State audit finds 'reasonable doubt' in ex-MetroHealth CEO bonus dispute

Ohio Auditor of State Keith Faber's office has issued a report finding insufficient evidence to justify a criminal referral of Akram Boutros, MD, former CEO of Cleveland-based MetroHealth, in a case involving allegations that he received unauthorized bonus payments.

Mr. Faber's office issued the report Nov. 12 after a criminal investigation and special audit of MetroHealth was conducted at the request of the Cuyahoga County Prosecutor's Office.

The report noted that the investigation began in December 2022, and that the Cuyahoga County Council also requested that Mr. Faber's office conduct a forensic audit of the health system's compensation and bonus system. 

The MetroHealth board fired Dr. Boutros in November 2022, alleging that the former CEO authorized more than $1.9 million in supplemental bonuses for himself over a five-year period, without notifying the board. 

Dr. Boutros, who planned to retire at the end of 2022, alleged board retaliation and denied wrongdoing. In a lawsuit that Dr. Boutros later dropped due to health issues,  he argued that his termination and the subsequent statement released by MetroHealth harmed his reputation and eliminated future employment prospects.

Mr. Faber's office was unable to determine whether Dr. Boutros had proper authorization to receive the supplemental bonuses, "as there was reasonable doubt based on the information gathered."

The report concluded that "while Dr. Boutros did not share the development and management of the [supplemental performance-based variable compensation] program directly with the board, he did share information with Findley Davies, which was tasked with reviewing executive compensation matters and reporting directly to the board." 

However, Mr. Faber's office noted it was unable "to identify any supporting documentation for overt authorization by the board for Dr. Boutros' participation in the SPBVC. Additionally, our work concluded the board did not effectively oversee the CEO's compensation as his total compensation was processed through the payroll system, which appears not to have been reviewed by either the board or the compensation consultants, thus directly contributing to its unawareness about the SPBVC program."

Dr. Boutros praised the findings.

"I am gratified that the Auditor of State's comprehensive investigation has confirmed the truth about my compensation and proves that I have done nothing wrong," said Dr. Boutros in a news release shared with Becker's. "Despite how my tenure ended, my 10 years at MetroHealth were the most gratifying of my career. I love the staff and patients and am honored to have led a team that significantly improved healthcare in Cuyahoga County, and shepherded MetroHealth to become the most socially responsible health system in Ohio."

MetroHealth's board shared the following statement with Becker's: "While the auditor's report does not find sufficient evidence to support a criminal referral, the report is clear on several key facts, including [No. 1] ' … Dr. Boutros did not share the development and management of the [SPBVC] program directly with the board … ' [No. 2] the auditor was 'unable to identify any supporting documentation for overt authorization by the board for Dr. Boutros' participation in the SPBVC,' and [No. 3] when confronted with the payment of the unauthorized bonuses, 'Dr. Boutros repaid the SPBVC bonuses, including interest, at a total of $2.1 million.'

"These facts make it clear that the board acted properly in terminating Dr. Boutros for cause and recouping millions of dollars in unauthorized bonus payments."

Jason Bristol at Cohen, Rosenthal & Kramer, an attorney for Dr. Boutros, told Becker's his firm plans to refile Dr. Boutros' civil damages case next week. 

The full report is available here.

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