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Bay Family of Companies: ERP Implementation and Guidance

Bethesda of Beresford is a skilled nursing home with therapy services in Beresford, South Dakota. The organization had been going through a transitional period and found itself in a position of declining reimbursement. Its bond covenant required it to have a debt ratio of 1.1 or greater; the ratio was less than that, so the nursing home found itself in a position where it was losing money.


Bethesda was then required to hire an outside consultant. Tom Richter, the administrator, had worked with David Brenne in the past and decided to seek assistance from Wipfli in determining how best to deal with the home’s situation.


Wipfli’s first task was to complete a thorough operational review of the nursing home. This included operational, financial, and clinical reviews. As a result of the reviews, Wipfli found a number of issues and provided recommendations for improving the nursing home’s overall Medicare reimbursement and operational efficiency. The nursing home implemented several of the recommendations, which have resulted in an immediate, positive impact on Bethesda’s bottom line.

Wipfli facilitated a Medicare MDS training session to increase MDS assessment skills and knowledge, thereby maximizing revenue capture. In addition, Wipfli made presentations to management and the board on its findings and recommendations and followed up with a written report that included an overall operational work plan to assist management in prioritizing and implementing recommendations. Wipfli also delivered the plan to the bond trustee, which allowed Bethesda to meet the requirements of its covenant. 


Overall, the nursing home has seen dramatic improvements since partnering with Wipfli. It has eliminated inefficiencies that were affecting its financial and operating performance. It has also streamlined its operational processes, which has resulted in vast improvement to its bottom line. In addition, Bethesda increased its debt ratio, thereby meeting its bond covenant.