CCI Health Services, which has provided care in Montgomery and Prince George's counties for more than 50 years, reported $55 million in revenue for fiscal year 2025, including over $20 million in government grants. The organization markets itself as offering high-quality, affordable health care and operates as a federally qualified health center, a designation that brings enhanced federal funding in exchange for serving medically underserved communities.

But audits covering fiscal years 2022 through 2025 identified persistent problems. In fiscal 2022, auditors found transactions recorded in the wrong fiscal year and ledger account, overstating contract revenue by $87,000 and understating pharmacy revenue by tens of thousands of dollars. They also found inaccurate and delayed financial reports, a failure by managers to review salary charges for federal awards, and outdated procurement policies.

In fiscal 2023, the organization failed to meet a cost-sharing requirement for a federal award, leaving nearly $1.2 million in questioned costs. Auditors wrote that management was unaware of the nonfederal share requirement and the need to report it, and asserted that additional indirect and overhead costs were incurred but not tracked in the general ledger.

The fiscal 2024 audit highlighted improper sliding fee discounts given to patients and a lack of supporting documentation that created potential errors in federal reports and financial statements requiring adjustments. Seven prior findings were marked resolved that year.

The most recent audit, covering fiscal 2025, showed that the prior year's findings were not resolved and that the $1.2 million in questioned costs from fiscal 2023 remained outstanding. One finding about general ledger accounts not being properly reconciled was marked partially resolved.

Across the four-year period, auditors repeatedly cited significant turnover in the finance department as the cause of the accounting problems. According to the 2024 audit, CCI brought in a new chief financial officer and expanded its accounting team. The 2025 audit noted the hiring of a new CFO and a revenue cycle manager, as well as the engagement of a health care technology company between March and May 2025 to address a backlog of payment posting and billing issues.

Sonya Bruton, CCI's president and CEO, said in an email that the organization is committed to financial transparency and independent oversight. She said the audits identified areas needing improvement and also showed that CCI took corrective action and resolved multiple findings.

Bruton said CCI takes all audit feedback seriously and has worked to strengthen financial management practices, internal controls and reporting. She said the organization looks forward to sharing its fiscal 2026 audit report once complete.

"Throughout a period marked by unprecedented challenges for health care providers, especially in primary care, CCI has remained focused on delivering high-quality health care to the communities we serve and responsibly stewarding the resources entrusted to us," Bruton said. She added that CCI has kept its doors open and continued providing medical, dental and behavioral health services to individuals and families who might otherwise go without care.

Erica Harris, an associate professor of accounting at Florida International University, said that for an organization with more than $50 million in annual revenue, the findings involve basic financial accounting policies that should already be in place. She said the repetition of findings across multiple fiscal years is especially concerning.

"Year over year, the repeated findings is the part that's really frustrating and I really think it is very surprising," Harris said. She added that the purpose of an audit is to ensure funds are used appropriately, and that organizations with unresolved findings should be scrutinized closely by funders.

CCI has received millions through the federal Health Center Program, including nearly $6 million allocated for fiscal year 2026. It also received a $5.6 million federal grant for family planning services from fiscal 2022 to 2027, $500,000 for COVID-19 vaccination services in fiscal 2023, and $940,000 in congressional earmarks in 2024.

U.S. Sen. Chris Van Hollen and former Sen. Ben Cardin, both Democrats, requested the earmarks, which were designated for renovating and equipping a CCI dental practice in Prince George's County. Van Hollen's office said federally qualified health centers receive federal funding with bipartisan support and are subject to eligibility and accountability standards set by the executive branch. The office noted that the Trump administration's Health and Human Services Department deemed CCI eligible for $5.7 million in health center funding for fiscal 2026.

Most recently, Democratic U.S. Sen. Angela Alsobrooks requested $4.5 million in earmarks for fiscal year 2027 to help CCI construct a new health center serving low-income residents. Alsobrooks' office said she is proud of her work to secure federal funding in a bipartisan effort for Maryland communities, particularly access to health care as the Trump administration works to slash access to health insurance and increase medication costs.

The Maryland Transparency Portal highlights grants totaling $5.1 million for immigrant and refugee health in 2022 and 2023. State budget documents also show capital grants totaling $3.2 million in 2023 and 2025.

The federal Health Resources and Services Administration said that when a health center is out of compliance with program requirements, it places a condition on its federal award. The agency said it remains in communication with CCI to ensure compliance and will continue monitoring the health center under Section 330 of the Public Health Service Act.

"HRSA is committed to ensuring that organizations funded under the Health Center Program meet program requirements and provide access to affordable, high-quality care within their communities," the agency said in an email.

The governor's office and the Maryland Department of Health did not comment after extended deadlines were provided.