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

KeyBanc Capital Markets (KBCM) and its healthcare practice, Cain Brothers, closed the syndication of $290 million of Senior Secured Credit Facilities in support of Altaris’ acquisition of the Life Sciences & Healthcare segment of Clarivate Plc (“Janus”). Proceeds were also used to support working capital and pay transaction-related expenses. KBCM was Joint Lead Arranger and Joint Bookrunner.

Clarivate’s Life Sciences & Healthcare segment is a leading technology-enabled data intelligence and services platform supporting pharma, biotech, and medtech customers across the product lifecycle, from R&D through commercialization. Janus’ products and services provide customers with unique insights at critical decision points, based on proprietary data and advanced curation capabilities. The business has a global footprint with ~2,400 employees, supported by 1,000+ scientific and regulatory specialists.

Founded in 2003 and based in New York, Altaris is a private equity firm focused on healthcare, investing across Pharmaceuticals & Pharma Services, Medical Devices & Diagnostics, and Healthcare Services. Altaris has raised five progressively larger funds and two dedicated co-investment vehicles. Known for its long-term investment approach, Altaris emphasizes value creation over time and employs a conservative use of leverage in its transactions.

On September 30, 2026, KeyBanc Capital Markets (KBCM) successfully advised Creedence Energy Services, LLC (Creedence or the Company), a portfolio company of Tower Arch Capital (Tower Arch), on its sale to Monomoy Capital Partners (Monomoy). KBCM was selected to serve as Creedence’s Sell-Side Advisor based on its strong institutional sponsor relationship, industry-leading Specialty Chemicals & Materials practice, proven M&A execution capabilities and relevant transaction experience.

Founded in 2014 and headquartered in Minot, North Dakota, Creedence is a leading independent provider of production and midstream chemical solutions to oil and gas operators across major U.S. producing basins. Creedence combines proprietary chemical formulations, advanced laboratory testing, blending capabilities, and responsive field service to develop tailored programs that optimize production, protect critical assets, and reduce equipment failures and downtime. Creedence’s solutions support existing production wells, midstream pipelines, and saltwater disposal facilities, and include specialized scale remediation and production stimulation treatments.

Headquartered in Salt Lake City, Utah, Tower Arch Capital is a growth-oriented middle-market private equity firm. Tower Arch seeks to partner with high-quality family- and entrepreneur-owned companies to deliver long-term value for their management teams and investors. Tower Arch brings operational, consulting, and financial expertise to companies to help them improve their operations, scale, and grow. Target investments include control positions in businesses with EBITDA between $8 million and $30 million.

Monomoy Capital Partners is a private investment firm with over $5.3 billion in assets under management across a family of investment funds. Monomoy focuses on investing in manufacturing, distribution, and services companies across industrial and consumer product sectors in North America. The firm is committed to providing middle-market businesses with strategic capital, management and operational expertise, and the ability to achieve sustainable success.

Cain Brothers, a division of KeyBanc Capital Markets, served as exclusive financial advisor to Dynamic Access, a portfolio company of RiverGlade Capital, on its sale to Blue Sea Capital.

Cain Brothers was engaged based on its experience in outsourced clinical services, expertise managing carveouts and business separations, and relationships within the relevant buyer universe. Working with RiverGlade and management, Cain Brothers designed and executed a competitive process to identify the optimal partner for Dynamic’s next phase of growth. The transaction continues Cain’s track record of representing sponsor-backed businesses and reinforces continued momentum within outsourced clinical services.

Headquartered in Dallas, Dynamic Access is the leading provider of outsourced vascular access services to hospitals and post-acute facilities across 25 states, performing more than 200,000 procedures annually. The company deploys specialized clinical teams to place and manage PICC lines, midlines, and peripheral IVs on-site, complementing its services with clinical education and supply management support that help facilities reduce complications and improve patient outcomes.

Founded in 2017, RiverGlade Capital is a Chicago-based investment firm focused on control buyouts of growth-oriented, lower middle market healthcare companies. The firm invests across provider services, outsourced services, and healthcare products and distribution. They partner with founder-owned, differentiated businesses to accelerate value and transform them into highly attractive strategic assets.

Blue Sea Capital is a private equity firm based in West Palm Beach, Florida, that invests in growth-oriented middle market healthcare companies valued up to $500 million. With over $2.4 billion in assets under management, Blue Sea Capital’s strategy is to partner with talented leaders and differentiated companies, typically as the first or second institutional investor, and deliver strategic and operational value-add that drives growth acceleration, industry outperformance and business transformation.

Cain Brothers, a division of KeyBanc Capital Markets, served as exclusive sell-side advisor to CommonSpirit Health on the sale of its affiliate, Trinity Health System, to the University of Pittsburgh Medical Center (UPMC). UPMC will integrate Trinity Health into their care network that currently serves Pennsylvania, New York and Maryland. 

Cain Brothers was engaged based on our expertise in hospital and health system M&A and strong understanding of the local market. Cain Brothers engaged parties interested in continuing Trinity Health’s mission and finalized a definitive agreement with UPMC. The transaction continues Cain Brothers' track record of successfully advising not-for-profit health systems and reinforces its leadership in the sector.

CommonSpirit Health is one of the nation’s largest nonprofit Catholic health systems, handling over 25 million patient encounters annually across 156 hospital-based locations and 2,600 care sites. Serving 24 states, CommonSpirit Health employs 160,000 team members, including 45,000 nurses and 30,000 physicians. 

Trinity Health, based in Steubenville, Ohio, is a network of hospitals, physician practices and specialty services across the Ohio Valley, committed to improving community health with excellence and faith-driven service. 

UPMC is a leading nonprofit healthcare provider and insurer headquartered in Pittsburgh, Pennsylvania. With 100,000 employees and more than 5,000 physicians, UPMC operates more than 40 hospitals and 800 outpatient sites across Pennsylvania, New York, Maryland, and overseas. UPMC Insurance Services covers more four million members and invests nearly $2 billion annually in community benefits, the most of any health system in Pennsylvania.

KeyBanc Capital Markets and Cain Brothers, a division of KeyBanc Capital Markets, successfully priced a $92.5 million follow-on offering of common stock for InnovAge Holding Corp. (NASDAQ:  INNV). Proceeds were for the benefit of selling shareholders, including Welsh, Carson, Anderson & Stowe and Apax Partners. 

InnovAge is the market leader in managing the care for high-cost, frail, and predominantly dual-eligible seniors through the Program of All-inclusive Care for the Elderly (PACE). With a mission of enabling older adults to age independently in their own homes for as long as safely possible, InnovAge’s patient-centered care model is designed to improve the quality of care its participants receive, while reducing over-utilization of high-cost settings. InnovAge believes its PACE healthcare model is one in which all constituencies — participants, their families, providers and government payors — “win.” As of June 30, 2026, InnovAge has served approximately 8,230 participants across 20 centers in six states.

On September 17, 2026, KeyBanc Capital Markets (KBCM) successfully advised GLP Canada Ltd. (GLP or the Company) on its partnership with Atlantic Street Capital (Atlantic Street).

KBCM was selected to serve as GLP’s Exclusive Financial Advisor based on its multi-year relationship with GLP’s management and ownership, industry-leading specialty distribution investment banking practice, long history of transaction success within the HVAC industry, access to the best potential private equity partners and proven M&A execution capabilities.

Founded in 1958 and headquartered in Oakville, Ontario, GLP is a leading specialty HVAC distributor serving customers across North America. Through its complementary Distribution and Applied segments, GLP offers a comprehensive portfolio of HVAC equipment, accessories, parts, components and engineered systems across mission-critical, industrial, modular, commercial and residential applications. The Company’s technical expertise, long-standing vendor relationships, broad product offering and white-glove customer support position GLP as a trusted channel partner to customers throughout Canada and the U.S.

Founded in 2006 and headquartered in Greenwich, Connecticut, Atlantic Street Capital is a private equity firm focused on partnering with ambitious entrepreneurs and management teams of lower-middle-market businesses. Atlantic Street combines deep industry expertise, hands-on operational support and capital resources to help its portfolio companies accelerate organic and acquisition-driven growth. Atlantic Street operates with over $1.5 billion of assets under management.

Cain Brothers, a division of KeyBanc Capital Markets, served as exclusive financial advisor to Icario, a portfolio company of CVC Capital Partners, on its sale to Vitality Group.

Leveraging deep experience in payer tech and member engagement, Cain Brothers ran a competitive process targeting strategic buyers. The transaction resulted in a strategic combination pairing Icario's member engagement platform with Vitality's global behavior-change franchise, expanding Vitality's reach into health plan member engagement and gaps-in-care closure in the U.S. market.

Icario is an AI-powered, digital-first member engagement platform that leverages whole-person data, proprietary analytics, GenAI, behavioral science and omnichannel communication to deliver personalized member experiences at scale. The company helps health plans translate complex member-level data into engagement programs that motivate healthy behaviors, close gaps in care and improve outcomes. Icario serves some of the nation's largest health plans, reaching millions of Medicare, Medicaid and commercial members, while delivering measurable improvements in quality performance, care outcomes and member engagement.

Vitality, a subsidiary of Discovery (JSE: DSY), a South Africa-based financial services group, is a leading health engagement platform that helps improve health outcomes through technology, data, AI, incentives and behavioral science. Backed by Discovery's global expertise in insurance, wellness and behavior change, Vitality serves more than 52 million lives across Europe, the Americas, Asia, Africa and Oceania.

Founded in 1981, CVC Capital Partners is a Luxembourg-based private equity firm with over $245 billion of assets under management. The firm invests across a diverse range of sectors, including business services, consumer and retail, healthcare, technology, and infrastructure, partnering with management teams to scale businesses and create long-term value across its portfolio.

On September 2, 2026, KeyBanc Capital Markets and Key Government Finance successfully closed the $60 million Senior Secured Tax-Exempt Credit Facility for Spirit Lake Tribe. The proceeds will be used to support the construction and development of the new Spirit Lake Health Center in North Dakota.

This transaction represents Key’s first financing for Spirit Lake Tribe and long-standing track record of tribal financings secured by health services revenues. Key was selected to serve as Sole Lender and Structuring Agent due to its healthcare financing experience and established expertise supporting Native American construction projects.

The new, visionary Spirit Lake Health Center will be a 60,000-square-foot facility located on tribal land in Saint Michael, North Dakota. The center will bring together primary care, dental, behavioral health, pharmacy, radiology, dialysis, and related services under one roof, significantly expanding capacity to support over 35,000 annual patient visits and serve more than 13,000 individuals, the majority of whom are low-income and Native American.

About Spirit Lake Tribe
Spirit Lake Tribe is a federally recognized Tribe located in Fort Totten, North Dakota, with over 7,900 enrolled members. The Tribe operates a diverse portfolio of enterprises, including Sioux Manufacturing Corporation, Spirit Lake Housing Corporation, Cankdeska Cikana Community College, Four Winds Community School, Tate Topa Elementary & Middle School, and Spirit Lake Casino & Resort. The various enterprises support the Tribe’s long-term vision of economic self-determination, community development, and enhanced quality of life for tribal members.

About Spirit Lake Tribe Healthcare
The Tribe has operated the existing Spirit Lake Health Center for over 50 years, providing essential healthcare services to the community. The proposed project will support the replacement of the existing facility to meet the growing demand for access to critical healthcare in one of North Dakota’s most under-resourced communities.

Cain Brothers, a division of KeyBanc Capital Markets, acted as Buy-Side Advisor to Adena Health System on its acquisition of Fairfield Medical Center.

Cain Brothers was engaged based on our long-standing relationship and ongoing dialogue with management, and expertise in advising not-for-profit health systems. Cain provided tactical and strategic process-related recommendations and insight, while advising on valuation and pro forma credit implications. The acquisition expands Adena’s footprint into central Ohio and strengthens its commitment to delivering coordinated, high-quality care across medically underserved and rural communities.

Adena Health is an independent, locally governed not-for-profit health system founded in Chillicothe, Ohio in 1895. For more than 130 years, Adena has focused on delivering high-quality, locally accessible care to the communities it serves. Adena serves nearly 400,000 residents across a nine-county region of south-central and southern Ohio through 40+ care sites, including four hospitals with 341 licensed beds. With more than 3,300 employees, Adena is one of the region’s largest employers.

Fairfield is a not-for-profit, full-service acute care hospital in Lancaster, Ohio that has served its communities for more than 110 years. The hospital serves over 250,000 residents across five counties and employs more than 2,000 caregivers.

In August 2026, KeyBanc Capital Markets (KBCM) successfully closed on $650 million in Senior Notes due 2036 for MasTec, Inc. (MasTec). KBCM acted as Senior Co-Manager on the transaction.

MasTec is a leading infrastructure construction company that provides engineering, building, installation, and maintenance services for communications, energy, utility, and transportation infrastructure across North America. The company serves telecommunications, renewable energy, power delivery, and pipeline customers through its diversified infrastructure solutions.

On August 31, 2026, KeyBanc Capital Markets (KBCM) successfully advised on the sale of Myers Tire Supply (MTS), a division of Myers Industries (Myers), to Lion Equity Partners (Lion). KBCM was selected to serve as Myers’ Exclusive Sell-Side Advisor based on its industry-leading Specialty Distribution investment banking practice, proven M&A execution capabilities and long-standing relationship with Myers.

Headquartered in Akron, Ohio, Myers is a leading manufacturer of specialized plastic and metal products for the consumer, vehicle, food & beverage, general industrial and infrastructure end markets. Myers operates a portfolio of established brands and manufactures a diverse range of products, including material handling containers, storage solutions, fuel and water storage products, ground protection systems and other engineered products. Myers employs over 2,000 individuals, with over 30 locations globally.

Founded in 1933 and headquartered in Akron, Ohio, MTS is one of the nation’s leading distributors of specialized tire supplies, tools and equipment for the tire service market. MTS provides comprehensive retread and repair consumables, wheel weights, equipment, tire pressure monitoring systems, valves, shop supplies and tools. MTS’s footprint spans the continental U.S., serving thousands of customers across the passenger and commercial automotive markets through four distribution centers.

Headquartered in Denver, Colorado, Lion is a lower middle-market private equity investment firm with over $170 million of assets under management.

KeyBanc Capital Markets and Cain Brothers, a division of KeyBanc Capital Markets, successfully closed the syndication of $1.1 billion of Senior Notes for Universal Health Services, Inc. (NYSE: UHS).

KeyBanc Capital Markets served as Senior Co-Manager due to its industry expertise, long-standing relationship with the company, and leading debt capital markets capabilities.

Proceeds will be used to repay $700 million of existing 2026 Notes maturing on September 1 and amounts outstanding under its revolving credit facility related to the Talkspace acquisition.

UHS owns and operates acute care hospitals, behavioral health facilities, outpatient centers and other healthcare service locations. The company owns and/or operates approximately 375 inpatient facilities and 168 outpatient and other facilities located across 40 states, Washington, D.C., the United Kingdom and Puerto Rico.

KeyBank successfully closed financing to support Delta Mechanical Contractors' acquisition of NexGen, a Rhode Island-based mechanical and electrical contractor specializing in HVAC service, preventive maintenance, controls, and electrical work.

A valued KeyBank client since 2018, Delta Mechanical Contractors provides commercial HVAC, plumbing, fire protection, and mechanical contracting services. Over the years, KeyBank has supported Delta's growth with working capital and real estate financing, helping the company strengthen its capabilities and expand its market presence.

The acquisition of NexGen represents a strategic step forward for Delta, adding electrical, controls, and preventive maintenance capabilities that complement Delta’s established construction expertise. The transaction enhances Delta’s ability to operate as a single-source provider of mechanical, electrical, and controls services, allowing the company to better support its customers through a broader range of in-house offerings.

Working closely with Delta and its advisor, Attract Capital, KeyBank provided a term loan to support the acquisition, a revolving line of credit for ongoing working capital needs, and a delayed draw term loan to help fund future growth initiatives.

KeyBank Community Development Lending and Investment (CDLI) provided $92.9 million in financing for Broadway & Imperial, a new 166-unit affordable housing development in South Los Angeles. The financing package includes a $43.8 million construction loan and a $18.1 million federal Low-Income Housing Tax Credit (LIHTC) equity investment from KeyBank CDLI. Key Commercial Mortgage Group arranged a $31 million Fannie Mae MTEB permanent loan, and KeyBanc Capital Markets underwrote a $31 million public bond issuance as part of the financing structure.

Broadway & Imperial is being developed by SoLa Impact, a Los Angeles-based social impact real estate firm focused on creating and preserving affordable housing in underserved communities. Since 2013, SoLa Impact has focused on developing and preserving housing in South Los Angeles, particularly in neighborhoods that have historically lacked access to capital.

Located at the intersection of Broadway and Imperial Highway, the development will provide housing for individuals and families earning between 30% and 70% of area median income. The development is located near transit and neighborhood services.

The new development will include 164 affordable apartments and two manager units in a four- and five-story building. Residents will have secure access to the property and a range of amenities, including a lobby, rooftop deck, community room, three landscaped courtyards, secure bicycle storage, and on-site parking with electric vehicle charging stations.  

Supportive services will be provided on-site by LifeSTEPS, which will include on-site educational, financial literacy, health and wellness, and counseling services. Residents will also have access to programs offered by the SoLa Foundation, including opportunities available through the SoLa Tech & Entrepreneurship Center Powered by Riot Games.

“Los Angeles continues to face a significant shortage of affordable housing,” said Robert Likes, president of KeyBank Community Development Lending and Investment. “Broadway & Imperial will bring 166 affordable homes to South Los Angeles, and we’re pleased to provide financing for the development.”

“Our mission has always been simple: invest in communities we know, create quality housing and help ensure long-time residents can continue to live in the neighborhoods they call home,” said Martin Muoto, CEO and founder of SoLa Impact. “Broadway & Imperial is exactly the kind of development Opportunity Zones were meant to encourage, and we’re proud to partner with KeyBank to bring these new homes to South Los Angeles.”

Matthew Haas and Eileen Tran of KeyBank CDLI and Shana Daby of Key Commercial Mortgage Group arranged the financing. Alex Stekler of KeyBanc Capital Markets marketed the bonds.

On July 28, 2026, KeyBanc Capital Markets Inc. (KBCM) successfully closed $220 million of Senior Secured Credit Facilities supporting GridStor’s utility-scale standalone battery energy storage project, White Tank. The facilities include a $140.4 million construction-to-term loan, a $42.8 million tax-credit bridge loan, and $36.9 million in letters of credit. Proceeds will be used to fund the project’s construction costs. KBCM acted as Coordinating Lead Arranger.

White Tank is a 100 MWac/400 MWh energy storage project located in Maricopa County, Arizona. The project is supported by a 20-year tolling agreement with Arizona Public Service, an investment-grade regulated utility. Built with tier-1 equipment, White Tank is expected to reach commercial operations in February 2027. Once operational, it will provide grid stability to over 80,000 Arizona homes.

This financing represents the first transaction between GridStor and KBCM.

About GridStor
GridStor is backed by Goldman Sachs Asset Management (GSAM), which acquired the company in 2022 to support the buildout of its utility-scale energy storage platform. GridStor focuses on delivering large-scale energy storage solutions that support grid reliability and help meet rapidly growing power demand from utilities, data centers, and other industrial customers. Its strategy is centered on developing and operating standalone battery storage projects that provide cost-effective, near-term infrastructure solutions in high-growth power markets.

About Goldman Sachs Asset Management
Founded in 1988, GSAM is a global investment manager with over $1 trillion in assets under supervision and a global platform spanning multiple asset classes, industries, and geographies. The firm serves clients across pension plans, sovereign wealth funds, insurance companies, financial institutions, endowments, foundations, family offices, and individual investors.

On August 27, 2026, KeyBanc Capital Markets Inc. (KBCM) successfully closed the syndication of a $40 million Incremental Term Loan A Facility for WarHorse Gaming, LLC, wholly owned by the Winnebago Tribe of Nebraska’s award-winning economic development corporation, Ho-Chunk, Inc. for an aggregate issuance of $340 million in Senior Secured Credit Facilities. Proceeds from the Incremental Facility will be used to support ongoing construction costs, working capital, and general corporate purposes.

KBCM served as a Joint Lead Arranger on the transaction due to our successful track record of executing syndicated transactions and industry expertise in the debt capital markets. This transaction represents the second transaction with WarHorse.

About WarHorse
The Tribe established WarHorse in 2022 to develop, own, and operate two commercial casinos in eastern Nebraska: WarHorse Gaming Lincoln, LLC and WarHorse Gaming Omaha, LLC. WarHorse completed its multi-phase development in April 2025 and currently features an aggregate of 1,900 slot machines, 28 table games, several F&B options, and other premium amenities. The third WarHorse Casino, expected to open in 2028, will be constructed in South Sioux City and feature over 700 gaming options adjacent to the newly constructed racetrack.

About Ho-Chunk
Ho-Chunk, Inc. was established in 1994 as an independent commercial entity owned by the Tribe. Ho-Chunk owns and operates a diversified portfolio of businesses spanning multiple end markets including gaming & real estate, manufacturing & distribution, consumer, and government contracting. As a long-term capital provider, Ho-Chunk prioritizes their dual mission of generating revenue and affecting positive social and economic impact.

About The Tribe
Winnebago Tribe of Nebraska is a federally recognized sovereign nation comprised of over 5,000 enrolled members. Tribal lands encompass over 27,600 acres across eastern Nebraska.

On August 24, 2026, Ridge Care Senior Living, Inc. (Ridge Care or the Company) completed the sale of a portfolio of six stabilized seniors housing communities to Ventas Healthcare Realty LLC (Ventas). The seniors housing portfolio offered a full continuum of care across 542 beds in North Carolina and South Carolina. KeyBanc Capital Markets served as Exclusive Sell-Side Advisor to Ridge Care. 

Ridge Care is a privately held and vertically integrated developer, owner and operator of seniors housing communities. Prior to the transaction, Ridge Care owned and operated nine communities, which offered independent living, assisted living, memory care and respite care. The Company is headquartered in Kernersville, North Carolina, less than a four-hour drive from all of Ridge Care’s communities. The senior leadership team is able to visit each community regularly and create personal connections with those who live and work there. Through these visits, management seeks firsthand feedback, enabling a high standard of care.

Ventas (NYSE: VTR) is an S&P 500 company enabling exceptional environments that benefit a large and growing aging population. Prior to the transaction, Ventas had approximately 1,450 properties in North America and the United Kingdom. The firm’s growth is fueled by its more than 900 seniors housing communities, which provide valuable services to residents and enable them to thrive in supported environments.

In August 2026, KeyBanc Capital Markets acted as Active Joint Bookrunner for Ameren Illinois Company’s (AIC) $400 million First Mortgage Bond offering. The bonds were issued at a spread of T+78 with a 5.5% coupon and mature in 2036.

AIC intends to use the proceeds for general corporate purposes, including the repayment of outstanding short-term debt.

About Ameren Illinois Company
Ameren Illinois Company is a subsidiary of Ameren Corporation, a public utility holding company. AIC is headquartered in Collinsville, Illinois, and operates in the rate-regulated electric generation, transmission, and distribution business, as well as the natural gas distribution business. The company provides electricity to approximately 1.2 million customers across more than 1,200 communities, with a service territory spanning 43,700 square miles.

On August 18, 2026, KeyBanc Capital Markets (KBCM) successfully advised Safe-Way Garage Doors LLC (Safe-Way or the Company), a portfolio company of CW Industrial Partners (CW), on its sale to Point 41 Capital Partners (Point 41). KBCM was chosen to serve as Exclusive Sell-Side Advisor based on its industry-leading Building Products practice and proven M&A execution capabilities.

Headquartered in Warsaw, Indiana, Safe-Way is a leading manufacturer of residential and commercial garage doors serving professional dealers, installers and distributors across North America. The Company offers a comprehensive portfolio of garage door products designed to meet a broad range of performance, aesthetic and end-market requirements. Safe-Way is recognized for its reputation for product quality, customer service and operational reliability, supported by a strategically located manufacturing footprint, long-standing customer relationships and industry-leading delivery performance.

CW is a Cleveland, Ohio-based private equity firm focused on middle-market industrial businesses that manufacture or service engineered products, components and equipment. With more than 20 years of experience, the firm partners with entrepreneurs, families and executives to drive long-term value creation.

Point 41 Capital Partners is a middle-market private equity firm that partners with management teams in the specialty industrials and services sectors and invests in North American-based companies with an enterprise value between $50 million and $350 million. Point 41's ideology is built upon four key principles — team, expertise, execution, and integrity — that guide the firm’s investment philosophy. In alignment with management teams, Point 41 offers 40 years of deep sector expertise and a proven approach to driving transformational growth.

KeyBank recently closed on a line of credit increase for CB20, Inc. The increased credit facility provides additional working capital support for CB20 as the company continues to grow organically in existing markets, expand into the Boston market, and introduce several new product offerings.

CB20 is an award-winning provider of managed IT and audiovisual services, proudly serving organizations across New York, Massachusetts, and the greater New England region. With more than 30 years of experience, the company has built a team of world-class engineers and established trusted relationships with leading hardware and software providers.

As CB20 enters the early stages of its five-year growth plan, KeyBank worked with the company to provide the financial flexibility needed to support its expansion strategy and continued growth. Beyond this financing, KeyBank supports CB20 through treasury management and card services, while also serving the owner's family through Key Private Client wealth management services.

Cain Brothers, a division of KeyBanc Capital Markets, acted as buy-side advisor to Bookmark Medical, a portfolio company of Kinderhook Industries, on its acquisition of the Michigan assets of Village Medical, a subsidiary of VillageMD.

Cain Brothers has a longstanding relationship with Kinderhook and maintains on-going dialogue with Bookmark on M&A and capital raising opportunities. Cain Brothers was engaged based on our deep expertise in primary care, with this mandate further bolstering our credentials in the broader physician group and value-based care sectors.

Bookmark Medical is a provider-led healthcare organization dedicated to improving lives through high-quality care. Serving patients across Arizona, Massachusetts, Michigan, and Tennessee, Bookmark partners with providers to deliver coordinated, patient-centered care rooted in strong community relationships. Through primary care, specialty care, and affiliated provider partnerships, the organization is expanding access to healthcare while improving health outcomes for the communities it serves.

Kinderhook Industries is a private investment firm that has raised over $11 billion of committed capital and has made 500+ investments and follow-on acquisitions since its founding in 2003. Kinderhook matches differentiated, growth-oriented investment opportunities with its financial expertise and proprietary network of operating partners. Kinderhook focuses on middle market businesses with defensible niche market positioning in healthcare services, environmental & equipment services, and industrials & manufacturing.

VillageMD provides high-quality, accessible health care services for individuals and communities across the United States, with primary, multispecialty, and urgent care providers serving patients in traditional clinic settings, in patients’ homes, and through online appointments. Committed to serving all patients and working with all payers, VillageMD consistently innovates value-based care, bringing integrated applications, population insights and staffing expertise to its owned and affiliate practices, ensuring high-quality care, better patient outcomes, and a reduction in the total cost of care.

On July 31, 2026, KeyBanc Capital Markets Inc. (KBCM) successfully closed a $1.05 billion Senior Secured Credit Facility for Avantus LLC (Avantus) in support of their expansive project pipeline. The Facility comprises a $520 million facility upsize to an existing $522 million corporate credit facility put into place in July 2024.

The expanded Facility will advance Avantus’ independent power producer (IPP) strategy and accelerate the execution of its portfolio across core markets in California and the desert Southwest. Its pipeline totals 24 GW of system capacity, including 13 GW of solar integrated with 44 GWh of storage. The near-term portfolio consists of 12 projects totaling 2.6 GWac of solar capacity and 2.5 GWac/9.8 GWh of battery storage capacity, and will generate revenue through long-tenor busbar power purchase agreements with various Tier-I offtakers.

KBCM joined the financing as a new Lead Arranger alongside other institutions.

Avantus Overview
Avantus develops, owns and operates utility-scale clean energy projects across California and the desert Southwest. The company’s development pipeline of solar with integrated storage will generate enough dispatchable power to serve more than 10 million Americans, day and night. Backed by strategic investment from KKR and EIG and building on more than a decade of industry leadership, Avantus is growing its position as an independent power producer, delivering affordable, reliable clean energy solutions to meet America’s growing energy demand.

On July 31, 2026, KeyBanc Capital Markets (KBCM) successfully advised Bearing Distributors, Inc. (BDI or the Company) on a strategic growth investment from Kelso & Company (Kelso). KBCM served as Exclusive Financial Advisor to BDI on the transaction.

KBCM’s advisory relationship with BDI, and its CEO and controlling shareholder, spans over 25 years. Accordingly, KBCM ran a high-touch process to drive a compelling outcome, while allowing the CEO and his team to align with a preferred partner with a shared vision for the Company. This partnership provides BDI with enhanced access to capital and operational resources to accelerate organic and inorganic growth. KBCM was selected based on its decades-long relationship with BDI, commitment to identifying attractive partnerships for founder- and family-owned businesses, industry-leading specialty distribution investment banking practice, access to like-minded potential investors, and proven M&A execution capabilities.

BDI is a leading distributor of bearings, power transmission and fluid power products, and related industrial solutions, serving a broad and diversified customer base across end markets in 11 countries. Led by its CEO, Carl James, BDI is headquartered in Cleveland, Ohio, with over 205 locations globally. The Company has built a strong reputation for technical expertise, deep supplier relationships, and a solutions-and-productivity service model that has made it a trusted partner to its customers.

Kelso is a North American-focused middle-market private equity firm founded on the principles of partnership and alignment of interest championed by Louis Kelso, the inventor of the Employee Stock Ownership Plan (ESOP). Kelso’s unique history drives a deep commitment to aligning the interests between the firm’s partners, management teams, strategic partners, and limited partners. Since 1980, Kelso has invested approximately $20 billion of equity capital in over 140 transactions. Kelso benefits from a successful investment track record, deep sector expertise, long-tenured investment team, and reputation as a preferred partner to management teams and corporates.

The transaction includes a $16,545,000 ($72,566/unit) non-recourse, first mortgage loan secured by a 228-unit affordable housing apartment complex known as VIA, located in Albuquerque, New Mexico. VIA was originally built in 1974. The subject improvements consist of 17 two-story residential buildings, one clubhouse building and one maintenance building, situated on 12.78 acres of land. The property will be rent- and income-restricted under the LIHTC, in which 102 units are restricted to 60% AMI. The proposed loan will be used to refinance the existing debt on the property. The loan is structured with a seven-year term, and subsequent to a four-year interest-only period, amortizes on a 30-year schedule.

The transaction includes a $44,951,000 ($138,737/unit) non-recourse, first mortgage loan secured by a 324-unit, garden-style apartment complex known as Pointe Grand Byron, located in Byron, Georgia. Pointe Grand Byron was built in 2024 and consists of 10 three-story apartment buildings. The property offers two-bedroom units of 1,170 square feet, located on 20.05 acres of land. The loan will be used for refinancing the existing debt of the property. The loan is structured with a seven-year term, and subsequent to a four-year interest-only period, amortizes on a 35-year schedule.

The transaction includes a $16,640,000 ($69,046/unit) non-recourse, first mortgage loan secured by a 241-unit affordable housing apartment complex known as Mont 44, located in Albuquerque, New Mexico. Mont 44, was originally built in 1973. The subject improvements consist of 24 two-three story residential buildings, one clubhouse building and one pool shed building, situated on 16.39 acres of land. The property will be rent- and income-restricted under the LIHTC, in which 110 units are restricted to 60% AMI. The proposed loan will be used to refinance the existing debt on the property. The loan is structured with a seven-year term, and subsequent to a four-year interest-only period, amortizes on a 30-year schedule.

The transaction includes a $15 million ($70,422/unit) non-recourse, first mortgage loan secured by a 213-unitpad MHC known as Lithia Springs Estates, located in Lithia Springs, Georgia. Lithia Springs Estates was built in 1972 and consists of eight Park Owned Homes (“POHs”) and 35 POH units that have a Lease w/ Purchase Option (“LPO”), which equates to 20.18% of the total available pads, located on 45 acres of land. The proposed loan will be used for refinancing the existing debt of the property. The loan is structured with a five-year term, and subsequent to a two-year interest-only period, amortizes on a 30-year schedule.

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.