Objective of this experience report is to address specific issues regarding standard SAP ERP implementation in a medical institution. Target Company is a state owned health care institution from Bosnia and Herzegovina. Report will treat selected issues which could trouble standard SAP ERP implementation trough predefined ERP implementation methodology for SAP ERP. This report presents observations/remarks based on experience of authors in particular SAP ERP implementation project in health care institution. Author’s goal is to provide useful insight into “real life” standard ERP implementation and problems that arise. Also, it should provide useful information for all stakeholders involved in the process of ERP implementation in public health care sector.