Audit: GMH is a financial mess, and is in a lot of trouble

Benjamin J. Cruz

Guam Memorial Hospital was $257 million in the hole as of September 30, 2022, and incurred recurring losses and negative cash flow from operations due to a chaotic host of financial factors, according to an audit released today by Public Auditor Benjamin Cruz.

This audit doesn’t even touch the financials of Fiscal Year 2023, which are believed to have worsened from Fiscal Year 2022, the audited period.

By September 30, 2022, GMH had $368.8 million in liabilities, and only $89.5 million in assets. Those assets in FY 2022 represent a $9.3 million increase from FY 2021, “primarily due to increases in patient accounts receivable, net by $9.8 million.”

Those monies owed by patients – via insurance companies, Medicare, Medicaid, MIP, and patients without any health coverage – grew significantly in just one year. According to the audit, by the end of FY 2022, GMH was owed $302.3 million, of which $252.8 million now is considered “uncollectible.”

From FY 2021 through FY 2022 – encompassing the same period GMH spent $4.5 million on the MedHealth revenue cycle management contract – amounts from patients who owed GMH money via collection agencies “and others” grew by 131 percent; via the Medicaid Assistance Program by 91 percent; and via self-pay accounts by 71 percent.

The amount of money owed to GMH for which the hospital and its responsible vendors have failed to bill patients doubled during the period of the MedHealth contract, shooting up from $7.5 million to $15.1 million, according to the audit.

“Consequently, these conditions will result in the accumulation of uncollectible and/or disputed receivables, and potential inadequate cash flows to meet GMHA’s current obligations,” the audit states.

“GMHA’s mandate to provide healthcare to all patients regardless of one’s insurance coverage or ability to pay has resulted in the continual growth of patient receivables,” the audit states. “For the last five years, self-pay patients received an average of $25.6M of care per year, of which GMHA collects an average of 31 cents per dollar billed to self-pay patients. The likelihood of collecting these self-pay accounts, which have an outstanding gross receivable of $74.3M as of FY 2022, is low.”

The audit also notes that GMH’s cash flow was manageable to an extent in FYs 2021 and 2022 because of the inflow of $66.6 million in federal pandemic funds to the hospital. “However, GMHA is expecting very little cash support in FY 2023 due to the end of the public health emergency,” the auditors warn.

Despite the hospital’s ever-worsening financials, the audit found that GMH management increased spending on administrative contracts almost as much as it increased expenses on contracts for nursing and pharmaceuticals. The audit states:

“Contractual services for administrative support, fiscal services, and medical staff collectively increased by $13.4M (or 79%) in FY 2022. Fiscal services had the highest increase of $3.9M (or 457%) due to the revenue cycle management consultancy; followed by Administrative support by $2.7M (or 99%) due to electronic health record implementation, repairs, and demolitions; and Medical staff by $6.7M (or 51%) due to more physician hiring and increase in salaries.”

The hospital’s accounting practices also appear to be in disarray, with four material weaknesses identified in internal control and compliance over financial reporting. The audit pointed out multimillion dollar overstatements in one expenditure category, and two revenue categories amounting to $23 million in accounting errors. One of its systems was unable to generate historical reports of its subsidiary ledgers, and several transactions from previous fiscal years were erroneously recorded in Fiscal Year 2022.


  • Alan San Nicolas

      10/06/2023 at 5:11 AM

    Etmas tatkilo na achaki (prublema), I ti ma apa-pasi tatté ( espitat ) I debi niha. Magahet-Fi’et na setbisio para I malangu gaigi. Lao taigue I man gai debi.

    • Imelda Tanapino

        10/06/2023 at 11:05 PM

      Abba abba Abba Abba said the monkey to the chimp.

      Can you not write in any language translatable by Google Translate?

      Please include a link that will translate your post into:
      Etc, etc.

      Your post seems to be untranslatable to any commonly used language.

      Perhaps there is some GovGuam created Department with a GovGuam , taxpayer paid 22% pay raise, appointed rich GovGuam “rmployee” who can translate you Filipino Island dialect.

      Until then, perhaps you could share your invaluable thoughts from your Filipino dialect with the rest of the world in a language we can understand, or at least translate using Google.

      • Imelda,
        Your reply is one of an ignorant person, maybe what you need to do is go back to school.. oh wait, you are a Filipino Born in America..😂😂, in case you are Filipino just remember where you or your family from, your family was uprooted and transplanted…. If you don’t know anything about other peoples island I suggest you keep your comments to yourself and if you are on island you should pack yourself and your family and replant where you can understand and if you still can’t understand then go back to school

    • Imelda Tanapino

        10/07/2023 at 12:05 AM

      What can you expect of people who only speak/write some un- translatable Filipino dialect?

      Do we live in Guan, USA – or do we live in a Guam that has been colonized by Filipinos?

      Historically, (~1600 – 1650) the Spanish, having ruled their Filipino peons for decades after the flip islanders killed Spanish Magellan, the Spanish colonizers sent their Flip peons to Guam, where the colonizing Spanish backed Flip military killed most of the Chamarrou males and raped most of the Chamarro females.

      A true ethnic Chamarrou would look more like someone from Chuuk than a person from the Philippines.

      Unfortunately, there is no such thing as a Chamarro – there is only mestizos, whose forefathers came to Guam as soldiers/rapists/murders/filipino agents of the Catholic Colonizing Spanish.

      You can see the result of the “chamarropinos” failef attempt at self-rule: Dirty Corrupt GovGuam

  • Imelda Tanapino

      10/07/2023 at 1:09 AM

    Hey, wanna buy a Guam Drivers License?

    Just talk to the right GovGuam flip people (since convicted, but never jailed) and pay them some money – and VOILA, you have a legitimate GovGuam drivers license.

    Young flip lady, Daphne Manspit-Shimizu, who is responsible for the people at GovGuam Rev & Tax, who sell Guam driver’s licenses, Filipino style, without a driving test.

    GovGuam Rev & Tax Daphne Manspit-Shimizu is also responsible for all of the Filipinos who do not answer the phone when you try to call GovGuam Rev&Tax – not to mention her other many failings.

    GovGuam has transferred her to a similar high-pay position in their labyrinth of lies.

    If you don’t believe me, try and make a phone call to ANY Flip GovGuam agency. Try GovGuam Public Health – no one answers and their emailbox is full/has never been checked/emptied. Try it for yourself:
    Guam Public Health 671-635-7418, or any other GovGuam phone number.

    Maybe these 22% pay raise Flip “senators” could make it a law that GovGuam agencies should answer their phones or their lazy, inefficient, flip asses will be fired.

  • Imelda Tanapino

      10/07/2023 at 1:31 AM

    Btw: I know Flip “senator” Bamba’s son has been released from prison after serving his time for selling ice, but I was wondering if the convicted ice seller and his Flip Bamba brother are still employed by GovGuam?

    Also, is Guiterez’ son still in a Chinese prison for selling heroin?

    Perhaps you could ask Flip judge lamorena about their trip to China and how much it cost to get Guiterez’ son transfered to a Hong Kong prison.

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