HAGÅTÑA (The Guam Daily Post) — While the debate continues over where and how to build a new public hospital on Guam, a couple of lawmakers have set their sights on exploring potential alternatives, either in the interim, while a new hospital is built, or as a permanent solution for the island’s health care needs.
To that extent, Sens. Jesse Lujan and Chris Duenas toured the Medical Arts Center in Dededo on Friday.
The facility sits adjacent to the Guam Regional Medical City and the property is owned by C.W. Holdings LLC, of which local attorney Cesar Cabot is a principal partner.
Cabot led the tour on Friday, but it was Lujan who reached out to him.
The senator indicated that he had been looking into the possibility of a public-private partnership to address public health needs on Guam. He told The Guam Daily Post Friday that he read about the Medical Arts Center and came down to see the facility while visiting a friend at GRMC.
“I said, ‘Man, this place is empty.’ So I placed a call to Cesar, and, with the argument going back (and forth) as to where the hospital’s going to be, I said, ‘Hey, is there a possibility that this can be an interim solution?’ So we met, and we spoke, and he gave us the details on what is happening,” Lujan said Friday.
“And it’s looking like it could be. It could be an interim, but it could (also) be an interim-permanent situation,” he added.
There is little debate over whether Guam needs a new public hospital. The issue currently is where to build it and what the scope will be. Presently, there are two bills at the Guam Legislature regarding the location for a new facility.
Bill 184-37, submitted by Gov. Lou Leon Guerrero, identifies six lots in Barrigada belonging to the Guam Ancestral Lands Commission, totaling 61 acres, for the construction of a medical complex. This would also include a new hospital and other facilities, but the plan to build an entire complex has been met with significant pushback.
Many in the medical community are calling for the governor’s plans to be scaled down to just a new hospital facility, and to build it at Ypao Point in Tamuning, a smaller portion of property, but one said to be in quick reach of most existing medical facilities and professionals.
Lujan said Friday that it will take some years to construct a new hospital regardless of where it’s built, adding that it’s no secret that Guam Memorial Hospital, the current public facility, is on borrowed time.
Duenas said Friday that deteriorating conditions at GMH necessitate immediate relief.
“Right now, typically, they have even (telemetry) nurse stations that actually are overloaded. So, you have an (intensive care unit) that’s overloaded with patients that are not even really at ICU level. You got basically an emergency room that’s overflowing consistently. So, (we need) some sort of relief. We’re already at that capacity,” Duenas said.
“So, it makes sense for us to take a look at something like this to make sure that we can immediately make sure that there’s more bed capacity, and that it also gives them the flexibility to start doing those interim repairs at GMH,” he added.
The Medical Arts Center isn’t totally complete yet, although the infrastructure is already there, and Cabot said he had been told that a build-out can be done within six months to a year, depending on what’s planned. The area can also be expanded with additional facilities, as indicated by a multiphase medical project development plan, which is what Lujan was referring to regarding an “interim-permanent situation.”
Potential uses
For the second and third floors, C.W. Holdings has been in discussions with a stateside company that operates 70 small hospitals and post-acute facilities, according to some of the discussion Friday.
“My understanding is that, there are some provisions, but they can probably almost run a hospital with no cost to the government of Guam,” Lujan said Friday regarding the stateside company.
Cabot said he’d rather the company confirm that, but it is his understanding that they’re willing to have the conversation to operate the facility for GovGuam at no costs, if they are ensured a certain number of paying clients.
Duenas also said the Guam Legislature sets aside about $35 million per year by law, referring to the 21st Century Healthcare Act.
“Until that new hospital is built, and we go out to obligate that funding source, until then, $35 million by law is available for a hospital. Why would you keep dumping money (into GMH)? … Yes, get it operational and make sure you mitigate most issues, but you can have a significant amount of beds that are ready to go that are here, as Cesar said, as an interim, while you’re constructing a hospital,” Duenas said.
At this time, however, there is nothing being developed in terms of legislation, according to Lujan and Duenas.
“When the (21st Century Healthcare Act) passed, it basically locked $35 million a year for debt service for a new hospital. … We’d basically go in and amend the law and say, ‘And now that $35 million can now be set aside for an interim facility, if there is one.’ We’re not saying this is it. We’re not out here doing any contracts or anything. We’re doing our due diligence to see what’s available. But say, for example, that came to be. Well, then that debt service is not serving any loans. Use it for the interim facility,” Duenas added.
Lawsuit
While the senators toured the facility and heard from Cabot on Friday, C.W. Holdings is involved in a lawsuit with GRMC regarding the Medical Arts Center.
C.W. Holdings LLC sued GRMC in late August for allegedly failing to pay more than $4.4 million in rent and other fees for the Medical Arts Center. The property is directly adjacent to GRMC and is meant to house clinics, a pharmacy and a number of other outpatient and wellness services.
GRMC answered the suit and raised claims of its own, alleging in part that the developer failed to complete work on time for the center.
Cabot said Friday that the case won’t affect the ability of the government of Guam or another potential tenant to consider using the facility.
“It’s a typical thing that happens from time to time between landlords and tenants. … That will have no impediment or obstacle whatsoever to this being considered as an interim solution,” Cabot said Friday.
Lujan said he agreed.
“Absolutely. And that’s one of the reasons why I contacted attorney Cabot a couple (of) weeks ago and we met. Actually, Sen. Chris and I and Sen. (Thomas) Fisher, we met as well at my office to see if this is feasible for us. We wanted to get the lowdown on, of course, the litigation and whether or not it can impact our thought in this being considered as an interim – or even a permanent – solution. And, you got the answer,” Lujan told the Post Friday.
Project co-owner Cesar Cabot, right, shows slides of his Medical Arts Center facility to Sens. Jesse Lujan, center, and Chris Duenas in Dededo on Friday, Nov. 3, 2023.
The Medical Arts Center still under construction in Dededo on Friday, Nov. 3, 2023.


