OPA tags deficiencies in Guam Memorial Hospital's physician contracts

By Jayvee Vallejera

The Office of Public Accountability has tagged 19 physician contracts at the Guam Memorial Hospital for some hiring deficiencies, but the hospital administration insists the deficiencies are “now moot.”

In a flash report released Monday, the OPA said its analysis indicated that the contracts were neither reviewed nor approved by the Attorney General’s Office and the Governor’s Office as required by policy.

The OPA found that some contracts did not have certifications of funding availability, while others had certifications but did not specify the time period to be covered, and still others did not specify the hiring date.

Some contracts identified job titles that differed from officially listed titles.

The GMH management said it “maintains significant disagreement” with OPA’s interpretation of hospital policies.

Officials explained that GMH has updated a number of its policies to resolve inconsistencies and deficiencies in its records and that the OPA based its findings on policies that no longer apply.

“The OPA’s report still applies the now-outdated policies. Therefore, even if the OPA’s interpretation of the prior policies is correct, it is no longer applicable and any potential findings from the audit are now moot,” it added.

The OPA report noted that GMH itself disclosed that its human resources team had uncovered “numerous deficiencies and inconsistencies with non-physician employee contracts executed under the previous personnel services administrator.”

In February, GMH hired a new personnel service administrator, who was tasked with correcting the deficiencies, including necessary updates to policies or amendments to affected contracts.

The OPA took note of an instance when GMH implemented a new hiring policy, changing earlier rules without the board of trustees’ review and approval.

The board eventually approved the new policy, nearly a month later and only after the OPA asked the GMH administration about the trustees' approval.

The OPA noted that the GMH board met twice before approving the new policy and mentioned nothing about the new policy during those two meetings.

Under the new policy, the personnel services administrator is no longer required to transmit contracts to the Bureau of Budget and Management Research, the Attorney General's Office and the governor's office for final approval.

The new policy requires the personnel service administrator to present the employment contracts to the hospital administrator—skipping the GMH board's human resources subcommittee—for review and final approval.

The OPA argued that a July 2021 GMH policy remained relevant to the 19 contracts analyzed in the report, noting that the new policy does not apply retroactively.

The OPA noted that the new policy applies only to contracts negotiated after it took effect in August.

Further, the OPA said changes to contract-related policies were only executed after OPA noted in an earlier report the lack of signatures by the Attorney General’s Office and the Governors’ Office on physician contracts.

In its response, GMH said the OPA failed to give sufficient weight to the hospital’s views on its own policies, and inaccurately claimed that the board of trustees’ review of amendments to the policy is not retroactive.

GMH accused the OPA of having "confirmation bias," saying it had already prejudged the hospital and was determined to find “deficiencies.”

It said the OPA came up with additional citations and reasoning after reviewing GMH’s response to the original draft of the report.

“These additional arguments create a constantly moving target intended to bolster prejudged ‘deficiencies’ from the OPA’s original draft, which tends to suggest the OPA has a confirmation bias and fails to give appropriate deference to GMH’s interpretation and understanding of its own internal policies,” GMH said.

The OPA said the flash report is for informational purposes only and adds to the results of an earlier report that examined the GMH’s physician contracts from fiscal years 2020 to 2023. The OPA did not apply any audit procedures to substantiate the figures in the report.

This latest report only covers the period from Jan. 1, 2022, to Dec. 31, 2023.

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