...- On March 16, 2020, the American Dental Association recommended that dentists delay elective procedures in light of the COVID-19 pandemic. - In addition, several states are encouraging people to stay at home to slow the spread of the virus. Consequently, we expect dental clinics will suffer sharp near-term revenue and profit losses due to the decline in patient traffic because we consider most dental procedures to be elective. - Despite Heartland Dental LLC's improved financial metrics in 2019, leverage remains high at 12x as of Dec. 31, 2019. We expect that lower patient traffic will lead to temporary increases in leverage in 2020 and an acceleration in cash burn, resulting in a capital structure that we do not believe is sustainable over the long term. - We are lowering our issuer credit rating on Heartland to '###+' from 'B-'. At the same time, we are lowering our rating on its first-lien debt to '###+' from 'B-' and our rating on its second-lien debt to '###-' from '###' to reflect...
