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.
Chart 1
Chart 2
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.
Primary Credit Analyst: | Blake C Fundingsland, Englewood + 1 (303) 721 4703; blake.fundingsland@spglobal.com |
Secondary Contacts: | Cynthia S Keller, Augusta + 1 (212) 438 2035; 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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