New York–based ASP NAPA Intermediate Holdings LLC (ASP NAPA)is consolidating American Anesthesiology (previously acquired by ASP NAPA in May 2020 from Mednax Inc.) into its existing anesthesia operations and proposing to refinance its existing debt. The consolidation and integration of the previously separate businesses and the refinancing will improve its scale, diversify customer and geographic mix, and address the near-term debt maturities. The proposed refinancing includes a new $610 million first-lien term loan to refinance $555 million in existing debt (includes a $20 million revolving credit facility, $313 million first-lien term loan outstanding on legacy ASP NAPA, and $76 million asset-based loan outstanding on American Anesthesiology), pay $15 million in transaction fees, and infuse some cash onto the balance sheet.