When your community health center opens its third, fifth, or twelfth location, it’s a milestone worth celebrating. But behind every expansion ribbon-cutting is a finance team silently bracing for the next wave of operational complexity.
Growth is good. But it can break things — especially outdated financial systems.
At too many Federally Qualified Health Centers (FQHCs), finance leaders are asked to scale operations, report accurately on federal funds, and support strategic decisions… all while using accounting tools that were never built for this level of complexity.
Let’s be clear: Legacy systems weren’t designed for multi-site, grant-funded, compliance-heavy healthcare organizations. And the cracks show fast as you grow.
This post explores the warning signs, the smarter path forward, and the real-life examples of two FQHCs — Wesley Community and Health Centers and Elica Health Centers — who made the switch before their systems cost them more than just time.
It’s one thing to manage a single clinic with basic general ledger needs. It’s another when your FQHC is juggling:
And still, many clinics remain stuck with local-server software and manual Excel reconciliation. It’s not sustainable.
James Mohrherr, Controller at Elica Health Centers, saw this firsthand as the California-based FQHC grew from three to twelve clinics. “We were using Sage 50—it was clunky, on-premise, and we had outgrown it,” he said. “When the pandemic hit and we were all remote, the wheels really started to come off.”
There’s a hidden cost to outgrowing your finance tools, and it’s not just inefficiency.
At Wesley Community and Health Centers in Phoenix, Arizona, CFO Sonya Wilkins knew the organization’s growth — from a church-based clinic to a multi-site health system with mobile clinics and a new $20M facility — demanded a more flexible and scalable ERP solution.
“QuickBooks just wasn’t cutting it,” she said. “Trying to meet UDS reporting requirements and separate roles like nurse practitioners from doctors meant constantly adding accounts. It was messy and manual.”
Modern FQHCs need more than a faster close (though Wesley did gain seven days back each month). They need control over their operations at scale.
Here’s what that looks like in action:
When Wesley implemented Multiview, they built out Related Accounting Details (RADs) to tag financial data across dimensions. “We can now pull income statements by RADs, track FTEs for UDS, and generate reports that reconcile every time,” said Wilkins.
Elica saw similar improvements. “Now I can click and print instead of digging through binders,” said Mohrherr. “Multiview made it easy to track grant-specific revenue and expenses—without creating 50 different GL accounts.”
So what should CFOs at growing FQHCs be thinking about? Here are some best practices from health centers that have scaled successfully:
Automating reconciliations, grant billing, and audit prep frees up your team to focus on analysis, not data entry. And it reduces the risk of human error across high-stakes reporting.
With delays in Medicaid reimbursements and ongoing board questions about program-level performance, FQHCs need live data — not month-old numbers.
Integrating your Electronic Health Records system with your ERP can eliminate duplication and improve visibility for smarter decisions.
Remote work isn’t going away — and neither are remote audits. A cloud-based ERP enables secure, permissioned access without waiting on IT or VPNs.
Do these statements sound familiar?
“We’ll upgrade when things slow down.”
Reality: They won’t. And waiting often creates more tech debt and operational risk.
“Our current system gets the job done.”
Reality: If “the job” is late reporting, stressed audits, and burned-out staff, that’s not success, it’s survival.
“We can’t afford a new system.”
Reality: What’s the cost of delayed UDS submissions, clawbacks, or another audit finding? The ROI of modernization shows up fast - in saved time, fewer hires, and cleaner books.
Multiview isn’t a generic ERP system trying to fit into a healthcare box. It’s built, implemented and supported by a team that understands healthcare finance, giving FQHCs key capabilities that support:
Scaling your FQHC shouldn’t mean stretching your finance team to the breaking point. You deserve systems that flex with your mission.
And as Sonya Wilkins from Wesley shared:
“Multiview probably saved us from needing another hire. We’ve automated so much. Our four-person finance team runs like a much larger department. We’re growing and need tools that grow with us. Multiview gives us that foundation—whether it’s managing grants or onboarding new locations.”
When the board approves a new site or program expansion, your team needs to respond with confidence — not duct tape.
Multiview ERP was purpose-built for this moment. For CFOs who are done patching problems, it’s the partner that lets you:
It’s not just about better tools. It’s about better outcomes — for your team, your board, and the patients who count on you.
Book a personalized demo of Multiview ERP