Metals Monthly

Cain Brothers, a division of KeyBanc Capital Markets, served as financial advisor to Strive Medical, a portfolio company of NMS Capital, on its sale to Cardinal Health (NYSE: CAH).

Cain Brothers was engaged based on its experience in the home medical supply and DME sectors. The transaction continues Cain Brothers' track record of representing private equity-backed companies and momentum within the post-acute and distribution sectors.

Strive Medical, headquartered in Irving, Texas, is a provider of direct-to-patient urological, wound care, ostomy, incontinence and other medical supplies to patients in their homes and across the U.S. Since its founding, Strive has focused on giving patients the highest quality customer service and best products available.

Cardinal Health is a distributor of pharmaceuticals and specialty products, a global manufacturer and distributor of medical and laboratory products, a supplier of home-health and direct-to-patient products and services, an operator of nuclear pharmacies and manufacturing facilities and a provider of performance and data solutions. The company's customer-centric focus drives continuous improvement and leads to innovative solutions that improve people's lives every day.

Founded in 2010, NMS Capital is a private equity firm managing over $2 billion in assets. NMS has partnered with founders and management teams in over 150 investments and follow-on acquisitions across Business Services and Healthcare Services. The firm’s strategy is to create long-term value by providing strategic and operational resources to accelerate organic and acquisition-driven growth to build industry-leading lower middle market companies in defensible and scalable end markets.

KeyBank Real Estate Capital and Blueprint Healthcare Real Estate provided $17.25 million in acquisition financing for Bethel Retirement Community, a 198-unit independent living and assisted living community in Modesto, California. The Sponsor, Alta-Northstar Senior Living, selected a five-year term with an earnout at first mortgage pricing with a national Life Company.

KeyBank Real Estate Capital has arranged $185 million in new Freddie Mac loans for Brookdale Senior Living Inc. (NYSE: BKD). Acting proactively, KeyBank and Brookdale refinanced pending 2027 debt maturities of Brookdale into new fixed-rate financing at an attractive rate of 5.38%. The new Freddie Mac debt is secured by seven seniors housing communities located on the West Coast. “Brookdale continues to address its debt maturities proactively, and this refinancing extends a portion of our 2027 maturities by six years to 2033 at economically similar terms,” said Dawn Kussow, Brookdale’s Chief Financial Officer. “This refinancing demonstrates the continued confidence our lending partners have in Brookdale’s business, communities, and long-term strategy. We extend our gratitude to Freddie Mac and KeyBank for their continued support and partnership.”

KeyBank Real Estate Capital and Blueprint Healthcare Real Estate provided $11 million in acquisition financing for The Villages of Windcrest, an 81-unit assisted living and memory care facility in Fredericksburg, Texas. The Sponsor, Senior Living Transformation Company (SLTC), selected a five-year term with an earnout at first mortgage pricing with a national Life Company.

On July 8, 2026, KeyBanc Capital Markets (KBCM) successfully closed on the syndication of a $250 million Revolving Credit Facility and $400 million Term Loan B, in addition to the offering of $450 million of Senior Secured Notes (together, the Credit Facilities) for American Greetings Corporation (American Greetings or the Company), a portfolio company of Elliott Management (Elliott) and Clayton, Dubilier & Rice (CD&R). Proceeds from the Credit Facilities will be used to refinance the Company’s existing Term Loan B, repay outstanding Revolving Credit Facility borrowings and pay transaction fees and expenses. KBCM acted as Joint Lead Arranger and Joint Bookrunner on the transaction.

About American Greetings
Founded in 1906 and headquartered in Cleveland, Ohio, American Greetings is a leader in the large and enduring Celebrations marketplace, which includes greeting cards, digital celebrations, e-gift cards, party goods, gift packaging, and physical gifts, such as balloons, candles, and plush toys, among other products.

About Elliott Management 
Elliott was founded in 1977, is one of the oldest firms of its kind under continuous management and manages multi-strategy funds with approximately $79.8 billion of assets under management as of December 31, 2025. A key element of Elliott’s investment approach is its focus on the creation – not just identification – of value. Since 2005, Elliott has made numerous investments in the consumer and consumer services sectors with a focus on industry-leading companies across a range of growth profiles and stages of maturities.

About Clayton, Dubilier & Rice
Founded in 1978, Clayton, Dubilier & Rice employs a distinctive approach to private equity investing, bringing together professionals and operating executives to pursue a strategy predicated on building stronger, more profitable businesses. Since inception, CD&R has managed the investment of more than $45 billion in over 110 companies. CD&R has a disciplined and clearly defined investment strategy with a particular focus on market-leading multi-location services, manufacturing, and distribution businesses. 

KeyBanc Capital Markets Inc. successfully closed ~$1.07 billion of syndicated senior secured credit facilities for US Fertility, a portfolio company of Amulet Capital Partners and L Catterton Partners. The financing included a $120 million Revolving Credit Facility, a ~$902 million Term Loan B, and a $46 million Delayed Draw Term Loan. Proceeds repriced the company’s existing credit facilities, lowering borrowing costs by 50 bps. KBCM served as Joint Lead Arranger, Joint Bookrunner, and Administrative Agent based on Cain Brothers’ expertise in the women’s health space, our long-standing relationship with the sponsors and 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. With $2.7 billion in AUM, they 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 AUM across nine fund strategies in 18 offices globally. They 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.

KeyBanc Capital Markets and Cain Brothers, a division of KeyBanc Capital Markets, closed the syndication of a $1.038 billion Add-on Term Loan B and the offering of $500 million of Senior Secured Notes for athenahealth Group, a portfolio company of Hellman & Friedman and Bain Capital. Proceeds were used to refinance existing debt. KeyBanc acted as Joint Lead Arranger and Joint Bookrunner.

athenahealth provides cloud-based enterprise software solutions for medical groups and health systems. The company’s software-as-a-service is bundled with high-impact technology-enabled services primarily offered to physicians, as well as health insurers and life sciences. The core offerings include electronic healthcare record, revenue cycle management and other complementary solutions.

Hellman & Friedman is a preeminent global private equity firm with a distinctive investment approach focused on large-scale equity investments in high-quality growth businesses and targets equity investments ranging from $350 million to over $2 billion.

Bain Capital is one of the world’s largest private, multi-asset alternative investment firms and targets equity investments ranging from $150 million to $1 billion.

In July 2026, KeyBanc Capital Markets (KBCM), in collaboration with KeyBank Real Estate Capital, successfully structured and closed a $112 million senior secured loan facility for 155 Jefferson Street Urban Renewal LLC, the owner and landlord of the Newark School of Architecture & Interior Design in Newark, New Jersey. KBCM served as Sole Lead Arranger on the transaction.

The loan proceeds were used to refinance the property's existing debt and fund the remaining construction costs associated with Phase 2 of the project, which includes a gymnasium and auditorium facility adjacent to the academic building. The school is currently operational and serving students, while completion of Phase 2 is expected to trigger commencement of full rental payments under the lease agreement. Construction is expected to be completed in early 2027.

155 Jefferson Street Urban Renewal LLC is an affiliate of Summit Assets and Winchester Equities — New York-based real estate developers and owner-operators. The sponsors developed the school through a public-private partnership structure under which Newark Public Schools leases the facility for a 30-year term, with an option to purchase the property for $1 at lease maturity. The lease is supported by the A- rated credit profile of the Board of Education of the City of Newark, New Jersey, providing a strong underlying credit foundation for the transaction.

Newark School of Architecture & Interior Design is a newly constructed public high school focused on career and technical education, offering programs in architecture, engineering, interior design, electronics, HVAC, plumbing, and real estate.

On July 1, 2026, KeyBanc Capital Markets served as Joint Bookrunner on Forgent Power Solutions, Inc.’s (Forgent) $2.5 billion Follow-On Offering of 50,197,500 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 exclusive financial advisor to Smile America, a portfolio company of Beach Point Capital Management, in its sale to Kaltroco. 

Cain Brothers was engaged based on its experience in dental, specifically the pediatric dental sector, and long-standing relationship with the financial sponsor. Cain Brothers’ broad sector coverage enabled the Company to access a wide array of buyers and financing sources to facilitate the transaction.

Smile America is the leading provider of school-based dental care services, with a mission to provide access to oral healthcare to underserved populations. Smile America currently provides preventative care and minimally invasive dental procedures to 370,000+ patients in 8,000+ schools across 20 states.

Beach Point is a global alternative investment manager focused on opportunities across the credit spectrum. The firm’s integrated platform spans high-yield bonds, senior loans, CLO origination, securitized credit, direct lending, real estate credit, as well as hybrid and flexible capital solutions. Founded in 2009, Beach Point is employee-owned and manages over $20 billion in assets.

Kaltroco is a private investment company with headquarters in Jersey, Channel Islands and investment professionals in Nashville, Zurich, and Cape Town. Kaltroco partners with founders and management teams to pursue ambitious growth objectives. As a family-backed investment company with no outside investors and no restrictions on structure or hold period, Kaltroco has the flexibility to invest on the timeline that best fits its portfolio companies' needs and its partner management teams' objectives. Since its founding, Kaltroco has invested in over 30 companies globally, with a focus on the healthcare services, business services, and consumer industries.

On June 16, 2026, KeyBanc Capital Markets served as Joint Bookrunner on a $550 million Senior Notes offering for California Resources Corporation. Proceeds will be used to refinance existing indebtedness and for general corporate purposes.

Cain Brothers, a division of KeyBanc Capital Markets, served as exclusive financial advisor to Nutrisense, a portfolio company of 1315 Capital, on its sale to Dexcom (NASDAQ: DXCM).

Cain Brothers was engaged based on its experience in the medical device and health tech sectors. The acquisition represents a significant strategic move for hardware-focused Dexcom to accelerate their push into the large, Type 2 diabetic and metabolic health markets. By leveraging Nutrisense’s tech-enabled, direct-to-consumer distribution and coaching layer, Dexcom intends to increase sensor penetration, improve retention and monetize glucose data. The transaction continues Cain Brothers’ track record of representing private equity-backed companies and momentum in cross-sector M&A. 

Nutrisense is a digital metabolic health platform that combines continuous glucose monitoring (“CGM”), a mobile app and registered dietitian coaching to help users better understand how food, sleep and lifestyle affect their blood sugar. The company primarily serves health-motivated and pre-diabetic individuals through a subscription model, translating real-time glucose data into personalized nutrition and behavior guidance aimed at improving metabolic health and weight management.

Dexcom is a leading glucose sensing and continuous glucose monitoring company focused on helping people take control of their health through innovative biosensing technology. For more than 25 years, Dexcom’s technology has helped transform how people manage diabetes and track glucose, providing real-time insights that support more informed decisions and greater confidence in daily health management.

Founded in 2014, 1315 Capital is a healthcare-focused investment firm with over $1 billion of assets under management. The firm invests in commercial-stage companies across healthcare services, pharma/medtech products, pharma/medtech outsourcing, and health & wellness, partnering with management teams to scale businesses that positively impact patients, physicians and the broader healthcare system.