...The 'A-' rating is supported by Givens Estate's (Givens) high independent living (IL) occupancy, strong overall demand indicators (including for assisted living and skilled nursing) in a favorable market, robust levels of unrestricted cash and investments, and sound operations across both of its communities, Givens Estates and Givens Highland Farms (GHF). The Negative Outlook reflects the potential effect on Givens's financial profile of an additional debt issuance expected in the next nine to 12 months in support of a sizable IL expansion and healthcare project, including new and expanded health care centers at both campuses. GHF currently does not offer assisted living (AL) on the campus and the project would be adding that service line at GHF. The projects areN expected to be funded with new debt, initial entrance fees, and cash flow. Both projects remain subject to final approvals and permits, including from local agencies. Fitch's forward look shows Givens with some debt capacity...