Cain Brothers: Healthcare
Investment Banking

Cain Brothers, a division of KeyBanc Capital Markets, served as exclusive financial advisor to the County of Santa Clara in the acquisition of Regional Medical Center from HCA Healthcare (NYSE: HCA).

On April 1, 2025, Santa Clara County completed the acquisition of Regional Medical Center from HCA Healthcare, integrating RMC into the County of Santa Clara Health System. The acquisition strengthens its commitment to the health and well-being of all communities in Santa Clara County.

Regional Medical Center is a premier healthcare facility known for providing comprehensive medical services, including emergency care, specialized treatments, and advanced surgical procedures. With this acquisition, RMC will expand important clinical programs and services, including trauma, stroke, obstetrics, and advanced cardiac services to patients living in East San Jose.

Santa Clara operates one of California’s most robust public healthcare systems, dedicated to serving the diverse needs of its communities. With a longstanding commitment to accessible healthcare for all residents, the county oversees the Santa Clara Health System, which includes hospitals, clinics, and specialty care services.

HCA Healthcare, a Fortune 500 company, is one of the nation’s leading healthcare providers, operating a vast network of hospitals and medical facilities across the United States.

Together with the KeyBank Beach Point Direct Lending Program, KeyBanc Capital Markets and Cain Brothers, a division of KeyBanc Capital Markets, successfully closed on Senior Secured Credit Facilities supporting SK Capital’s acquisition of Spectrum Vascular.

SK Capital’s investment in Spectrum, a provider of vascular access and medication management products, will enable the Company to accelerate growth initiatives and expand its presence. Through its relationship with the Company and deep understanding of the end market, Cain Brothers was able to provide value-added support to SK Capital in their evaluation and execution of the transaction. The Credit Facilities consisted of a Revolving Credit Facility, a Unitranche Term Loan, and a Delayed Draw Term Loan.  

Spectrum Vascular is an innovative medical device company focused on vascular access and medication management. The Company’s mission is to improve the lives of patients worldwide by providing caregivers with high quality, innovative products with exceptional customer service. Innovation has been a core strategic pillar throughout Spectrum Vascular's history and many of its products have been designed to deliver antimicrobial protection and thrombus reduction. Spectrum Vascular was formed through the acquisition of the vascular access businesses of Cook Medical and AngioDynamics. For more information, please visit www.spectrumvascular.com.

SK Capital is a private investment firm with a disciplined focus on the specialty materials, ingredients, and life sciences sectors. The Firm seeks to build resilient, sustainable, and growing businesses that create substantial long-term value. SK Capital aims to utilize its industry, operating, and investment experience to identify opportunities to transform businesses into higher performing organizations with improved strategic positioning, growth, and profitability, as well as lower operating risk.

KeyBanc Capital Markets and Cain Brothers, a division of KeyBanc Capital Markets, successfully priced $1.0 billion of Convertible Senior Notes Due 2030 for Integer Holdings Corporation. 

The offering was upsized from $750 million to $875 million, prior to the exercise of the overallotment option. The Notes will mature in 2030 and bear interest at a rate of 1.875% per annum, with a conversion premium of 27.50%. Both the coupon and the conversion premium priced at the midpoint of the initial talk ranges. Proceeds from the offering will be used to refinance a portion of the company’s outstanding 2028 Convertible Senior Notes, repay borrowings under its revolving credit facility, fund the cost of capped call transactions, and for general corporate purposes.

Integer is one of the largest medical device contract development and manufacturing organizations in the world, serving the cardiac rhythm management, neuromodulation, and cardio and vascular markets. As a strategic partner of choice to medical device companies and OEMs, Integer is committed to enhancing the lives of patients worldwide by providing innovative, high-quality products and solutions. Integer’s brands include Greatbatch Medical^® and Lake Region Medical^®.

KeyBanc Capital Markets and Cain Brothers, a division of KeyBanc Capital Markets, successfully closed the syndication of $625 million of Senior Secured Credit Facilities in support of ImageFirst Holdings, a portfolio company of Calera Capital.

The Credit Facilities consist of a $125 million Revolving Credit Facility, and a $500 million Term Loan B. Proceeds from the Credit Facilities will be used to refinance existing indebtedness and fund a distribution to shareholders.

ImageFirst is a leading provider of outsourced laundry and textile rental services with a focus on outpatient and specialty healthcare in the U.S. With 70+ locations across 33 states serving over 28,000 customer locations, the Company provides mission critical services to their customers who cannot care for patients without clean linens and other laundry products.

Founded in 1991, Calera Capital is a private investment firm based in San Francisco and Boston that has invested over $4 billion of equity into leading middle market companies. Calera has significant experience and a successful track record of investment in commercial services, healthcare services, and other businesses similar with ImageFirst.

KeyBanc Capital Markets and Cain Brothers successfully closed the syndication of $1.058 billion of Senior Secured Credit Facilities in support of Eversana, a portfolio company of JLL Partners and Water Street Healthcare Partners. 

The Credit Facilities consist of a $108 million Revolving Credit Facility and a $950 million First Lien Term Loan. Proceeds from the Credit Facilities will be used to refinance existing indebtedness and pay transaction-related expenses. 

Eversana is a Chicago-based provider of drug commercialization services for pharmaceutical and biotechnology customers with over 6,000 employees and 30 locations across the globe. Services include strategic advisory, market access, global pricing, HEOR, and agency with expertise in over 100 therapeutic areas. The Company serves a diverse customer base of over 650 organizations, including the top 25 pharmaceutical companies and top 10 biotechs in the world.

JLL Partners is a New York–based middle-market private equity firm specializing in healthcare, industrials, and business services. Since being founded in 1988, JLL Partners has raised $5.8 billion across eight funds, working to accelerate growth and elevate their portfolio companies through organic growth initiatives, operational enhancements, and strategic M&A. 

Founded in 2005, Water Street Healthcare Partners is a private equity firm focused exclusively on the healthcare industry. The Sponsor has ~$7.5 billion in AUM and is investing out of its fifth fund. Water Street is currently an investor in 21 healthcare companies across numerous healthcare subsectors.

Cain Brothers, a division of KeyBanc Capital Markets, served as exclusive financial advisor to EmblemHealth. 

EmblemHealth has sold its wholly owned subsidiary, ConnectiCare, to Molina Healthcare (NYSE: MOH). The transaction enables Molina to add an established government business with a recognized brand, a statewide provider network and a new state, while EmblemHealth will use proceeds to focus on existing business lines. Cain Brothers was engaged as exclusive financial advisor because of its long-standing relationship with EmblemHealth as well as deep domain expertise in managed care. 

ConnectiCare is a leading health plan in Connecticut and has been dedicated to making the state a healthier place to live and work since its founding in 1981. ConnectiCare has a range of products and services for businesses, municipalities, and individuals, as well as those who are Medicare-eligible, and is the leading provider of individual health insurance in the state.

EmblemHealth is one of the nation’s largest nonprofit health insurers, with more than 3 million members and an 80-year legacy of serving New York’s communities. The company offers a full range of commercial and government-sponsored health plans to employers, individuals, and families, as well as convenient community resources. As a market leader in value-based care, EmblemHealth partners with top providers and hospitals to deliver quality, affordable care.

Molina Healthcare, a FORTUNE 500 company, provides managed healthcare services under the Medicaid and Medicare programs and through the state insurance marketplaces.

Cain Brothers, a division of KeyBanc Capital Markets, served as exclusive financial advisor to Medsurant Health, a portfolio company of New Capital Partners, on its sale.

Cain Brothers was engaged as Medsurant Health’s exclusive financial advisor based on its knowledge and relationships in clinical outsourced services. Cain Brothers worked with New Capital Partners to design and execute a broad auction process to identify the optimal partner for Medsurant Health. The transaction continues Cain Brothers’ track record of representing sponsor-backed businesses and expertise within the clinical outsourced services sector.

Medsurant Health is a leading outsourced provider of comprehensive patient monitoring solutions for complex surgical cases, detecting and mitigating neurophysiological complications during brain, spine, and peripheral nerve surgeries. As the nation’s largest pure-play provider of intraoperative neuromonitoring (IONM) services, Medsurant is a trusted operating room partner to more than 350+ hospitals and 1,200+ surgeons, across 15+ states.

Founded in 2001, New Capital Partners is a middle-market private equity investment firm based in Birmingham, Alabama. New Capital is a thesis-driven firm of entrepreneurs and former operators, focused on investing in founder-owned, lower middle-market companies where it can partner with management to provide exceptional service to each portfolio company’s customers. Focus areas include healthcare technology & services, financial technology & services, and business technology and services.

KeyBank Beach Point Direct Lending Program and Cain Brothers, a division of KeyBanc Capital Markets, successfully closed Senior Secured Credit Facilities in support of Strive Medical LLC, a portfolio company of NMS Capital.

In January 2025, Cain Brothers, a division of KeyBanc Capital Markets successfully led the syndication of Senior Secured Credit Facilities for Strive Medical as Left Lead Arranger, Joint Bookrunner and Administrative Agent. The Credit Facilities consist of a Revolving Credit Facility, a Unitranche Term Loan and a Delayed Draw Term Loan. Proceeds from the Credit Facilities were used to refinance existing indebtedness, finance the acquisition of Charles Pharmacy & Surgical and provide capital for future acquisitions.

Headquartered in Irving, Texas, Strive provides urological, wound care, continuous glucose monitoring, and other disposable medical supplies to patients across the US. Since its founding, Strive’s focus is to provide patients with the highest quality customer service and best products to manage their chronic medical conditions. The acquisition of Charles Pharmacy & Surgical complements the Company’s existing product offering and adds insulin pumps and other supplies that further increase Strive’s footprint in the diabetes space.

Founded in 2010, NMS Capital is a New York based private investment firm focused on driving sustainable growth for middle market companies. NMS typically seeks to provide first-time institutional capital, with a focus on the healthcare and business services sectors. NMS currently has ~$1.5 billion in assets under management along with ~$550 million of founder capital retained in their businesses.