Effingham, Ill.-based dental service organization (DSO) Heartland Dental Care LLC's leverage remains very high, and we expect the company will continue to pursue aggressive expansion plans. We are lowering our corporate credit and senior secured first-lien debt ratings on Heartland Dental Care LLC to 'B-' from 'B'. The outlook is stable. We are also lowering our senior secured second-lien debt rating on the company to 'CCC' from 'CCC+'. The stable outlook reflects our view that while Heartland's debt leverage remains high, at over 8x, and the company continues to aggressively pursue de novo growth, margins and free cash flows have been steady to slightly improving. On Nov. 30, 2015, Standard&Poor's Ratings Services lowered its corporate credit rating on
