MetroHealth Hospital, West 25th Street, Clark-Fulton, Cleveland
MetroHealth Systems' new hospital on West 25th Street in Cleveland. Credit: Paul Rochford/Signal Cleveland

An independent audit initiated by MetroHealth System released Friday concluded that former CEO Dr. Akram Boutros withheld information about bonus pay from the hospital’s board of trustees. 

The audit report offered these findings: 

  • The board  is the only authority that can determine and approve CEO bonuses  
  • Boutros created and approved his own evaluations to calculate his bonus pay 
  • Boutros did not tell the board on multiple occasions about awarding himself bonus pay 

The board hired the accounting firm BDO to investigate how Boutros received nearly $2 million in bonus pay between 2018 and 2022 without the board’s knowledge. After learning of the extra compensation, the board fired him in November 2022.

Boutros returned the bonuses, with interest, before he was let go. But he has maintained that his actions were legal and has since filed three lawsuits against the board, including one seeking millions for defamation. One lawsuit has been dismissed.

The board said in a statement that it will implement new policies to prevent this from happening again. They include:

  • The hospital CEO compensation will be evaluated through a new resolution from the board 
  • Consultants hired by the hospital must go through human resources 
  • The board will receive data on executive payroll at least once a year 
  • The board will create a separate committee to examine and monitor executive pay procedures 

The board will examine the recommendations at its next executive meeting in March. 

Jason Bristol, the lawyer representing Boutros, said in an email to Signal Cleveland that the audit report is untrue and that the board knew about Botrous’ bonus and evaluation metrics.

“BDO was hired by the Tucker-Ellis law firm, the same law firm that produced the biased and incomplete initial report,” Bristol said.  “There is nothing independent about this audit report. The report continues to deny allegations that we could definitively prove to be true today: The MetroHealth board of trustees approved the bonus program.  They knew the CEO was included in the program. They approved the bonus payments for all eligible employees every year. The bonuses were awarded only after a robust assessment.” 

Though Bristol denies the findings of the report, he says the board failed to provide oversight of the executive compensation payments while giving Boutros authority to sign off on employee compensation. 

“The BDO report does, however,  highlight that the board on multiple occasions fully delegated authority of salary  and wages for all employees to Dr. Boutros and that Dr. Boutros’ bonus payments were made only after board approval of the bonus amounts for all eligible employees,” Bristol said.  “At the end of the day, the board falling down on the job and supposedly not knowing about a bonus program for 200 leaders over five years does not equal concealment.  The board’s continued response is an unparalleled admission of board malfeasance.” 

News of the audit release comes after Craig Richmond, former chief financial officer, resigned from the hospital system Wednesday. The audit is critical of some of Richmond’s oversight of the bonus structure.  

The full audit is available here.

Health Reporter (she/her)
Candice, a Cleveland Documenter since 2020, has been a freelance writer whose reporting and digital media work have appeared in The Daily Beast, VICE, Cleveland Magazine and elsewhere. She has written about health, equity and social justice.