By the Bay Health

Rebuilding financial operations for a $100M+ nonprofit after two back-to-back acquisitions

THE PROJECT
We partnered with By the Bay Health during a period of rapid expansion, stepping in as interim CFO to strengthen financial operations, improve reporting, and support a smooth integration following two acquisitions.

THE CLIENT
By the Bay Health is a nonprofit healthcare organization with over $100 million in annual revenue, primarily generated through earned income, with additional support from donations and grants.

The organization’s mission is to deliver high-quality, community-integrated healthcare, providing compassionate support and care in the home for individuals and communities. In January 2024, the organization completed two acquisitions to expand its reach and deepen its nonprofit impact, serving more patients and families through a unified, mission-driven approach. This merger introduced new operational and financial complexities typical of a growing, multi-entity organization.

THE PROBLEM
Following the acquisitions, the organization entered a transition phase to align systems, processes, and teams across entities. Financial reporting, payroll, and systems required further optimization to fully support the organization at its new scale.
By the Bay Health initially engaged us for an HR assessment in September 2024. As broader finance needs emerged, we stepped in as interim CFO in November 2024 to help guide the organization through this next phase.

THE SOLUTION
We conducted a full assessment of systems, processes, and team structure, then executed improvements across four key areas:

Team & Leadership
We refined the finance team structure, clarified roles, and supported the successful search and onboarding of a permanent CFO to ensure long-term continuity.
Systems & Infrastructure
We optimized the NetSuite environment and implemented AP tools to improve efficiency, reduce manual work, and strengthen controls.
Close Process & Reporting
We established a consistent monthly close cadence and transitioned reporting fully into NetSuite, enabling more timely, reliable financial insights and improved board reporting.
Audit & Payroll
We supported the transition to a national audit firm with relevant expertise and partnered with HR to streamline payroll processes, improving accuracy and coordination.

THE RESULT
By the end of the engagement, By the Bay Health had a stronger, more scalable finance function aligned with its growth:

• Consistent, system-driven financial reporting with a structured close process
• Enhanced audit readiness and successful transition to a specialized audit firm
• Streamlined payroll operations with significantly improved accuracy
• Clear, data-driven board reporting supporting confident decision-making
• A fully onboarded CFO positioned to lead the function forward

By stepping in during a critical inflection point, we gave By the Bay Health the foundation it needed to operate with confidence, meet audit expectations, and sustain growth, leaving behind a team, a CFO, and a set of systems ready to carry it forward.