While Pluto Acquisition I Inc. (AccentCare) has slowly improved operating performance, it does not yet generate positive free cash flow and faces debt maturities in 2026. The company proposed a debt restructuring that we view as distressed under our criteria, as first- and second-lien term loan lenders will receive less than originally promised. As a result, we lowered our issuer credit rating on Pluto to 'CC' from 'B-'. We also lowered the issue-level rating on the first-lien term loan to 'CC' from 'B-'. Our 'B-' rating on the revolving credit facility is unchanged. We do not rate Pluto's second-lien term loan. The negative outlook reflects our expectation that upon completion of the exchanges, we will lower the issuer credit rating