U.S. Renal Care Working With Barclays for Potential HY Bond Deal to Refinance Debt

U.S Renal Care is seeking to refinance its existing debt through a potential high-yield bond deal via Barclays, according to sources.

The offering would be a high-yield bond split between first lien and second lien to refinance the company’s 10.625% first lien 2028 notes and its 2028 term loan B, according to sources.

In May, Octus reported that the company was weighing refinancing its debt in either the broadly syndicated or private credit market on the back of strong financial performance.

U.S. Renal Care is the largest provider of in-center and home dialysis services in the United States, according to its website. The company is backed by Bain Capital, Summit Partners, and Revelstoke Capital Partners.

The company’s first-quarter 2026 adjusted EBITDA rose 10.5% year over year to $63 million, as reported. Total liquidity at the end of the quarter was $278 million, which included $151.6 million in cash. Total debt stood at $1.96 billion, while gross leverage was 7x.

U.S. Renal Care holds a Caa1/B- corporate credit rating from Moody’s Ratings and S&P Global Ratings, respectively. In December 2025, Moody’s revised its outlook to stable and said U.S. Renal Care has “a stable business model with steady recurring revenue reflecting the essential nature of dialysis service providers.”

An investor familiar with the potential offering said that while they view the company as lower quality, the strong first-quarter financial performance and stable outlook from Moody’s provide an improved refinancing window.

The company restructured its debt in 2023 through an uptier transaction that also carved out an unrestricted subsidiary. A second investor said they expect the deal to collapse everything separated in the 2023 transaction back into a single entity, pulling the RemainCo and the unrestricted subsidiary’s separate term loan back together.

A refinancing would have to fold the UnSub back into the restricted group and consolidate the primed tiers at once, the investor added, noting that a clean refi of the RemainCo alone is not feasible.

Bain Capital has been very active this year in the healthcare sector. In February, Bain acquired Jazz Venture Partners-backed Arrive Health and PSG Equity-backed DoseSpot, which it combined to form a new healthcare technology organization, Octus reported. The new entity has since been named Interra Health, according to a press release from advisor TripleTree.

In May, Octus reported that Bain was nearing a deal to acquire Guided Practice Solutions, dba GPS Dental, from Main Post Partners for a high-single-digit EBITDA multiple.

Last month, Octus reported that Bain Capital Credit is leading a $750 million private credit facility to support a single-asset continuation vehicle for WindRose Health Investors-backed home health tech company Dragonfly Health.

Newly issued senior direct lending facilities to back leveraged financings in the healthcare sector compressed to an average of SOFR+522.5 bps in the second quarter of 2026 from SOFR+526.4 bps in the first quarter of 2026, according to Octus’ Private Credit dashboard.

The company’s $1.25 billion term loan due June 2028 was indicated today at 98.07/99.06, according to Solve. Its 10.625% 2028 notes were last quoted today at a price of 89 to yield 16.993%, according to MarketAxess.

Americas Covenants published an analysis of U.S. Renal Care last November.

Barclays and Bain Capital declined to comment. U.S. Renal Care and Summit Partners did not respond to requests for comment.