This paper by the Federal Reserve Board examines the flexibility of debt modification using FR Y-14Q regulatory data on C&I loans. The study finds that loan-level modifications of key contractual terms, such as interest and maturity, occur at least once for 41% of loans. Cross-sectional differences in modifications are substantial and amplified by borrower distress. Relative to single-lender loans, syndicated loans are 1.5 times more likely to be modified and interest rate changes are twice as likely. The findings call into question whether credit dispersion makes loan modifications more challenging and relationship lending between banks and small borrowers can be a barrier to loan modification.