An audit by the Guam Office of Public Accountability has identified significant financial management and internal control issues at Guam Cancer Care, despite the nonprofit’s continued delivery of services to cancer patients.
The report, OPA Report No. 26-04, reviewed Guam Cancer Care’s handling of funds in fiscal years 2023 and 2024 and was prompted in part by concerns tied to the theft conviction of a former senior employee. It is the first in a two-part audit, focusing on sources of funds.
Auditors found the organization relied heavily on grants from the Guam Cancer Trust Fund, receiving about $905,000 in FY2023 for direct services and $96,000 for outreach, and $1.2 million in FY2024. While all grant funds were fully expended, a large share went to salaries and fringe benefits—$415,000 in FY2023 and $421,000 in FY2024—raising concerns that personnel costs could grow and limit funding available for direct patient care.
The audit also flagged budget reallocations made without documented approval from the Guam Cancer Trust Fund Council, along with inconsistencies between approved budgets and final reports. In one case, a $97,000 invoice was reimbursed for $98,000, with corrected documentation still pending.
Additional concerns centered on transparency and oversight. Administrative costs exceeded projected levels, and financial reports lacked signatures and supporting schedules, calling their reliability into question.
Auditors identified multiple weaknesses in the handling of donations, which totaled about $255,000 over the two-year period. These included the absence of a detailed donations activity report, incomplete records for direct deposits, and payroll expenses paid through donation funds that were not reflected in official reports.
Internal control deficiencies were also cited, including limited segregation of duties, lack of documented reconciliations, and gaps in standard operating procedures governing donations.
The audit further raised issues with an audit consultant contract, including unclear roles, missing timesheets, and the absence of a timely official audit report. A “final report” dated 2023 was not provided until 2025.
Separately, auditors noted no formal internal investigation was conducted into a former employee later convicted of theft, despite prior indications of misconduct.
Public Auditor Benjamin Cruz concluded that while Guam Cancer Care continues to provide critical services, stronger financial controls, clearer guidance, and improved transparency are needed. The report outlines 11 recommendations aimed at strengthening accountability and oversight.