Review cadence
- Source date
- 2026-07-16
- Claim review
- 2026-07-19 · 23/23
- Proven sweep
- 2026-07-16
- Target
- TT · monthly
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Guam has 1 community health centers across 2 sites serving 8,595 patients — the #55 FQHC state by patients in the national-breadth layer. Its community health centers depend on the federal Community Health Center Fund, authorized only through December 2026.
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We keep source date, claim review, and a completed source sweep separate. None of these clocks substitutes for another.
8,595 reported patients
Actual values: 9/12 · source-backed: 8/12
Visible gaps: NPPES operator identity, EHR, history, reported financials.
Hash-pinned review: 2026-07-19 · next 2027-01-15
This public log starts July 14, 2026. Zero logged changes does not mean a page or claim never changed before that date.
2026-07-19 · addition
New tracked GU development added to the state intelligence feed.
2026-07-19 · addition
New tracked GU development added to the state intelligence feed.
2026-07-16 · material correction
Corrected this GU record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-16 · material correction
Corrected this GU record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-16 · material correction
Corrected this GU record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-16 · material correction
Corrected this GU record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-16 · material correction
Corrected this GU record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-16 · material correction
Corrected this GU record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-16 · material correction
Corrected this GU record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-16 · material correction
Corrected this GU record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-16 · material correction
Corrected this GU record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-16 · material correction
Corrected this GU record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-16 · material correction
Corrected this GU record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-16 · material correction
Corrected this GU record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-16 · material correction
Corrected this GU record after a full claim-and-source sweep replaced stale, unsupported, or mismatched framing with the currently supported evidence.
2026-07-16 · addition
New tracked GU development added to the state intelligence feed.
2026-07-16 · addition
New tracked GU development added to the state intelligence feed.
2026-07-16 · addition
New tracked GU development added to the state intelligence feed.
2026-07-16 · addition
New tracked GU development added to the state intelligence feed.
2026-07-16 · addition
New tracked GU development added to the state intelligence feed.
2026-07-16 · addition
New tracked GU development added to the state intelligence feed.
2026-07-16 · addition
New tracked GU development added to the state intelligence feed.
2026-07-16 · addition
New tracked GU development added to the state intelligence feed.
2026-07-15 · addition
New tracked GU development added to the state intelligence feed.
2026-07-15 · addition
New tracked GU development added to the state intelligence feed.
2026-07-15 · addition
New tracked GU development added to the state intelligence feed.
2026-07-15 · addition
New tracked GU development added to the state intelligence feed.
2026-07-15 · addition
New tracked GU development added to the state intelligence feed.
Send a correction or new source to improve this state page.
Guam's Medicaid financing remains structurally different from state financing: federal law gives the territory an annual spending ceiling under Social Security Act Section 1108 even though its 83% federal medical assistance percentage is permanent. Guam has one HRSA Health Center Program reporting awardee, and DPHSS lists Northern Region Community Health Center in Dededo and Southern Region Community Health Center in Inalåhan under its Bureau of Primary Care Services. HRSA's 2024 UDS data report 8,595 patients; 6,171 (71.80%) were Medicaid/CHIP patients and 1,390 (16.17%) were uninsured. Current federal law excludes Guam and the other territories from the $50 billion Rural Health Transformation Program, while the Community Health Center Fund currently lists appropriations only through December 31, 2026. The operating picture is therefore mixed: the permanent 83% matching rate and the territory's exclusion from the new Medicaid community-engagement rule are stabilizers, but the federal ceiling, the pending health-center-fund deadline, and disaster recovery remain material constraints.
Patient-weighted across the 1 centers with UDS 2024 data.
Guam Code, Title 10, Section 12313 treats an advanced practice registered nurse as a licensed independent practitioner who may serve as the primary or acute care provider of record. Within the APRN's education, certification and population focus, the statute authorizes advanced assessment, diagnosis, referrals, admission and discharge, and prescribing, ordering, dispensing and furnishing therapeutic measures, including controlled substances. Prescribing controlled substances requires a federal DEA registration and compliance with Guam and federal law. The statute requires consultation or referral when a patient's needs exceed the APRN's expertise; it does not impose a general physician-collaboration agreement on nurse practitioners.
Guam operates Medicaid under a federal block-grant cap (not standard FFP); the headline risk is the hard funding ceiling plus reduced federal match and the end of pandemic-era enhanced territory allotments.
Jurisdiction operating analog
This framework does not force territorial Medicaid or Compact assistance into state-only fields. Every lane preserves its own authority and source.
Guam's Medicaid program is territorial, not state-equivalent: the federal medical assistance percentage applies only while section 1108 allotment remains available. Once the federal ceiling is exhausted, the ordinary state model of continuing federal match does not take over.
Centers for Medicare & Medicaid Servicesreviewed 2026-07-14Guam's disaster SPA paid a 10% increase only for Medicaid clinic services delivered by community health centers from April 11 through June 10, 2026. As of this review it is an expired emergency bridge, not a recurring FQHC rate increase or a valid forward revenue baseline.
Centers for Medicare & Medicaid Servicesreviewed 2026-07-14The Guam Board of Nurse Examiners operates through the territorial Department of Public Health and Social Services and reviews RN and advanced-practice matters. Workforce records must cite Guam licensure status; a license or scope label from another state is not a substitute.
Government of Guam, Department of Public Health and Social Servicesreviewed 2026-07-14Guam's Medical Referral Assistance Office coordinates airport and local transport for patients traveling off island and requires a clinician referral or insurer authorization. Treat this as an active referral pathway, while separately verifying airfare, lodging, payer approval, receiving-facility acceptance, and clinical escort needs.
Guam Medical Referral Assistance Officereviewed 2026-07-14The Government of Guam Department of Administration employment page is the official public-sector feed and links to the territory's application system. Preserve announcement dates, closing dates, and attached pay specifications; a temporarily empty or migrated list means unknown demand, not zero demand.
Government of Guam, Department of Administrationreviewed 2026-07-14Guam is expressly ineligible for a direct RHTP award because the CMS notice limits applicants to the 50 states and excludes U.S. territories. Do not assign Guam a state award amount, state application status, or zero-dollar award.
Centers for Medicare & Medicaid Servicesreviewed 2026-07-14Role implications
Pick the right lens and open a personalized daily brief. Links carry only state, role, and audience in the URL.
Guam ranks #55 by FQHC patients, with 1 organizations and 2 sites tied to federal grant exposure.
Use this as the board agenda frame: exposure, owner, decision date, and the first source to recheck.
71.8% Medicaid/CHIP, 16.2% uninsured, and uninsured share is 16.2%.
Turn the payer mix into scenarios for PPS, 340B, grants, and patient-volume stress.
HRSA organization data while public job-source coverage expands; largest systems and directory links show where hiring capacity may need verification.
Use the state read to pick roles to watch, openings to save, and retention risks to discuss with managers.
Guam combines 8,595 FQHC patients with full practice NP practice context and access pressure from payer mix.
Map the signal to panel access, team-based care, top-of-license planning, and patient-impact follow-up.
PIPCA, state policy context, and the December 31, 2026 CHC Fund cliff define the sources to keep current.
Assign one source owner for state policy, one for federal deadlines, and one for billing/audit implications.
Guam has 1 FQHC employers in the directory and HRSA organization data while public job-source coverage expands to compare before applying.
Use the state context to choose target employers, tailor proof, and save the next job or resource in My Progress.
Browse FQHC jobs in Guam and nationwide.
The observation remains unknown until a reproducible source sweep or manual review is completed. No published match does not mean zero layoffs.
The row count describes the official artifact, not a count of FQHC layoffs. · Official source
23 primary-sourced findings on Guam FQHC policy and financing.Newest item: 2026-07-16
DPHSS's July 16 release says the Santa Rita WIC Clinic remained temporarily closed until further notice because of continued power problems. Effective immediately, the Inalåhan WIC Clinic at the Southern Region Community Health Center shifted from Tuesday-and-Thursday service to Monday–Friday, 8:30 a.m.–4:30 p.m., except Government of Guam holidays and the last Friday of each month, to accommodate participants normally served at Santa Rita.
DPHSS also said its No Wrong Door policy allows participants to use Northern, Central, or Southern WIC clinics. This is a public-health service-continuity change hosted at a community health center, not a new hospital or general FQHC service line; the release does not quantify appointments, participants redirected, staffing, capacity, benefit issuance, referral completion, reopening date, or outcomes.
On July 14, 2026, OpenGov Guam posted an undated Department of Administration notice stating that the Department of Public Health and Social Services intended to employ Patrick Sotto as Territorial Epidemiologist at $100,335 per year, step 05 of pay grade SX. July 14 is the portal posting date, not an employment, signing or effective date.
The notice says the posting satisfies Guam’s above-step recruitment and transparency requirements. This is notice of an intended personnel action, not proof that employment began or remains current, that the position is newly created, full time or still open, or that a competitive recruitment occurred.
It provides no start date, duties, benefits, funding source, vacancy duration, applicant pool, team size, retention evidence, added service capacity or outcomes. The role concerns government-wide public health; the source does not assign it to either Guam Community Health Center or establish staffing for the directory-listed Health Center Program awardee.
The PDF itself is undated.
Guam DPHSS's July 14 update says the Northern Region Community Health Center resumed services after Typhoon Bavi and, through Friday, July 17, added walk-in periods from 6:00–8:00 a.m. and 5:00–7:00 p.m. for non-emergency concerns and follow-up care, alongside regular Monday–Saturday hours of 8:00 a.m.–5:00 p.m.; new patients and walk-ins were welcome.
Pharmacy and laboratory services were not available during the extended periods, some routine or preventive care could require regular-hour scheduling, and emergencies remained directed to 911 or an emergency room. The Southern Region center remained open Monday–Friday, 8:00 a.m.–5:00 p.m. This is a short recovery schedule, not proof of availability after July 17, added staffing, visit capacity, wait-time change, storm damage, hospital diversion, or patient outcomes.
The current text of 42 U.S.C. 254b-2 appropriates $4.6 billion to the Community Health Center Fund for FY2026 and $1,159,452,055 for October 1–December 31, 2026. It lists no appropriation after that date.
Guam's Health Center Program awardee should therefore treat funding beyond December 31 as pending congressional action, while recognizing that the statutory fund is national and this source does not specify Guam's future award amount.
Guam Regional Medical City says Patient Experience Partner Benita Jones earned certification as a Chuukese medical interpreter and that certified Chuukese interpretation is now available 24 hours a day, seven days a week at the hospital. GRMC is a hospital and is not Guam’s directory-listed HRSA Health Center Program awardee.
The source does not say Jones is a new hire, identify the certification issuer or credential number, describe shift, on-call or backup coverage, quantify interpreted encounters or language demand, or provide wait-time, comprehension, safety or patient-outcome measures.
CMS approved Guam SPA GU-26-0001 on June 10, 2026, with an effective period of April 11 through June 10, 2026. The disaster-relief amendment applied a uniform 10% increase to Medicaid rates for covered services delivered by Community Health Centers under the clinic benefit.
Because the approved window ended June 10, operators should treat the increase as time-limited Typhoon Sinlaku relief, not a recurring rate change.
The University of Guam reported that 35 students received Bachelor of Science in Nursing degrees at its May 24 commencement after a May 19 pinning ceremony. UOG describes the program as ACEN-accredited and says its curriculum combines classroom instruction, evidence-based practice, clinical rotations across Guam, preceptor mentorship, and virtual-reality and SimX simulation.
The source reports a 100% first-time NCLEX pass rate for the Spring 2023 cohort and at least 95% for each Spring cohort from 2020 through 2022 and from 2024 through 2025. Those historical rates are not results for the 2026 cohort: the new graduates still had to take the NCLEX to become registered nurses.
The source does not establish how many will test, pass, obtain Guam licenses, accept local jobs, work for community health centers or remain on island. Its nursing annex and capacity for cohorts of up to 60 were prospective and are not counted as realized capacity.
CMS's June 1, 2026 fact sheet states that the Medicaid community-engagement requirement applies in 43 states and the District of Columbia and that U.S. territories are not subject to it. Guam therefore does not need to implement this particular requirement.
The fact sheet does not establish that Guam is exempt from every other Medicaid provision or quantify any resulting change in coverage or health-center revenue.
The directory-listed Government of Guam- Department of Administration awardee operates publicly through DPHSS as the Guam Community Health Centers. DPHSS says providers and staff are completing training, workflow preparation and implementation work for a new electronic health record system with a projected go-live in September 2026; it warns that patients may experience longer waits or minor service delays during the transition.
The release describes expected care-coordination and operational benefits, not realized results. It does not identify the vendor, contract value, funding source, migration scope, training hours, downtime, security or interoperability specifications, baseline wait times or measured outcomes.
In its April 30, 2026 budget presentation, GMHA requested $212.1 million for FY2027 and identified a $36.3 million funding gap. GMHA also reported $390 million in accounts receivable while describing improved FY2026 performance: spending $5.4 million below budget and collecting $60.5 million against a $51.5 million target.
These are GMHA-reported budget and collection figures; the presentation does not quantify downstream effects on Guam's community health centers.
The House Appropriations Committee's FY2027 Agriculture report lists $1.76 million for Guam Memorial Hospital Authority's Z-Wing Structural Stabilization and Emergency Access Restoration project under the Rural Community Facilities Program. The committee approved the measure on April 29, 2026.
This is a committee-stage appropriation, not proof that an enacted award has been obligated or paid.
A Government of Guam recovery release dated April 17, 2026, states that DPHSS extended Northern Region Community Health Center hours to Monday–Friday, 8 a.m.–9 p.m., and Southern Region Community Health Center hours to Monday–Friday, 8 a.m.–5 p.m., plus Saturday, 8 a.m.–5 p.m., until further notice. The release ties the schedule to ongoing Typhoon Sinlaku recovery; it does not quantify visits or claim a specific reduction in hospital demand.
On April 2, 2026, DPHSS announced four Saturday Back-to-School In-Reach Clinics at the Guam Community Health Centers: May 23 and July 18 at Northern Region Community Health Center in Dededo, and May 30 and July 25 at Southern Region Community Health Center in Inalåhan, from 10 a.m. to 3 p.m.; registration was to end at 2 p.m. or when supplies ran out.
The announcement offered childhood vaccinations, school physical exams and selected adult vaccinations. It said the centers serve people covered by Medicaid, MIP and private insurance as well as uninsured patients, bill insurance when applicable and offer a sliding-fee discount to qualifying patients.
These sites operate through DPHSS under the directory-listed Government of Guam- Department of Administration awardee. This is a published schedule, not confirmation that any clinic occurred or remained unchanged after the announcement, that every service or vaccine was available on every date, or that appointments, supplies or no-cost care were guaranteed.
It does not report attendance, staffing, incremental capacity, wait times or outcomes, and it does not extend FQHC status to other DPHSS outreach locations.
The directory-listed Government of Guam- Department of Administration awardee operates publicly through DPHSS as the Guam Community Health Centers. DPHSS says it added postdoctoral psychologist Dr. Christopher Otero, who is now seeing patients alongside licensed psychologist Dr. Mamie Balajadia, and that appointments with Dr. Otero are available at both the Northern and Southern community health centers.
The clinics serve people covered by Medicaid, MIP and private insurance as well as uninsured patients. The release confirms one added clinician and two named psychology clinicians, not two full-time-equivalent positions; it does not publish clinic schedules, appointment slots, caseload, compensation or funding, independent licensure for the postdoctoral role, encounter volume or outcomes.
Todu Guam Foundation Health & Wellness Center says licensed clinical psychologist Alan Butler joined MindCare and that patients may now schedule appointments with him. The nonprofit clinic says MindCare includes psychiatric care, psychotherapy, psychological assessments and collaborative treatment planning alongside primary care.
Todu Guam is not Guam’s directory-listed HRSA Health Center Program awardee; the source does not establish FQHC status, employment or contract status, a new full-time-equivalent position, schedule, appointment capacity, caseload, compensation or funding, or outcomes.
H.R. 7514, introduced February 11, 2026, would allow eligible rural health facilities to use USDA credit assistance for refinancing, information technology and equipment, and certain ancillary needs.
The bill remains introduced and referred to committee, so it has not yet changed financing authority or produced an award for a Guam facility.
CMS states that only the 50 states are eligible for the Rural Health Transformation Program; the District of Columbia and U.S. territories are not eligible. The program provides $10 billion in each of fiscal years 2026–2030, and CMS announced awards to all 50 states on December 29, 2025.
Guam therefore has no direct award under this program unless Congress changes the eligibility law.
H.R. 6494, introduced December 5, 2025, would eliminate the statutory limitations on federal Medicaid payments to Guam and the other U.S. territories beginning in FY2026.
Congress.gov shows the bill at the introduced stage, referred to the House Energy and Commerce and Ways and Means committees. The annual ceiling therefore remains current law unless this or another measure is enacted.
CMS approved Guam SPA GU-25-0002 on December 3, 2025, effective July 1, 2025. The amendment removes a named Average Wholesale Price source for prescription drugs and updates links to several fee schedules.
It is a reimbursement-reference change; the CMS summary does not claim a uniform rate increase.
HHS's FY2027 FMAP notice confirms that the Consolidated Appropriations Act, 2023 made Guam's 83% federal medical assistance percentage permanent. That percentage determines the federal share of otherwise matchable spending; it does not remove Guam's separate annual federal-payment ceiling under Social Security Act Section 1108.
Operators should not describe September 30, 2027 as the expiration of Guam's 83% rate.
The Guam Community Health Centers, operated through DPHSS by the directory-listed Government of Guam Department of Administration awardee, announced that board-certified OB/GYN Christopher Bieling had joined its women's-health services. DPHSS said appointments were available at both the Northern and Southern Region Community Health Centers, where Bieling would provide high-risk obstetric care and mentor CHC providers in colposcopy procedures.
The source confirms access to one named specialist at two sites, not two clinicians or two full-time-equivalent positions. It does not specify employment or contract status, schedule, appointment slots, panel size, referral criteria, number of providers mentored, mentoring hours, competency results, compensation, funding, visit volume, delivery services or patient outcomes.
SPA GU-24-0002, approved January 7, 2025 and effective December 1, 2024, records Guam's state-plan assurances for mandatory reporting of the Child Core Set and the behavioral-health measures in the Adult Core Set. The amendment establishes the reporting obligation; it does not itself report Guam's measure results or quantify a new community-health-center workload.
Todu Guam Foundation announced on August 7, 2024 that its Health & Wellness Center had been approved as a National Health Service Corps site. NHSC-approved sites can participate in federal loan-repayment and scholarship placement programs, giving the organization a clinician recruitment and retention channel.
The announcement does not establish that Todu Guam is a federally funded FQHC or verify the site's current NHSC status in 2026.
By patients (HRSA UDS 2024). Tap for the full profile.
| Organization | Patients | Sites | Uninsured | Revenue (990) | Resilience | District |
|---|---|---|---|---|---|---|
| Government of Guam- Department of Administration Tamuning | 8,595 | 2 | 16.17% | — | Exposed | GU-98 |
| District | Representative | Sites |
|---|---|---|
| GU-98 | James C. Moylan | 2 |
Guam ranks #55 by FQHC patients and #54 by organization count among the 57 national-breadth jurisdictions. All 1 centers depend on the federal Community Health Center Fund, authorized only through December 31, 2026.
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FQHC data from the HRSA bulk-sites file + UDS 2024 + IRS 990. State policy profile via NACHC/KFF/AANP. Intelligence items cite primary sources. Federal items apply to all states; state items are Guam-only. Updated 2026-06-30.