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Pacific Islands Development Program, East-West Center

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Guam Hospital Employee Salary Records Raise Concerns
Some staff reportedly overpaid by more than 200 percent

By Joy White

HAGTA, Guam (Marianas Variety Guam, Nov. 14, 2012) – The Office of Public Accountability (OPA) released a report yesterday questioning the accuracy of salaries received by a number of Guam Memorial Hospital (GMH) employees.

According to OPA, several GMH employees received 2 to 227 percent more than their base pay due to excess hours and poor timesheet keeping.

For physicians, OPA found that one individual was compensated in excess of 200 percent of his base pay for two consecutive years.

During its investigation, OPA also found that thresholds for pay were not established, the GMH Authority (GMHA) Safe Hours of Work Policy was not enforced, and timekeeping and payroll controls were not implemented.

According to OPA, 78 employees receive more than $100,000 annually. Of those 78, OPA reviewed 15 employees who were physicians from the emergency room, ICU/CCU, laboratory, radiology, OB/GYN and pediatrics. The report also included nurses, pharmacists, administrators, and hospitalists.

Of the 78, 37 employees received 25 percent more than their base pay and 16 of these cases occurred in all three years, while seven occurred in two years, and 14 occurred within a single year.

In addition, among the 37 overpaid employees, 20 of them received more than 50 percent over their base pay and 4 received more than 100 percent of their base pay in at least one of the three years.

Work hours

A handful worked an alarming number of hours. From 2009 to 2011, two employees worked more than 3,000 hours. One employee never took sick leave. The other worked nearly 3,500 hours in one year.

With these large amounts of hours being worked, there is a concern that GMH is violating the Safe Hours of Work Policy which puts both employees and patients in danger.

An instance of dual employment without approval was also discovered by OPA. In this instance, the Emergency Room physician received more than $300,000 from 2009 to 2011, and worked an average of 49 hours per week.

According to GMH’s personnel policy, outside employment must be approved by the administrator and responsibilities and duties at GMH take priority.

Many of the compensation issues stem from lack of documentation or a complex pay structure. OPA found that verifying the work hours kept by physicians and GMH personnel was neglected. Hours paid did not match existing work schedules, there were no appropriate schedules to verify time keeping, and the schedule did not provide regular work shifts.

In addition, several timesheets were not approved or reviewed by the medical director or a second reviewer.

There are 44 pay codes within the pay structure which are manually inputted. This may lead to wrong pay codes being used and opens the door to opportunities for abuse, waste, and fraud. An ER physician, for instance, received payments for certain pay codes he was not entitled to.

"Overall, our message is that there is lack of management oversight," stated Llewelyn Terlaje, auditor-in-charge of the auditing team that compiled the report. "What allowed these individuals to receive in excess of their base was lack of scrutiny and lack of management oversights – for physicians. For nurses, they were allowed to receive different types of pay which allowed them to receive over their base pay."

Of the sample they reviewed, Terlaje stated none of the increases were a result of pay increases or bonuses.

GMH response

GMHA officials had provided an official response to OPA regarding the report on Nov. 5, concurring with the recommendations and findings.

The hospital stated that changes will be put in place to guarantee stricter regulations and promote efficiency. Committees will also be created to scrutinize compensation and overtime. A new hospital payroll module is likewise planned to be implemented by 2013. GMHA also stated it would continue to find ways to better enforce the Safe Hours of Work Policy, threshold policy, and dual employment policy.

GMHA officials also met with the auditing team on Nov. 7 to discuss the report.

GMH Administrator Joseph Verga is on emergency leave and was unavailable for comment. Acting Administrator Dr. Larry Lizama was also unavailable for comment as of press time.

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