Ambulances were again being diverted away from Guam Memorial Hospital for at least several days this month because the emergency room was filled to capacity with people waiting for beds.

The diversions have been an issue for the hospital, which has a nursing shortage. And while proposed legislation could help GMH address the shortage, local elected officials’ attention has been on other issues this year.

And so, it’s Dec. 31 and many of the ills that plagued GMH at the start of the year remain unresolved – the hospital's roof still leaks and the electrical panel and the aircon system still need to be replaced.

In November, visitors from the U.S. Army Corps of Engineers said the hospital must urgently address these problems, and the soon-to-be obsolete electronic health records system in that list as well.

Additionally, there are other issues that are small today but will grow to become big problems if they aren’t fixed now – such as the cracks in the walls.

The visiting engineers also noted GMH was one of the most well-maintained hospitals they’ve seen, particularly in the island’s harsh environmental conditions and considering its financial struggles.

“There’s a sense of validation of things we kind of knew,” said William Kando, who has overseen facilities and maintenance at GMH over the last few administrations.

Fixing the hospital

Kando’s team is working on the capital improvement projects it can do with the money it can pull together.

The elevator replacement project “is well underway,” GMH officials stated. “Elevator #2 scheduled for completion early March 2020 and Elevator #1 is scheduled for completion in May 2020.”

The many other issues GMH faces remain unfunded, however.

This summer, during budget discussions, GMH asked for about $60 million to help fix the roof and other things. It didn’t get the money.

But it was evident from the Army Corps of Engineers that something needs to be done to fix things, from the rooftop all the way down to the power distribution room on the bottom floor.

On the roof, “poor water drainage and ponding is quite evident … drain caps are corroded, broken or even missing,” the Army Corps engineers noted.

“Major cracking has occurred throughout this top layer, which the facility has attempted (to) patch. The roof leaks excessively, causing interior damage to ceilings, walls, equipment etc., failure of components is inevitable due to age, which can lead to leaky buildings, mold growth and infection control issues.”

Financial support

Whether the final Army Corps report, which is expected in March, leads to a new hospital or a $200 million to $300 million overhaul of the existing facility, the reason GMH is in such bad shape has yet to be addressed.

Each year, the hospital loses money – mainly because, by law, it must treat all who walk through its doors, regardless of their ability to pay.

In fiscal 2018, GMH spent $33 million more than it earned in revenues, according to an audit released earlier this year.

Officials hope that the recent federal law providing more Medicaid funding and decreasing Guam’s matching requirement will help the hospital, but haven’t said by how much.

HR 1865 was signed by the president and became Public Law 116-94. The new law makes $127 million in Medicaid funds available to Guam for fiscal 2020 and 2021, and decreases the rate at which Guam must match the federal money from 45% to just 17%.

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