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Independent Audit Confirms Former CEO Concealed Unauthorized Bonus Payments

An independent audit confirms and expands upon previous findings that showed former MetroHealth President & CEO Akram Boutros, MD, circumvented rules and processes to pay himself $1.9 million in unauthorized bonuses and took deliberate steps to conceal his actions from the Board of Trustees and other parties.

Tucker Ellis, the law firm that conducted the initial investigation for the Board of Trustees which led to Dr. Boutros’ dismissal in November, retained the national accounting firm BDO to perform a thorough review of the polices, practices and issues surrounding the former CEO’s actions. The results of the audit have now been received, and in response to media requests are being made public. The report can be downloaded below.

At issue is a supplemental bonus plan created and controlled solely by Dr. Boutros.

BDO’s findings include:

  • Dr. Boutros included himself as an eligible employee in the supplemental bonus pool without Board approval. The Board has sole authority to evaluate and approve bonuses for the CEO.
  • Dr. Boutros performed self-evaluations of his achievements and calculated his own supplemental bonus payouts.
  • On multiple occasions, Dr. Boutros failed to disclose his supplemental bonuses to the Board, compensation consultants and other parties.

Based on the findings of the original Tucker Ellis investigation and the independent audit, MetroHealth and the Board of Trustees are taking specific steps to strengthen policies and processes and improve organizational oversight. Steps already taken include:

  • The MetroHealth CEO’s annual PBVC compensation (or any bonus compensation) must now be the subject of a separate Board of Trustees resolution and will be audited to assure compliance with all MetroHealth compensation policies and requirements.
  • Compensation consultants, who have been hired by MetroHealth in the past to advise on rates of pay at peer health systems and compensation trends, must now verify details of the CEO’s pay and benefits with MetroHealth Human Resources, rather than relying on data provided by the CEO alone.
  • The Board will receive actual payroll data for all senior executives at least once annually.
  • The Board has created a stand-alone compensation committee to manage all policies and procedures related to executive pay.
  • MetroHealth is conducting a national search for a Chief People Officer whose duties will include supervising Human Resources and providing regular updates to the Board. MetroHealth has issued an RFP for a compensation consultant and is in the process of negotiating an agreement with a compensation consultant.

The Board of Trustees will consider additional recommendations included in the audit during its next meeting.


About The MetroHealth System

Founded in 1837, MetroHealth is leading the way to a healthier you and a healthier community through service, teaching, discovery, and teamwork. Cuyahoga County’s public, safety-net hospital system, MetroHealth meets people where they are, providing care through five hospitals, four emergency departments and more than 20 health centers. Each day, our nearly 9,000 employees focus on providing our community with equitable healthcare — through patient-focused research, access to care, and support services — that seeks to eradicate health disparities rooted in systematic barriers. For more information, visit