Costa Rican healthcare infrastructure projects delayed by poor management, says comptroller

A total of 53 healthcare infrastructure works have been delayed by the poor management of construction funds by the Costa Rican social security agency (CCSS), according to an audit conducted by the comptroller CGR.

The audit aimed to verify whether the governance of the program for the improvement of services, infrastructure and equipment of the healthcare, logistics and financial centers overseen by CCSS, with the support of a trust established for this purpose with Banco de Costa Rica, complies with the applicable regulatory and technical framework. The analysis covered the period from January 2020 to October 2024.  

“The CCSS did not establish a governance structure that would enable it to promote the timely planning of projects, the sustainability of resources over time and the management of risks to achieve its objectives," the report reads.

The Banco de Costa Rica trust oversees the construction of 53 priority projects including healthcare facilities, 18 CCSS branches, four regional offices, a storage and distribution warehouse and a lab.

The document adds that the trust was "not accompanied by a strategy and a supervisory framework consistent with the CCSS’s role and responsibilities regarding the program.”

CCSS’s lack of functional programs prevented the trust from approving the start of the priority projects until 2019, significantly delaying the plans, said the CGR.

“Additionally, the program began with inaccuracies in the estimation of construction square meters, as well as the omission of land acquisition costs and maintenance of the facilities,” it added.

The comptroller advised CCSS to create the governance structure through “decision making, roles, and responsibilities, updated planning, cost, and reach, risk management” and involve all stakeholders, as well as to “establish a model for reception, operation and maintenance” of the projects.