‘No confidence vote’ vs Muña

By a 4-1 vote, the Commonwealth Healthcare Corp. board adopted yesterday a vote of “no confidence” against CEO Esther L. Muña for her alleged continued failure to respond to requests for documents and information vital to the decision-making process of the healthcare agency.

Muña got the vote of no-confidence from board chair Joaquin Torres, vice chair Pedro Dela Cruz, and trustees Roy Rios and Philip Mendiola-Long. Voting against the motion was trustee Tony Raho, who participated via teleconference. The board being advisory only, the resolution has no legal force or effect.

Muña, along with acting CFO Cora Ada and Medical Affairs director Dr. Sherleen Osman, once again opted not to attend the meeting yesterday. No designee was provided as requested by the board yesterday, prompting the board to defer several items on the agenda.

The no-confidence vote made it to the agenda yesterday after trustees agreed to amend the agenda and included the item under new business.

Mendiola-Long said his no-confidence vote is a result of the “failures” that the CEO had demonstrated in key areas and not a personal attack on Muña’s character, nor was it an “I feel pissed” reaction to her absence at the last two board meetings. He said it is strictly about the “management and professionalism” shown by the CEO.

Trustees said the no-confidence vote should serve as a “warning” for Muña to regain their lost confidence.

“At least, at this point in time, the board made her understand that we’re not comfortable with the status quo, we’re not comfortable with continuing to receive no response or answer [from her],” Mendiola-Long said.

Does Muña have the ability to perform as CEO? “That is the question we have today,” Mendiola-Long said. “The confidence is no longer there because that ‘ability’ is not showing through.”

Topping Mendiola-Long’s list of Muña’s 10 failures are the lack of a plan on the Commonwealth Utilities Corp. issue. CUC had threatened to disconnect the hospital’s non-essential services if the CHCC fails to pay its monthly bill in full by June 30. The hospital’s average monthly power consumption is $539,000.

“This is an issue that is severe, that puts the lives of our patients in immediate jeopardy and also on [Center for Medicaid and Medicare Services] compliance issues as well as public health grant issues. Understanding that there may be other issues the CEO and her staff are working on which are also important, I would have hoped the CEO will recognize how important is the issue with CUC and entertain us to walk through the plan and how we can help,” Mendiola-Long said.

Also of extreme concern is the lack of cash flow report and organization planning, which he tied in to the Marianas Public Land Trust line of credit. Drawdown of the MPLT funds hinges on the hiring of a permanent CFO, which has been vacant for two years.

From his initial viewing of current CHCC cash flow, Mendiola-Long said that CHCC is faced with the possibility of not meeting payroll.

“I have no problem going before the Legislature and the governor [to ask for money]. However, we need something [to show them], a plan,” he said.

He also questioned the lack of report on the payment settlement with CMS pertaining to prior year reimbursement amounting to approximately $800,000.

“We were assured that this is coming through…but up until today, it’s not coming through. There was no explanation to the board on what’s the problem with the delay,” he added.

Without this expected “settlement funds” from CMS and the unavailability of the MPLT line of credit, cash flow is expected to be impacted.

Accrual of a significant amount of overtime costs in many departments was also a concern as well as updates on recruitment for vital positions like nurses.

Mendiola-Long also scored Muña’s failure to account for what is happening with the collection agency it contracted in Guam. He said no reports were provided to the board despite requests.

Also cited was the lack of report or action on the board resolution about credentialing staff.

In failing to provide at least one of the 10 reports being requested by the board, Mendiola-Long said: “It makes me think that this is either inefficient or incapability or just not respecting the authority of the board.”

Vice chair Dela Cruz and Rios echoed Mendiola-Long’s sentiments and expressed hope that Muña will now start working with the board.

“The reason I moved the board to adopt the no-confidence vote is to [make it] serve as a warning…that we mean business here,” said Dela Cruz.

Raho said he cannot support the no-confidence vote as he recognized the valuable work Muña is doing for the organization. Instead of the vote of no-confidence, he tried to persuade colleagues to wait for the CEO’s evaluation and from there a decision can be made.

Raho also pointed out that, as an advisory body, the board cannot force the CEO to take its advice if she doesn’t want to.

The vote of no-confidence, he added, will also send the wrong message to federal partners. He asked for a contingency plan in the event something comes up and the CEO position becomes vacant.

After the vote, Mendiola-Long later asked for the board to contact recruitment firms to come up with a pool of candidates in the event the CEO position suddenly becomes vacant.