outside of clinical roles.
“I've been kind of pondering because this is not about me. It's not about Lillian, and it's not for Lillian. It's for them. It's for the people of Guam, for the community and for the patients that we serve,” she said.
Recruiting skilled staff was another priority. Perez-Posadas said she wanted people “with the caliber that they can creatively come up with some solutions, be innovative, to think outside of the box and not feel that they are helpless and hopeless.”
The most difficult obstacle, she said, has always been funds. “Because we are a public hospital, and so we rely on the government general funds to financially support the hospital,” Perez-Posadas said.
GMH has always been underfunded. Medicare reimbursements and private insurance payments cover only a fraction of costs, leaving the hospital unable to pay vendors on time or compensate doctors at full rates.
“If you go to a restaurant, you pay for your meal, right? And the restaurant owner is able to then buy the supplies, the items that they need to continue making sure that they have the meals and the ingredients and to pay their employees. Well, if we don't get reimbursed 100 percent, how can you survive?” she said.
Beyond finances, Perez-Posadas pointed to the hospital’s age and shortages across multiple professions.
“Operationally, again, because it's an old hospital, the structure itself leaks. Internally, the cables and the electrical wires don't have the wires, because it was built more than 50 years ago,” she said.
“Workforce is another big factor, a big challenge. We all know nursing shortages throughout the island and doctor shortages also. Radiologists, technologists, respiratory therapists, pharmacists and even dietary nutritionists, we're short of those individuals.”
Asked about what stands out most, Perez-Posadas did not hesitate: the Covid-19 pandemic.
“That was very tough, very complicated, because it's a new virus. It's a novel virus that we didn't have a whole lot of information on, or even training, and even supplies,” she said.
Other crises followed, including Typhoon Mawar and cybersecurity breaches
that forced staff back to paper documentation. Through each, Perez-Posadas said the hospital endured.
GMH was designated as the island’s Covid hospital while continuing to provide maternal and pediatric care. Perez-Posadas recalled the daily meetings, retrofitting of spaces and fears among staff.
“So, of course, we lost again. We're short already, but we lost more individuals working in our hospital, and we were designated as the Covid hospital,” she said. “Really pulling together, and we survived it, and we thrived above that Covid pandemic situation.”
GMH received two prestigious Healthcare Asia Awards for the way it handled the emergency room during the pandemic.
Perez-Posadas said she hopes her successors remember compassion as the foundation of leadership.
“Compassion not just for the patients, but for each other, with each other. Working with kindness and understanding,” she said. “And in this organization, we're trying to instill in the minds of our employees the just culture, meaning let's not blame the individual, let's not find fault on the individual, but let's take a look at the issues and the systems.”
She said leaders should listen more and speak less. “Listening to the staff is something that I want to encourage the leaders and the managers, and even the co-workers, to listen to each other, compassionately and understandingly.”
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