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U.S. Not-For-Profit Health Care Rating Actions, May 2021

S&P Global Ratings affirmed 30 ratings without revising the outlooks and took five rating actions in the U.S. not-for-profit health care sector in May 2021. There were five new sales in May. The five rating and outlook actions were comprised of the following:

  • Two downgrades (includes one hospital that was downgraded and then also immediately placed on CreditWatch with negative implications);
  • Two favorable outlook revisions (to stable from negative); and
  • One unfavorable outlook revision (to negative from stable).

The table below summarizes S&P Global Ratings' monthly bond rating actions for U.S. not-for-profit health care providers in May. We based the credit rating affirmations and rating actions on several factors within enterprise and financial profiles, including business position, utilization, financial performance, debt levels, bond-issuance activity, physician relationships, and the external regulatory and reimbursement environment. This also incorporates our negative sector outlook and related assessment of COVID-19 and associated operating pressures connected to uneven volumes and higher expenses, particularly labor and staffing.

May 2021 Not-For-Profit Health Care Ratings Actions
State Rating Outlook Action Description
Hospitals

Bibb County Healthcare Authority

AL BB Stable Rating maintained; outlook revised from negative Robust financial performance and balance sheet improvement

Children's Hospital of Alabama

AL AA- Stable Rating maintained Credit quality consistent with existing rating

City of Hope

CA A+ Stable Rating maintained Credit quality consistent with existing rating

Cottage Health

CA AA- Stable Rating maintained Credit quality consistent with existing rating

FirstHealth of the Carolinas

NC AA- Stable Rating maintained Credit quality consistent with existing rating

Lawrence General Hospital

MA B- Not meaningful Rating lowered from 'B'; rating placed on CreditWatch with negative implications Weakened liquidity position

Lawrence Memorial Hospital

KS A Stable Rating maintained Credit quality consistent with existing rating

Madison Memorial Hospital

ID BB+ Stable Rating maintained; outlook revised from negative Expected operating margin improvement and solid liquidity

Norman Regional Health System

OK A- Negative Rating maintained; outlook revised from stable Weaker-than-expected financial performance and balance sheet deterioration

OU Medicine

OK BB+ Stable Rating maintained Credit quality consistent with existing rating

Reid Health

IN A- Stable Rating maintained Credit quality consistent with existing rating

Self Regional Healthcare

SC A+ Stable New sale; rating maintained Credit quality consistent with existing rating

Winona Health Services

MN BBB Stable Rating maintained Credit quality consistent with existing rating

Woman's Hospital Foundation

LA A Stable Rating maintained Credit quality consistent with existing rating
Health systems

Allegheny Health Network

PA A Stable Rating maintained Credit quality consistent with existing rating

Atrium Health

NC AA- Stable New sale; rating maintained Credit quality consistent with existing rating

Carilion Clinic

VA AA- Stable Rating maintained Credit quality consistent with existing rating

Christiana Care Health System

DE AA+ Stable Rating maintained Credit quality consistent with existing rating

Guthrie Clinic

PA A Stable Rating lowered from 'A+'; previous outlook negative Persistent operating losses

Health First

FL A Stable Rating maintained Credit quality consistent with existing rating

Kaiser Foundation Hospitals (Kaiser Permanente)

CA AA- Stable New sale; rating maintained Credit quality consistent with existing rating

Memorial Health System

IL AA- Stable Rating maintained Credit quality consistent with existing rating

Nebraska Methodist Health System

NE A Stable Rating maintained Credit quality consistent with existing rating

Northwestern Memorial HealthCare

IL AA+ Stable Rating maintained Credit quality consistent with existing rating

OhioHealth

OH AA+ Stable Rating maintained Credit quality consistent with existing rating

OSF Healthcare System

IL A Stable Rating maintained Credit quality consistent with existing rating

Piedmont Healthcare Inc.

GA AA- Stable Rating maintained Credit quality consistent with existing rating

TriHealth

OH A+ Stable New sale; rating maintained Credit quality consistent with existing rating

University of Kansas Health System

KS AA- Stable Rating maintained Credit quality consistent with existing rating

University of Vermont Medical Center

VT A Stable Rating maintained Credit quality consistent with existing rating

Wake Forest Baptist Medical Center

NC AA- Stable Rating maintained Credit quality consistent with existing rating
Long-term care and human service providers

Anderson Center for Autism

NY BB+ Stable Rating maintained Credit quality consistent with existing rating

Concordia Lutheran Ministries

PA AA- Stable Rating maintained Credit quality consistent with existing rating

Noland Health Services

AL A Stable Rating maintained Credit quality consistent with existing rating

Westhills Village Retirement Community

SD A+ Stable New sale; rating maintained Credit quality consistent with existing rating

Related Research

This report does not constitute a rating action.

Primary Credit Analyst:Alexander Nolan, Centennial + 1 (303) 721 4501;
alexander.nolan@spglobal.com
Secondary Contacts:Cynthia S Keller, New York + 1 (212) 438 2035;
cynthia.keller@spglobal.com
Suzie R Desai, Chicago + 1 (312) 233 7046;
suzie.desai@spglobal.com

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