Ohio Public Finance Quarterly

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.

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 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 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.

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.