US Fertility completes Debt Refinancing and Acquisition of Genetics & IVF Institute

Cain Brothers, a division of KeyBanc Capital Markets, served as advisor to SuperCare Health in its sale to Excellere Partners and KeyBanc Capital Markets served as Joint Lead Arranger, Joint Bookrunner, and Administrative Agent for debt financing associated with the transaction. 

Cain Brothers was engaged based on our long-standing relationship with the Company as well as knowledge of the durable medical and home medical equipment market and connectivity with buyers who would value SuperCare’s capitated and fee-for-service business model. Concurrently, KBCM syndicated Senior Secured Credit Facilities, proceeds of which were used to fund the acquisition, support capital expenditures and for general corporate purposes. 

Founded in 1974 and headquartered in City of Industry, California, SuperCare is a provider of comprehensive complex respiratory care management solutions for adults and children. Its product portfolio consists of ventilators, airway oscillation, CPAP, BiPAP, oxygen concentrators, respiratory medication and home medical equipment. The Company’s business segments are Complex Respiratory Care, Pediatric Respirator Care, and Value-Based Care. SuperCare operates 27 branches across five states and serves 150,000+ patients annually. 

Founded in 2006 and based in Denver, Colorado, Excellere is a private equity investment firm focused on investing in the Healthcare, Business Services, and Industrials industries. The Sponsor has ~$2.2 billion of assets under management and has raised four funds to date, with its latest fund (Excellere Capital Fund IV) raising $875 million of committed capital.

Cain Brothers, a division of KeyBanc Capital Markets, served as advisor to SuperCare Health in its sale to Excellere Partners and KeyBanc Capital Markets served as Joint Lead Arranger, Joint Bookrunner, and Administrative Agent for debt financing associated with the transaction. 

Cain Brothers was engaged based on our long-standing relationship with the Company as well as knowledge of the durable medical and home medical equipment market and connectivity with buyers who would value SuperCare’s capitated and fee-for-service business model. Concurrently, KBCM syndicated Senior Secured Credit Facilities, proceeds of which were used to fund the acquisition, support capital expenditures and for general corporate purposes. 

Founded in 1974 and headquartered in City of Industry, California, SuperCare is a provider of comprehensive complex respiratory care management solutions for adults and children. Its product portfolio consists of ventilators, airway oscillation, CPAP, BiPAP, oxygen concentrators, respiratory medication and home medical equipment. The Company’s business segments are Complex Respiratory Care, Pediatric Respirator Care, and Value-Based Care. SuperCare operates 27 branches across five states and serves 150,000+ patients annually. 

Founded in 2006 and based in Denver, Colorado, Excellere is a private equity investment firm focused on investing in the Healthcare, Business Services, and Industrials industries. The Sponsor has ~$2.2 billion of assets under management and has raised four funds to date, with its latest fund (Excellere Capital Fund IV) raising $875 million of committed capital.

On March 11, 2026, Sonida Senior Living, Inc. (Sonida), one of the largest, pure-play owner-operators and investors in U.S. senior living communities, announced the completion of its merger with CNL Healthcare Properties, Inc. (CHP), a real estate investment trust that owns a national portfolio of high-quality senior housing properties. Sonida acquired 100% of CHP in a cash and stock transaction valued at approximately $1.8 billion. The common stock of the combined company will trade under Sonida's existing ticker symbol “SNDA” on the NYSE. KeyBanc Capital Markets served as Exclusive Sell-Side Advisor to CHP. 

CNL Healthcare Properties is a real estate investment trust focused on institutional-quality senior housing holdings, including stabilized, value-add and ground-up development assets. 

Sonida Senior Living is one of the largest, pure-play owner-operators and investors in U.S. senior living communities, with a focus on independent living, assisted living and memory care communities and services for senior adults. Sonida provides compassionate, resident-centric services and care as well as engaging programming at its senior housing communities.

In March 2026, KeyBanc Capital Markets acted as Active Joint Bookrunner on $1.2 billion of First Mortgage Bonds due 2036 and 2056 for Northern States Power Company Minnesota (“NSPM” or the “Company”). 

NSPM is an operating utility engaged primarily in the generation, purchase, transmission, distribution and sale of electricity in Minnesota, North Dakota, and South Dakota. As of December 31, 2025, the Company provided electric service to approximately 1.6 million customers and natural gas service to 0.6 million customers.

NSPM priced $1.2 billion of First Mortgage Bonds in two tranches:

• $600 million of First Mortgage Bonds due 2036 at a spread of T+75 bps for a coupon of 4.85%
• $600 million of First Mortgage Bonds due 2056 at a spread of T+85 bps for a coupon of 5.55%

The deal was very well received by the market, pricing with a negative new issue concession on both tranches and a 6.2x orderbook oversubscription overall.

The Company intends to use the net proceeds to repay short-term borrowings and for general corporate purposes.

NSPM is an existing client of Key.

On March 3, 2026, KeyBanc Capital Markets (KBCM) successfully closed the syndication of $70 million Senior Secured Credit Facilities (the Credit Facilities) for BMM Testlabs (BMM or the Company). The Credit Facilities are comprised of a $20 million Revolving Credit Facility and a $50 million Term Loan A. Proceeds from the Credit Facilities will be used to fund The Visualize Group’s acquisition of the Company, for working capital needs and general corporate purposes, and to pay transaction fees and expenses. KBCM served as Joint Lead Arranger and Joint Bookrunner on the transaction.

BMM is the longest-established and most experienced private independent gaming certification lab in the world, with an unbroken 45-year track record of service to the global regulated gaming industry since 1981. BMM has successfully tested and certified the full scope of gaming products, including Class III, Class II, VLT, AWP, HHR, iGaming, sports betting, social, pari-mutuel, and lottery products. The Company employs more than 700 professionals in 16 offices worldwide and holds more than 700 licenses to serve customers across six continents. BMM’s world headquarters are in Las Vegas (USA), with offices in Argentina, Australia (Melbourne and Sydney), Brazil, Canada, India, Italy, Macau, Romania, Peru, Poland, Singapore, Slovenia, South Africa, and Spain.

Founded in 2023, The Visualize Group is a New York City-based private equity firm focused on making concentrated and high-conviction investments in companies operating within mission-critical, services-based sectors. Through its Cornerstone & Control strategy, the firm invests in generationally enduring businesses as a collaborative partner in public companies and a controlling partner in private companies.

On February 26, 2026, KeyBanc Capital Markets served as Active Joint Bookrunner on a $750 million Senior Notes offering for Matador Resources Company. Proceeds will be used to repay existing indebtedness, and for general corporate purposes.

Cain Brothers, a division of KeyBanc Capital Markets, served as financial advisor to Healthcare Linen Services Group, a portfolio of York Capital Management, in its sale to The Sterling Group.

Cain Brothers was engaged based on our extensive knowledge of the healthcare and hospital end market and connectivity with buyers who would value HLSG’s infrastructure-oriented service model. This transaction continues Cain Brothers’ strong track record of representing healthcare distribution and logistics solutions. Terms were not disclosed.

HLSG is a leader in linen management services for the healthcare and hospitality industries. Since its founding over 100 years ago, the Company has grown to include six premier regional brands, 20 state-of-the-art laundry process facilities, nearly 2,000 employees, and serves leading institutions across 19 states in the central U.S.

York Capital Management is a New York-based global alternative investment firm founded in 1991 by James Dinan. The firm specializes in event-driven, multi-strategy, and special situation investing across public and private markets. York manages roughly $19 billion in assets.

The Sterling Group acquires and builds industrial and business services companies. Sterling brings significant experience to route-based, multi-site and logistics-heavy businesses and has targeted the healthcare linen services sector. Sterling’s interest in HLSG reflects the platform’s mission critical role, its modernized infrastructure, and the stability of outsourced linen management.

Cain Brothers, a division of KeyBanc Capital Markets, served as exclusive sell-side advisor to Central Maine Healthcare in its affiliation Prime Healthcare Foundation. 

Cain Brothers was engaged to assist in the negotiations and affiliation process due to its domain expertise and understanding of the New England healthcare market. The affiliation will help achieve Central Maine and Prime’s joint long-term commitment to deliver the highest quality, most advanced health care to communities across central, western, and mid-coast Maine. The agreement includes continued local governance and management, ongoing community commitment and significant capital investment in the region.

Central Maine Healthcare is an integrated delivery system serving 400,000 people in central, western and mid-coast Maine. With over 600 physicians and advanced practice professionals in more than 40 locations, CMH includes Central Maine Medical Center, a Levell III Trauma Center in Lewiston, as well as critical access facilities, Bridgton and Rumford hospitals, and two long-term care communities. 

Prime Healthcare is a health system operating 44 hospitals and more than 300 outpatient locations in 14 states, providing over 2.6 million patient visits annually. It is one of the nation’s leading health systems with nearly 45,000 employees and physicians. Fourteen of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity.

On February 13, 2026, Olympic Steel, Inc. (Olympic Steel or the Company) and Ryerson Holding Corporation (Ryerson) announced that they have completed their all-stock merger. KeyBanc Capital Markets (KBCM) served as lead Financial Advisor and provided a Fairness Opinion on the transaction.

KBCM was selected to serve as Olympic Steel's lLead Financial Advisor and Fairness Opinion Provider based on the group's deep industry expertise in metals distribution and processing, extensive transaction expertise in complex mergers and acquisitions and a decades-long partnership with the Company.

Founded in 1954, Olympic Steel is a leading U.S. metals service center focused on the direct sale and value-added processing of carbon and coated sheet, plate and coil steel products; stainless steel sheet, plate, bar, and coil; aluminum sheet, plate, and coil; pipe, tube, bar, valves, and fittings; tin plate and metal-intensive end-use products, including stainless steel bollards; commercial, residential, and industrial venting and air filtration systems; Wright® brand self-dumping hoppers; and metal canopy components. Headquartered in Cleveland, Ohio, Olympic Steel operates from 53 facilities.

Founded in 1842, Ryerson Holding Corporation (NYSE: RYI) is a leading value-added processor and distributor of industrial metals. The company offers a broad portfolio of carbon and stainless steel, aluminum, and alloy products, along with extensive metal processing capabilities, including cutting, forming, machining, and fabrication. Ryerson has ~4,300 employees and ~110 locations across North America, Mexico, and China, serving a diverse customer base in industries such as heavy equipment, industrial machinery, and energy.

On February 12, 2026, KeyBanc Capital Markets, Inc. (KBCM) successfully closed the syndication of $219 million Senior Secured Credit Facilities (the Credit Facilities) for the Soboba Band of Luiseño Indians (the Tribe). The Credit Facilities consist of a $129 million Revolving Credit Facility and $90 million Tax-Exempt Term Loan. Proceeds from the Credit Facilities will be used to refinance existing indebtedness, fund the development and construction of a cogeneration plant (the Project) at the Soboba Casino Resort, and pay transaction-related fees and expenses.

KBCM was selected to arrange and lead the financing due to its long-standing relationship with the Tribe, cultivated through years of partnership and dialogue, along with unmatched experience and expertise in the Native American Financial Services industry, and successful track record of syndicating transactions in the gaming space.

The Project
The Tribe plans to develop and construct a combined heat and power plant to cogenerate electricity and hot water at Soboba Casino Resort. The Project will modernize the property's energy infrastructure through the integration of a microgrid controller, electrical infrastructure upgrades and electric vehicle charging infrastructure. Collectively, these improvements will enable Soboba Casino Resort to generate 100% of its electricity demand on-site and significantly enhance the property's long-term operational resilience.

Soboba Band of Luiseño Indians Overview
The Tribe is a sovereign nation with over 1,600 enrolled members. Since time immemorial, the descendants of the Soboba people are those who have lived on and occupied the land that is presently known as the cities of San Jacinto, Hemet, Valle Vista and Winchester, California. Today, the ~8,000-acre Soboba Indian Reservation lies in the lower reaches of the San Jacinto Mountains, across the San Jacinto River from the city of San Jacinto. The Tribe owns and operates Soboba Casino Resort, an award-winning property that features over 100,000 sq. ft. of gaming space, including 2,000+ slot machines and 30+ table games, and is further complemented by a 200-room hotel, spa, PGA-rated golf course, and more.

KeyBanc Capital Markets and Cain Brothers, a division of KeyBanc Capital Markets, acted as Co-Manager in the $3.8 billion offering of Senior Notes for Thermo Fisher Scientific Inc. (NYSE: TMO).

Cain Brothers and KeyBanc Capital Markets served as Co-Manager due to its industry expertise and long-standing relationship with the Company.  Proceeds will be used to fund the cash consideration related to the acquisition of Clario Holdings as well as general corporate purposes.

Thermo Fisher manufactures scientific instruments, consumables, and chemicals. The Company offers analytical instruments, laboratory equipment, software, and supplies to pharmaceutical and biotech companies, hospitals and clinical diagnostic labs, universities, research institutions, and government agencies.

On February 10, 2026, KeyBanc Capital Markets Inc. (KBCM) served as Joint Bookrunner on SOLV Energy, Inc.’s (SOLV or the Company) $589.4 million Initial Public Offering of 23,575,000 shares, including overallotment.

In support of the IPO, KBCM successfully closed the syndication of a $200 million Senior Secured Revolving Credit Facility (the Credit Facility) for SOLV Energy Acquisition, LLC, a subsidiary of SOLV. The Credit Facility will support the Company’s working capital and general corporate needs. KBCM acted as Joint Lead Arranger, Joint Bookrunner, and Administrative Agent.

SOLV is a leading provider of engineering, procurement, and construction (EPC) services to build solar photovoltaic plants and energy storage facilities. The Company specializes in the installation and maintenance of solar farms, small rooftop panels, battery storage facilities, and high voltage substations, enabling organizations to transition towards clean and sustainable energy solutions. For more information, visit https://www.solvenergy.com. 

Founded in 1994, American Securities (the Sponsor) is a leading U.S. private equity firm that invests in North American companies, primarily in the industrial and services sectors. With $23 billion under management, American Securities partners with businesses generating $200 million to $2 billion in annual revenues, combining deep sector expertise, differentiated insights and proven internal capabilities to serve as transformational partners that drive growth and build enduring value. The Sponsor’s investment philosophy emphasizes capital preservation through disciplined investing and hands-on engagement, paired with repeatable value creation processes and operational excellence. American Securities is based in New York with an office in Shanghai. For more information, please visit https://www.american-securities.com.

On February 4, 2026, KeyBanc Capital Markets served as Joint Bookrunner on Forgent Power Solutions, Inc.’s (Forgent) $1.74 billion Initial Public Offering of 64,400,000 shares, including overallotment.

Forgent is a provider of engineered protection and control equipment used in data centers, the power grid, and energy-intensive industrial facilities. Major product categories of electrical distribution equipment that Forgent sells include electrical houses, substation enclosures, generator connection cabinets, power skids, automatic transfer switches, dry type transformers, remote power panels, switchboards, and switchgear.

Cain Brothers, a division of KeyBanc Capital Markets, served as buy-side advisor to MyTown Health Partners in its acquisition of MDB Health Services.

Cain Brothers has a long-standing relationship with management and the sponsor, Webster Equity Partners, as well as expertise and unique insight into the target, given a successful track record of advising primary and post-acute care groups. Cain Brothers was engaged to provide strategic guidance as well as transaction and diligence support. The acquisition expands MyTown’s presence across medically underserved communities and strengthens its commitment to delivering coordinated, high-quality clinical services.

MyTown is a physician-led management organization that works with practices in rural communities to improve access and enhance clinical outcomes. With over 50 clinics across eight states, MyTown’s growing network supports clinicians in the delivery of high-quality, outcome-driven primary care, urgent care, behavioral health, and women’s health services in medically underserved markets.

MDB Health Services is a multi-disciplinary provider serving post-acute care facilities in Mississippi, Louisiana, and Arkansas. Founded in 2013, MDB has grown from its origins in behavioral health services to include primary care, behavioral health, wound care, and foot care. MDB’s clinicians deliver coordinated clinical care that is tailored to the needs of residents in long-term care settings.

Webster Equity Partners is a healthcare-focused private equity firm focusing on high impact growth strategies to deliver optimal outcomes for its investors, portfolio companies and the communities that they serve. Its mission is to deliver superior returns to partners through investment and development of patient-centric healthcare organizations.

On February 1, 2026, KeyBanc Capital Markets, Inc. (KBCM) successfully closed $30 million Senior Secured Credit Facilities for The Berg Group. The proceeds will support Kava Equity Partners’ acquisition of The Berg Group and pay related transaction fees and expenses. Kava is a portfolio company of the Southern Ute Indian Tribe Growth Fund.

KBCM was selected to serve as Sole Lender due to its transaction experience and its long-standing relationship with the Southern Ute Indian Tribe and its Growth Fund.

The Berg Group
Founded in 1967, and based out of Minnesota, The Berg Group has grown from a local drywall operation into a national multi-scope specialty services provider, offering integrated solutions across pre-construction services, prefabricated product installation and framing and finishes.

Kava Equity Partners & The Southern Ute Indian Tribe Growth Fund
Kava Equity Partners is the direct private equity investment group for the Growth Fund and strategically invests in lower middle market businesses. Kava seeks to make equity investments in companies that are aligned with Southern Ute Indian Tribe’s cultural, environmental, and economic values. Established as part of the Tribe’s modern economic strategy in the late 1990s, the Southern Ute Growth Fund was formed in 2000 and is headquartered on the Southern Ute Indian Reservation in Southwestern Colorado. The Growth Fund manages the business investments of the Southern Ute Indian Tribe.

Southern Ute Indian Tribe
The Ute people are the oldest continuous residents of what is today the state of Colorado. Historically a loose confederation of 10 bands, the Mouache and Caputa bands make up the present-day Southern Ute Indian Tribe. In the 1950s, natural gas was discovered on the Southern Ute Indian Reservation. Nominal royalty payments collected from the 1950s through the 1980s did little to support tribal members. In the 1980s, in pursuit of economic and cultural self-determination, the Tribe created its own gas production company. From that initial investment, the Tribe has grown and diversified its holdings across multiple industries. Today, the Tribe is the largest employer in La Plata County, Colorado, maintains the AAA credit rating, and oversees a thriving investment portfolio with assets in 14 states and the Gulf of America.

On January 30, 2026, KeyBanc Capital Markets served as Joint Lead Arranger and Co-Documentation Agent on a $5 billion Senior Secured Revolving Credit Facility for SM Energy Company. Proceeds will be used for general corporate purposes.

Cain Brothers, a division of KeyBanc Capital Markets, served as exclusive financial advisor to National Radiology Solutions in its sale to Premier Radiology, a portfolio company of Grovecourt Capital Partners.

Cain Brothers developed a relationship with the founder, Robb Kolb, and discussed potential transaction alternatives. Collectively, the team decided to run a targeted process due to preemptive interest, with the option to expand into a broad sale if needed.

Premier Radiology is a leading provider of teleradiology solutions in outpatient settings across the United States, delivering fast, accurate, and secure medical image interpretations. Founded in 2006 and headquartered in Deerfield Beach, Florida, the company interprets over three million medical images annually through a network of more than 165 board-certified, fellowship-trained radiologists.

Grovecourt is a private equity firm based in West Palm Beach, Florida, specializing in investments in founder-led and family-owned businesses in the lower middle market business services and healthcare services sectors.

On January 27, 2026, Makarora Management LP (Makarora) announced that, together with Ares Alternative Credit funds (Ares), it completed the previously announced all-cash acquisition of Plymouth Industrial REIT, Inc. (Plymouth), valued at approximately $2.1 billion. Pursuant to the terms of the transaction, Plymouth shareholders will receive cash consideration of $22.00 per share. With the completion of the acquisition, Plymouth will no longer be traded or listed on any public securities exchange.  

KeyBanc Capital Markets served as a Sell-Side Advisor to Plymouth Industrial REIT. 

Plymouth Industrial REIT, Inc. (NYSE: PLYM) is a full-service, vertically integrated real estate investment company focused on the acquisition, ownership and management of single and multi-tenant industrial properties. 

Makarora Management LP is a New York-based investment management firm established in 2024 and led by senior professionals with extensive experience investing through global property market cycles. The firm seeks to provide differentiated capital solutions to the commercial real estate sector spanning a wide range of investments, including opportunistic credit, structured capital, and equity. 

Ares Management Corporation (NYSE: ARES) is a leading global alternative investment manager offering clients complementary primary and secondary investment solutions across the credit, real estate, private equity and infrastructure asset classes. As of September 30, 2025, Ares Management Corporation's global platform had over $595 billion of assets under management, with operations across North America, South America, Europe, Asia Pacific and the Middle East.

On January 22, 2026, KeyBanc Capital Markets served as Joint Bookrunner on EquipmentShare.com Inc.’s (EquipmentShare or the Company) $859.3 million Initial Public Offering of 35,075,000 shares, including overallotment. 

EquipmentShare is a digitally native equipment rental platform serving primarily non-residential construction end markets. Enabled by its technology platform, T3, which provides real-time telematics, management, and predictive maintenance of its fleet, the Company offers a tech-forward, seamless equipment rental experience. EquipmentShare serves customers with an integrated solution designed to make their jobsites more efficient, safer, and lower cost.

On January 9, 2026, KeyBanc Capital Markets closed on the $69 million Senior Secured Credit Facility (the Facility) for Greystar and JLC Infrastructure. The Facility shall be used to finance the redevelopment of a 493-bed property known as Sansom Place West, which is an on-campus graduate student housing facility, and delivered under a long-term ground lease with the University of Pennsylvania (UPenn). 

The unit mix emphasizes studio apartments (403 units) – a preference identified by current Accolade residents – plus 45 two-bedroom units. The site consists of two 16-story towers located within walking distance of all 12 of UPenn’s graduate schools and transit options, including SEPTA trolleys, buses, and regional rail. SPW will operate on a 75-year ground lease, with flexibility to lease to undergraduates, students from nearby universities, or the public via a leasing waterfall.

The University of Pennsylvania is a private Ivy League research university founded in 1740 near the western portion of the City of Philadelphia, Pennsylvania. UPenn offers more than 90 undergraduate degrees and 12 master’s and doctorate schools. The university is highly selective, receives over 60,000 first-year applicants annually, and has an acceptance rate of less than 6%, reflecting its academic rigor and competitiveness.

On January 8, 2026, KeyBanc Capital Markets served as Co-Manager on a $500 million Senior Notes offering for Murphy Oil Corporation. Proceeds will be used to repay existing indebtedness and for general corporate purposes.

On November 3, 2025, KeyBanc Capital Markets Inc. (KBCM) successfully closed $1.05 billion of Senior Secured Credit Facilities (the Facilities) for Apex Clean Energy (Apex). The Facilities are comprised of a $500 million Term Loan Facility, a $400 million Letter of Credit Facility, and a $150 million Revolving Credit Facility. Proceeds will be used to fund Apex’s next phase of growth. KBCM acted as Coordinating Lead Arranger.

Apex Clean Energy Overview
Apex Clean Energy was founded with a singular focus: to accelerate the shift to clean energy. Through origination, development, construction, and operation of utility-scale wind, solar, and storage facilities and distributed energy resources, Apex is expanding the renewable frontier across the United States. The company’s mission-driven team uses a data-focused approach and an unrivaled portfolio of projects to create solutions for the world’s most innovative and forward-thinking customers.

KeyBank Community Development Lending & Investment provided capital for the new construction of Twisp Family Haven, a 48-unit affordable housing project in Twisp, Washington. 48 units will serve families and individuals earning no more than 30–60% Area Median Income (AMI). 20 units will be set aside for Permanent Supportive Housing (PSH), with 8 units receiving project-based Section 8 vouchers and 12 units reserved for households who are or have experienced homelessness. Supportive services will be offered to all residents by Room One and will include case management, transportation, assistance in accessing employment, and drug and alcohol counseling. We want to thank Catholic Charities of Eastern Washington for their sponsorship and shared mission to build much-needed affordable housing in Washington.

The financing includes a $10.9 million construction loan arranged by Caleb Stephens.

Cain Brothers, a division of KeyBanc Capital Markets, served as exclusive financial advisor to Tenor Health Foundation in its acquisition of Commonwealth Health, an affiliate of Community Health Systems, Inc. (NYSE: CYH). Cain Brothers also arranged debt financing associated with the transaction.

Tenor Health acquired Commonwealth Health, a subsidiary of Community Health Systems. Commonwealth is a three-hospital health system in northeast Pennsylvania that includes Regional Hospital of Scranton (186 beds), Moses Taylor Hospital (122 beds) and Wilkes-Barre General Hospital (369 beds). Rosemawr Management provided acquisition financing.

With a mission rooted in advancing equitable and innovative care, Tenor Health Foundation was formed to identify, own, manage, and turn around financially challenged hospitals. Tenor Health is committed to the needs of its communities, providing compassionate care and delivering quality patient outcomes.

Community Health Systems operates 70 affiliated hospitals in 14 states, as well as more than 1,000 sites of care, including physician practices, urgent care, freestanding emergency and occupational medicine clinics, and imaging, cancer and ambulatory surgery centers. CHS reported consolidated annual revenues of over $12 billion.

Cain Brothers, a division of KeyBanc Capital Markets, served as financial advisor to FHN in its affiliation with Mercyhealth. 

After years of discussion, FHN elected to pursue a change-of-control transaction with the goals of improving the organization’s cost structure and injecting outside capital. Cain Brothers led a competitive process, resulting in two fully negotiated letters of intent. The Board selected Mercyhealth, out of Rockford, Illinois, who committed to contribute a minimum of $100 million over five years. The transaction was signed on September 30, 2025, and closed on December 31, 2025.

FHN is a regional healthcare system serving northwest Illinois and southwest Wisconsin. FHN is headquartered in Freeport, Illinois and consists of a 100-bed full-service hospital known as FHN Memorial Hospital, 16 outpatient sites that treat over 45 specialties, a comprehensive Cardiovascular Center and a leading Cancer Center. Over 1,500 people visit FHN each day, and FHN is one of the leading employers in northwest Illinois.

Mercyhealth is an Illinois not-for-profit system serving northern Illinois and southern Wisconsin. Mercyhealth operates five acute-care hospitals with over 500 beds, a large multi-specialty physician group, over 85 primary and specialty care clinics, a rehabilitation hospital, and a significant home health and hospice business. Mercyhealth was created after the merger of Mercy Health in Janesville, Wisconsin and Rockford Health System in Rockford, Illinois. Mercyhealth produced $1.3 billion in revenue in 2025.

KeyBank Community Development Lending & Investment provided capital for the new construction of Cedar Commons II, a 64-unit senior affordable housing project in Bellingham, Washington. All 64 units will serve senior citizens earning no more than 30%-60% Area Median Income (AMI). The property will feature 26 Permanent Supportive Housing (PSH) units, with 13 units reserved for households with one or more physically disabled member and 13 units reserved for senior citizens who are or have experienced homelessness. We want to thank Opportunity Council and Shelter Resources for their sponsorship and shared mission to build much-needed affordable housing in Washington.

The financing includes a $15 million construction loan arranged by Caleb Stephens.

KeyBank Community Development Lending & Investment (CDLI) provided a $10.1 million construction loan on behalf of Chicanos Por La Causa (CPLC) to finance the acquisition and rehabilitation of Casa del Pueblo, a 9% LIHTC, 96-unit fully subsidized senior affordable housing property in Tucson, Arizona. 

All the units are one bedroom and restricted to 40% area median income (AMI). The units are 100% occupied and the current tenants will not be displaced. Casa del Pueblo was originally constructed in two phases: one building in 1997 with 58 units and the other in 2011 with 38. The buildings feature three community rooms, fitness equipment, a computer room, lawn space with picnic area and a ramada with a barbecue. Services from the CPLC Healthy Aging program, such as congregate meals and health resources, are available for Casa del Pueblo residents to foster social, emotional, mental, and physical well-being.

CPLC is a nonprofit community development corporation with a 56-year history of empowering lives through more than 30 different programs across Arizona, California, Colorado, Nevada, New Mexico, and Texas, including efforts in affordable housing and community development, with over 3,000 units under management. KeyBank CDLI closed a different construction loan for CPLC in early 2025. 

Matthew Haas from KeyBank CDLI structured the construction financing. Permanent financing was provided by the City of Tucson through HOME Investment Partnership Program (HOME) Funds, the State of Arizona through the Arizona Housing Trust Fund, and Rocky Mountain Community Reinvestment Corporation (RMCRC). The National Equity Fund (NEF) provided LIHTC equity. 

KeyBank Community Development Lending & Investment provided capital for the new construction of Hub 27, a 53-unit affordable housing project in Cleveland, Ohio. All 53 units will serve families and individuals earning no more than 60%-70% Area Median Income (AMI). The property will feature amenities for residents, including bike storage, a clubhouse, courtyard with playground, fitness center, and a rooftop terrace and deck. We want to thank Pivotal Housing Partners and Metro West Development Organization for their sponsorship and shared mission to build much-needed affordable housing in Ohio.

The financing includes a $13.7 million construction loan arranged by David Lacki, $18.6 million in LIHTC equity arranged by Derek Reed, and bond underwriting provided by KeyBanc Capital Markets led by Sam Adams.

KeyBank Community Development Lending & Investment provided capital for the new construction of Benning Road Metro Apartments, a 109-unit affordable housing project in Washington, D.C. All 109 units will serve families and individuals earning no more than 30%-80% of Area Median Income (AMI). The property will feature 22 units of Permanent Supportive Housing (PSH) to be covered by vouchers administered by the Local Rent Supplement Program (LRSP). Supportive services will be offered to residents, facilitated by the project’s development partner, Marshall Heights Community Development Organization, and will include workshops about financial management, employment readiness, entrepreneurship, and rental counseling. We want to thank The NRP Group for their sponsorship and shared mission to build much-needed affordable housing in Washington, D.C.

The financing includes a $43.7 million construction loan arranged by Seaver Rickert and a $11.6 million permanent loan arranged by Robbie Lynn.

KeyBank Community Development Lending and Investment (CDLI) provided a $27.3 million construction loan on behalf of the Housing Authority of Salt Lake City (HASLC) to finance the rehabilitation and new construction of Permanent Supportive Housing and a subsidized apartment community in Salt Lake City. KeyBank’s Commercial Mortgage Group (CMG) also arranged permanent financing with a $16 million Freddie Mac 9% LIHTC forward commitment. The rehabilitation and new construction will consist of 218 units:

• Sunrise Metro – Renovation of existing 100-unit, four-story structure with the addition of 18 new units to the second floor
• Atkinson Stacks – New construction of 100-unit, six-story structure

Units are restricted at 25%-35% of area median income (AMI) across six studios and 212 one-bedrooms. The new building will include commercial space on the bottom floor to be occupied by Sacred Circle, a supportive services and case management provider. Sacred Circle will provide substance abuse counseling, employment, financial support and other services as needed. They will also operate a clinic and pharmacy.

Unit amenities include kitchen range, refrigerator, laminate countertops, and vinyl floors. Property amenities currently in Sunrise Metro include a courtyard, garden, dog run, case management offices, supportive service spaces, and a food pantry. With the expansion and renovation, the HASLC is adding a gym, programmed outdoor spaces, a pharmacy, and a medical clinic to be staffed by Sacred Circle Healthcare, projected to have 12 full-time employees at the site.

“We sincerely thank KeyBank for supporting this transformative project,” Daniel Nackerman, Executive Director, Housing Authority of Salt Lake City noted. “The new and renovated housing will offer safe, affordable homes along with essential services that uplift residents. By promoting community and stability, we are making notable progress toward improving lives and strengthening neighborhoods in Salt Lake City.”

The federal and state LIHTC credits will be purchased/syndicated by The Richman Group. Rachel Grudzien of KeyBank CDLI and Hector Zuñiga of KeyBank CMG structured the financing. 

KeyBanc Capital Markets and Cain Brothers successfully closed the syndication of $1.07 billion Senior Secured Credit Facilities for US Fertility Enterprises, LLC, a portfolio company of Amulet Capital Partners and L Catterton Partners. 

Proceeds from the transaction supported the recapitalization of US Fertility, which included a new equity investment led by L Catterton and the Company’s acquisition of Genetics & IVF Institute.  The financing was comprised of a $120 million Revolving Credit Facility, an $825 million Term Loan B, and a $125 million Delayed Draw Term Loan. 

KBCM was selected to serve as Joint Lead Arranger and Administrative Agent based on Cain Brothers’ expertise in the women’s health space, our long-standing relationship with Amulet Capital Partners, and our best-in-class leveraged finance platform.

US Fertility is the largest fertility group in the U.S., offering a broad range of assistive reproductive technology services and ancillary life sciences offerings. Since 2021, the Company has grown from ~85 physicians across 59 locations to the leading IVF platform in the nation with over 200 physicians across 118 treatment locations and 32 embryology labs.

Founded in 2015, Amulet Capital Partners is a middle-market private equity firm focused exclusively on making investments in the broader healthcare industry. They have $2.7 billion in AUM and are currently investing out of their third fund. Amulet partners with strong businesses across high-conviction, high-growth subsectors within the broader life sciences outsourcing, healthcare provider, and payor and payor services ecosystems.

Founded in 1989, L Catterton is the largest consumer-focused private equity firm in the world, with over $38 billion of equity capital across nine fund strategies in 18 offices globally. They have $38 billion in AUM and have extensive experience in consumer healthcare and multi-site service platforms. L Catterton has an operationally focused value creation approach, augmented by a deep operating team with highly differentiated capabilities. 

KeyBank Community Development Lending & Investment provided capital for the acquisition and rehabilitation of West Branch & River Road Apartments, a two-property affordable housing portfolio totaling 68 units in Stowe, Vermont. The portfolio will benefit under a project-based Section 8 contract serving families, seniors, and disabled individuals earning no more than 50%-60% of Area Median Income (AMI). The property will feature amenities for residents including onsite laundry and a community clubhouse. We want to thank Steele Properties for their sponsorship and shared mission to preserve much-needed affordable housing in Vermont.

The financing includes a $4.5 million equity bridge loan arranged by Rachel Grudzien and a $12.2 million construction-to-permanent loan arranged by Hector Zuniga.