The Guam Memorial Hospital Authority leadership is set to go before senators next week for their budget hearing.  A nursing shortage, vendor debt, delayed and denied payments from insurers compounding a budget shortfall. This budget cycle, Guam's only public hospital is short $21.9 million according to hospital administrator and CEO Lillian Perez-Posadas during a recent GMH board meeting. 

She met with senators to push for the increased funding, but so far, no guarantees. "They can’t guarantee we will get the $21.9 million, so they’re asking us if we can settle for less than that. But no, we need the $21.9 million," she said.

The ask is over $10 million more than last year, according to GMH chief financial officer Yuka Hechanova.  It’s to pay their personnel and to pay off their debt to vendors to get much-needed supplies - all amid a nursing shortage that's forced them to hire more travel nurses. 

And on top of that, denials and delayed payments from local insurers further compounding the public hospital’s finances. Perez-Posadas said, "That’s been a real big challenge and that’s why we end up not being able to pay our vendors and that impacts our supplies and it impacts our provision of patient care. Staff and nurses are getting frustrated that they are not able to do whatever they need to do to provide the care for the patient, because surprise, they don’t have supplies."

The Medicare reimbursement disparity is an ongoing issue, as the CEO noted, "We have come to the conclusion that our payers are not paying us appropriately. We are not getting reimbursed what we provide and what we claim."

The board weighing whether they should take more aggressive action against local insurers, like suing them.  "Because right now we are sending them ‘you owe us this much and you owe us this much’ as we’re sending interest statements on outstanding balances but he wants us to take it further. We need to sue these people," Hechanova said.

In the meantime, hospital leadership will be advocating for their budget before lawmakers on May 5