Day 100 After M&A: The Forgotten Phase That Derails IT Plans

The deal closes, the announcement goes out, and the Day 1 cutover works well enough. Email is live, the main applications are accessible, and leadership can tell the board the merger is officially complete.

From the outside, the acquisition looks finished.

Inside IT, the clock has just started.

For DSOs, MSOs, and other multi location healthcare and service organizations, the real test of an acquisition happens between Day 1 and roughly Day 100. This is when the new locations either become fully integrated, standardized, and supportable, or remain a patchwork of legacy systems that drag on performance and margin.

This article focuses on that forgotten period between Day 1 cutover and long term stability. It shows how problems are seeded during IT due diligence, how they surface in the C suite, and what a healthier, planned version of Day 100 can look like.

Most executives assume Day 100 problems are the result of poor execution. In reality they are usually designed in much earlier, during rushed or incomplete IT due diligence.

Incomplete visibility versus a complete IT picture

Typical due diligence concentrates on financials, legal exposure, and a quick assessment of technology risk. The IT portion often consists of a spreadsheet of systems, a few high level conversations with the seller, and a quick view of contracts. Physical infrastructure such as cabling, racks, switching, and wireless design frequently receives only a passing glance.

In an ideal scenario, IT due diligence produces a clear picture of every site, not only at the system level but also at the infrastructure level. That means knowing how each location is wired, how devices are connected, where single points of failure exist, and what needs to change to match your standards.

“Good enough for go live” versus defined future state standards​

Under deal pressure, the bar quietly drops to “good enough for Day 1.” If a clinic can still see patients or an office can still process work on close date, leaders declare victory and move on. The problem is that “good enough” is rarely defined, and there is no written standard for what a fully integrated site is supposed to look like.

In an ideal scenario, the buyer defines a clear future state before the deal closes. There is a reference design for what a converted site should be: network layout, wireless coverage, cabling type, equipment stack, and connectivity for all required devices. Due diligence is used to compare current reality to that standard, not simply to confirm that nothing is on fire.

Contract and warranty blind spots versus lifecycle alignment

Legal and finance teams will usually confirm that contracts can transfer and that there are no obvious legal issues. What often gets missed is whether those contracts and warranties align with the buyer’s technology roadmap. The result is a mix of vendor agreements, expired warranties, and support models that do not match how the buyer wants to run IT.

In an ideal scenario, contracts and warranties are reviewed with lifecycle and standardization in mind. The team validates which agreements should be kept, which should be exited, and where there are gaps that will matter at Day 100 and beyond. The target is a clean, predictable support structure that gives IT room to execute, rather than a pile of obligations that quietly constrain the integration.

Internal capacity assumptions versus realistic execution planning

During diligence it is very common to assume the internal IT team can “figure it out after close.” The team is seen as flexible and capable, which is often true, but the workload across dozens or hundreds of locations is not quantified. There is no specific plan for who will visit sites, who will document networks, or how many concurrent rollouts the team can handle.

In an ideal scenario, integration work is scoped and resourced the same way construction or renovation would be. The organization knows how many locations can be converted in a given month, what level of onsite presence is needed, and where external partners will be used to provide field services, structured cabling, and multi-site coordination.

When these ideal practices are not in place, Day 100 challenges are baked into the deal from the beginning.

Stop the cycle of technical debt before it begins by partnering with an execution team that identifies hidden risks and secures your long-term ROI.

From the C suite perspective, the first ninety to one hundred twenty days after close often feel confusing. The acquisition technically succeeded, yet complaints and surprises keep surfacing.

Operational instability

Operations leaders start hearing about little disruptions that never quite resolve. One group of clinics complains about intermittent Wi Fi issues that slow patient intake. Another region has printers that constantly drop off the network. A few locations still rely on old processes because new systems do not perform reliably on their local infrastructure.

None of these issues appear large enough individually to justify a major project. Taken together they reduce throughput, increase frustration, and create a sense that the acquisition has made daily work harder instead of easier.

Integration debt

Shortcuts taken to hit Day 1 dates turn into recurring friction. Temporary network connections become semi permanent. Old equipment remains in production because it was “working well enough.” Documentation is scattered across emails and local notes.

This is integration debt. It represents all the technical and process work that should have been done as part of integration, but was deferred. Just like financial debt, it accrues interest in the form of extra tickets, longer troubleshooting, and higher risk. By Day 100 leadership starts to notice that simple changes take longer and cost more than expected.

Capacity crunch

Your internal IT team is talented, but not infinite. In a multi location organization, they already manage core systems, security, and ongoing support. When an acquisition closes, they must juggle those responsibilities with integration work.

Between Day 30 and Day 120 the reality sets in. New integration projects compete with existing commitments. Strategic initiatives stall. Leaders find themselves choosing between investing effort in stabilizing acquired locations or moving forward with other planned upgrades. Either way, something important is delayed.

Reporting and audit risk

Finance and compliance leaders expect post acquisition reporting to become smoother, not more complicated. Instead they often discover inconsistent data flows and unclear system ownership. Some locations report under old structures while others follow new ones. Auditors ask questions that are difficult to answer because no one can reliably describe how specific locations are configured.

By Day 100, this mix of instability, integration debt, capacity strain, and reporting risk becomes visible. That is when the Strategy Gap can no longer be ignored.

From an IT and operations standpoint, the period between Day 1 and Day 100 tends to follow a predictable pattern.

Day 1 to 30: Firefighting and false confidence

Immediately after close, the focus is on obvious issues. Credentials, access, and core applications are top priority. If the new locations can continue to operate and the main systems function, leaders breathe a sigh of relief.

This early period can create false confidence. Because there was no major outage, the assumption is that the hardest part is over. In reality, many of the most important integration tasks have not yet begun.

Day 31 to 60: Gaps become visible

As daily operations settle, teams start to notice differences between sites. One clinic has reliable, fast wireless in every operatory, while another has dead zones. One office’s equipment is neatly racked and labeled, another uses a tangle of patch cables and personal devices.

Internal IT begins to feel the friction. Simple support requests require detective work because documentation is inconsistent or missing. Remote troubleshooting is difficult because no one is entirely sure how the location is wired.

Day 61 to 120: Integration debt comes due

By this stage, the backlog is growing. For each temporary workaround put in place to get through Day 1, there is now a corresponding project that should be completed to clean it up. New acquisitions may already be on the horizon, adding pressure to the same small internal team.

This is where the organization either addresses integration debt with a structured plan or accepts that the acquired locations will remain partially standardized for the long term. Without a plan, every new acquisition compounds the complexity of the environment.

The Strategy Gap is the distance between what leadership expects from an acquisition and what the organization has actually resourced and planned for in IT.

On paper, the merger or acquisition usually includes goals such as unified systems, consistent patient or customer experience, and smoother reporting. These goals assume that every location will eventually look and behave like a standard site.

In practice, budgets and timelines often stop at Day 1. The effort required to move from “up and running” to “fully standardized and documented” is not fully scoped. Internal IT is expected to handle the work in the background while also supporting the rest of the organization.

In a multi-location environment, that assumption is rarely realistic. Site by site design, cabling, wireless optimization, and device connectivity take time, planning, and coordinated execution. When that work is not built into the strategy, technology unification stalls around Day 100 and never quite recovers.

To understand whether an acquisition is truly on track at Day 100, leadership can start with a simple scorecard. Answer these questions honestly:

• Do we have a current, accurate inventory of network, cabling, and key infrastructure for every acquired site?
  
  

• Can we describe a clear standard for what a “fully converted” site looks like, and do we know which locations meet that standard today?
  
  

• Can internal IT support any acquired site without calling the previous owner, a local vendor, or an informal “go to” person in the building?
  
  

• Are there temporary configurations or workarounds still in place that were added to get through go live?
  
  

• Have we rationalized contracts and warranties so that hardware and services align with our long term technology roadmap?
  
  

• Do operations leaders feel that the acquisition made their daily work smoother, or do they still feel like they are working in two different worlds?
  
  

• Are support tickets related to the acquisition trending down by Day 100, or are they steady or increasing?
  
  

• Can finance and audit teams get reliable, consistent data from all acquired locations without manual reconciliation?

If the honest answer to several of these questions is no, the organization is carrying integration debt from the acquisition. The good news is that this debt can be addressed with a structured approach to Day 100 and beyond.

Most multi-location groups do not want to build a large internal field services team in order to handle M&A integration work. At the same time, relying on a loose network of local vendors makes it difficult to standardize and document sites at scale.

MellinTech sits in the space between those two extremes.

For DSOs, healthcare organizations, and other multi-location enterprises, MellinTech acts as a technology partner focused on the physical and practical side of integration. Your internal IT team retains ownership of systems, security, and strategy. MellinTech provides the capacity and coordination needed to execute consistently at the site level.

That includes:

Standardized site designs and documentation
Working with your leadership and internal IT, MellinTech helps define what a “good” site looks like in terms of network, low voltage cabling, Wi-Fi, AV, and device connectivity. That standard becomes the blueprint for new construction, acquired locations, and long term moves, adds, and changes. As work is completed, each site is thoroughly documented so future support is faster and more reliable.

Coordinated multi site rollouts and clean up
Instead of tackling locations one at a time in an ad hoc sequence, MellinTech creates a structured program for conversions and upgrades. This covers discovery, planning, scheduling, onsite execution, and closeout across all affected sites. The goal is to clear integration debt and bring locations up to standard without overwhelming internal staff.

Onsite field services for moves, adds, and changes
After the initial integration phase, MellinTech continues to support your environment with on-demand field services. When equipment needs to be relocated, new rooms are built, or existing spaces are repurposed, MellinTech can handle the cabling, physical installation, and connectivity so your internal team can stay focused on higher level initiatives.

The result is a practical way to close the Day 100 Strategy Gap, not by hiring a larger internal team and not by turning everything over to a general purpose help desk provider, but by adding a specialized partner that understands multi-location environments.

Why can't our internal IT team just handle this over time?

In a small environment, internal IT can often clean up integration work in the background. In a multi-location organization with twenty-five, fifty, or hundreds of sites, the volume of work is different. Site by site discovery, design, and physical changes requires time on the ground and dedicated coordination. Without that, integration debt lingers for years and compounds with each new acquisition.

We have a project manager. Isn't that enough for closeout?

A strong project manager is important, but they still need people who can execute at each site. For Day 100 work, this means having trusted field technicians who can visit locations, update cabling and racks, validate wireless coverage, and confirm that devices are connected as planned. A project manager without consistent field capacity can only do so much.

How do we avoid these Day 100 issues in future deals?

The key is treating M&A integration as a productized, repeatable process, not a one-off project. This involves standardizing your IT site template and choosing a partner who specializes in rapid, quality deployment across multi-location portfolios. By outsourcing the execution phase, your internal team can focus on the high-level architecture and strategic oversight.

If you have a recent acquisition that still feels partially integrated, or you see more deals ahead in the next six to twelve months, now is the time to reassess your approach.

Clarify your standards for a fully converted site, assess your current infrastructure and integration scorecard, and decide whether your internal team has the capacity to close the Strategy Gap on its own. If not, consider how a dedicated multi site technology partner like MellinTech can extend your reach.

The goal is not only to get through Day 1, but to reach a point where every acquired location is stable, standardized, and ready to support the next phase of growth.