Guam - The Guam Memorial Hospital's financial struggles are no secret and today the Office of Public Accountability released an audit reinforcing the fact that the island's only public hospital's cash situation is flatlining.

"First of all, I'm not surprised," said Senator Dennis Rodriguez, Jr. "We've known all along that the hospital is hemorrhaging."  Rodriguez, the chairman of the Legislative Committee on Health, said the OPA's latest report on GMH's compensation controls revealed "weak basic controls to ensure authorized and accurate compensation to personnel who were paid more than $100,000 annually." He added, "And what we found there is pretty much lack of oversight where there was no policy established for thresholds and even safe hours policies were violated, and also time keeping controls weren't in place."

Audit supervisor Llewelyn Terlaje says the OPA report shows this was particularly prevalent for physicians' compensation where there was a general lack of review or reluctance to question the hours worked by doctors. Further, there is no system in place to correlate the hours compensated to physicians compared to billable hours charged to patients. These and other management oversight weaknesses contributed to employees receiving more than 25% over their base pay between fiscal years 2009 through 2011.

Rodriguez says GMH management needs to crack down now more than ever. "They need to show that's physicians and doctors are also held accountable, and the audit will show that physicians were able to do whatever they wanted to without anyone looking over them without the proper oversight," he said.

Public Auditor Doris Flores Brooks says many of the findings were surprising  including how one full-time emergency physician was averaging some 50 hours per week and had  second full-time employment yet not a single record on file was kept on the hours he was working. Meanwhile, in 2010 a radiologist  received compensation of $765,000 or 219% over the base pay authorized for part-time radiologists.

Said Brooks, "Another physician has been working on average over 60+ hours plus per week and did not take any leave in the three years, annual or sick leave, and yet was average over 60+ hours per week for three years straight."

The OPA has since met with GMH officials where they did concur with the OPA's findings. More than a handful of recommendations were suggested to include enforcing GMH's policy for all employees to clock-in electronically, establish built-in mechanism with the payroll system, implementing compensation threshold policies and developing a tracking system to correlate physicians hours worked and paid to billings by physicians.

"What's next is does GMH has the political will to implement these changes and these controls and that's really then next thing. If costs don't change then that's indicative that they haven't implemented the policy," Brooks noted.