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U.S. Not-For-Profit Health Care Rating Actions, February 2024

S&P Global Ratings maintained 23 ratings without revising the outlooks, took one positive rating action, and two negative rating actions in February. In addition, we revised one outlook favorably, and revised one outlook unfavorably, both without changing the ratings in the U.S. not-for-profit health care sector.

There were seven new debt issuances in the month, two of which were new issuers with an initially assigned rating.

The five rating actions and outlook revisions consisted of the following:

  • One upgrade on a stand-alone hospital in the 'AA' category due to sustained financial stability;
  • Two downgrades; with a system moving into the 'A' rating category, and a stand-alone hospital moving into the 'BBB' rating category;
  • One outlook revised to stable from negative on a stand-alone hospital; and
  • One outlook revised to negative from stable on a stand-alone hospital.

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February 2024, U.S. not-for-profit health care rating actions
State Rating Outlook Entity Type Action Description

Allina Health System

MN A+ Stable System Downgrade Operational losses with weakened balance sheet metrics

Bayhealth Medical Center

DE AA- Stable Stand-alone Maintained Credit quality consistent with existing rating

Blue Ridge Healthcare System

NC A Stable Stand-alone Maintained Credit quality consistent with existing rating

Boulder Community Health

CO A- Stable Stand-alone Maintained Credit quality consistent with existing rating

Children's Hospital of Orange County

CA AA- Stable Stand-alone Maintained; New sale Credit quality consistent with existing rating

City of Hope

CA A Negative System Maintained; New sale Credit quality consistent with existing rating

CommonSpirit Health

CO A- Stable System Maintained; New sale Credit quality consistent with existing rating

Cook Children's Medical Center

TX AA Stable Stand-alone Maintained Credit quality consistent with existing rating

Cooper Health System

NJ A Positive Stand-alone Rating initially assigned; new sale Rating initially assigned based on sturdy operating margins and volume growth through strategic partnerships

Dallas County Hospital District

TX AA Stable Stand-alone Upgrade Sustained financial stability growth with improved debt position and revenue diversity

Ector County Hospital District

TX BBB- Stable Stand-alone Maintained Credit quality consistent with existing rating

Elwyn

PA BB+ Stable Human service provider Maintained Credit quality consistent with existing rating

Fort Healthcare

WI A- Stable Stand-alone Maintained; New sale Credit quality consistent with existing rating

Greater Baltimore Medical Center

MD A Negative Stand-alone Maintained Credit quality consistent with existing rating

Griffin Health Services

CT BB+ Stable Stand-alone Maintained Credit quality consistent with existing rating

Lawrence Memorial Hospital

KS BBB+ Stable Stand-alone Downgrade Weakening financial profile from ongoing losses and weak DCOH

Long Island Community Hospital

NY A Stable System Maintained Credit quality consistent with existing rating based on a subordinate guarantee from NYU Langone Hospitals

Madonna Rehabilitation Hospital

NE A- Negative Stand-alone Unfavorable outlook revision Uneven operating performance and declining days' cash on hand

Margaret Mary Health

IN BBB- Stable Stand-alone Rating initially assigned; new sale Rating initially assigned based on trend of positive performance, dominant market position and healthy payer mix

MedStar Health

MD A Stable System Maintained Credit quality consistent with existing rating

NYU Langone Hospitals

NY A+ Stable System Maintained Credit quality consistent with existing rating

Riverside Health System

IL A+ Stable Stand-alone Maintained Credit quality consistent with existing rating

Rogers Memorial Hospital

WI A Stable Stand-alone Maintained Credit quality consistent with existing rating

Saint Francis Regional Medical Center

MN A- Stable Stand-alone Maintained Credit quality consistent with existing rating

Saint Lukes University Health Network

PA A- Stable System Maintained; New sale Credit quality consistent with existing rating

St Luke's Health System

ID A Stable System Maintained Credit quality consistent with existing rating

St. Charles Health System

OR A Stable Stand-alone Favorable outlook revision Strong operational rebound and solid days' cash on hand

TidalHealth

MD A Negative Stand-alone Maintained Credit quality consistent with existing rating

University of Colorado Hospital Authority

CO AA Stable System Maintained Credit quality consistent with existing rating

Virginia Mason Medical Center

WA BBB+ Stable System Maintained Credit quality consistent with existing rating; Credit rating and action is based on Group Rating Methodology criteria with CommonSpirit Health.

This report does not constitute a rating action.

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blake.fundingsland@spglobal.com
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cynthia.keller@spglobal.com
Suzie R Desai, Chicago + 1 (312) 233 7046;
suzie.desai@spglobal.com
Amy He, New York +1 2124380381;
amy.he@spglobal.com

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