France-based nursing homes operator Colisee Group accelerated its external growth strategy in first-quarter 2021, with nine acquisitions in France and Spain funded entirely by drawings under its revolving credit facility (RCF); its other debt (including mainly real estate debt) also increased to around €110 million as of end-March 2021 from €25 million in September 2020. The company is now proposing a €150 million add-on to its existing €875 million term loan to pay down its RCF. Although Colisee's operating performance was trending toward our base-case scenario, supported by gradual recovery of occupancy rates especially since March 2021, the recent increase in leverage reduces prospects for the S&P Global Ratings-adjusted debt-to-EBITDA ratio to fall below the 7x target by 2022. We