Client Response - During FY 2024 and part of FY 2025, the organization experienced front desk personnel turnover and operational disruptions due to facility remodeling, which required multiple relocations of staff and records. These factors contributed to gaps in the availability of supporting documentation needed to validate certain patient billing amounts. Management acknowledges the importance of retaining complete and accurate documentation to support billing, particularly for services subject to the sliding fee scale. While only a portion of the tested items were impacted, we recognize that missing documentation created the appearance of errors that could not be recalculated during audit testing. To address this, the organization is implementing corrective measures, including: • Strengthening record retention procedures to ensure all supporting documentation for billing and sliding fee scale adjustments is readily available for review. • Enhancing training for staff on billing documentation requirements tied to federal program compliance. • Establishing periodic internal reviews to confirm that billing aligns with program rules and is fully supported.