For multiple years, Stout has provided integration onboarding services for a private equity-backed ophthalmology platform with an active add-on acquisition strategy. We continue to lead tactical accounting and finance integration management for acquisitions, working closely with practice administrators and physicians through both the pre- and post-close phases.

As part of the integration onboarding, we also perform the Accounting Standards Codification 805 purchase accounting analysis and related valuation work to deliver opening balance sheets for the company. In 2025, this included supporting the company’s largest acquisition to date: the onboarding of a managed services organization (MSO) comprising approximately 15 separate entities.

Our scope covers preparation of closing statements, individual closing and opening balance sheets for each entity, and a consolidated closing and opening balance sheet for the group. Many of the acquired practices kept their books on a cash basis, which required us to execute a cash-to-accrual conversion as part of the closing balance sheet analysis, so the financials were presented on the appropriate basis for purchase accounting.

The engagement runs on accelerated closing statement timelines, and we step in with additional support where practices are understaffed or stretched thin, often compounded by gaps in institutional knowledge from third-party resource use or the departure of key employees ahead of the transaction. This requires close coordination with our valuation group to establish fair values for leases, fixed assets, and intangible assets, each with its own data requirements and timeline dependencies within an already compressed schedule.

Alongside these compliance-focused workstreams (opening balance sheets and valuation), we provide integration support throughout the transition: maintaining the relationship between the acquired practice and the company, tracking open items and contingencies through an active integration playbook, and serving as coordination lead to keep the process on track across workstreams.

We have consistently delivered timely, audit-ready results while navigating the complexities of multi-entity consolidation, data quality challenges, and tight timelines, building a value-focused relationship with the company along the way.