Dallas-based home health, personal care, and hospice service provider Pluto Acquisition I Inc. (doing business as AccentCare Inc.) has been underperforming, most notably with still-sizeable cash flow deficits. While we expect operating initiatives will drive modest revenue growth and margin expansion, the underperformance heightens the risk it will be more difficult to achieve sufficient cash flow improvement to meet the additional $43 million cash interest expense following the December 2025 conversion of a payment-in-kind (PIK) obligation to cash pay. Nevertheless, the company currently has sufficient liquidity to cover projected cash shortfalls over the next two years, giving AccentCare some runway to improve operations, increase margins, and achieve positive discretionary free cash flow. As a result, we affirmed all ratings, including
