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COMMENTS

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

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

S&P Global Ratings affirmed 17 ratings without revising the outlooks and took 12 rating actions in the U.S. not-for-profit health care sector in August 2021. There were 11 new sales in August including ratings initially assigned to AtlantiCare Health System, N.J. and St. Lukes Hospital of Duluth, Minn. We also assigned an issuer credit rating to Antelope Valley Hospital, Calif. The 12 rating and outlook actions were comprised of the following:

  • Three stand-alone hospital downgrades all into speculative grade;
  • Two upgrades, including one stand-alone hospital and one health system;
  • Five favorable outlook revisions (four to stable from negative and one to positive from stable); and
  • Two unfavorable outlook revisions (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 August. 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 stable sector view and our assessment of COVID-19, economic developments, and market volatility.

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

AnMed Health

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

Antelope Valley Hospital

CA BBB Stable Rating initially assigned Rating initially assigned

AtlantiCare Health System

NJ AA- Stable New sale; rating initially assigned Rating initially assigned

Bayhealth Medical Center

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

Bellin Health

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

Covenant HealthCare System

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

Crawford County Hospital District

IL BBB Stable New sale; rating maintained Credit quality consistent with existing rating

Emanate Health

CA A Stable Rating maintained Credit quality consistent with existing rating

Good Shepherd Group

PA A- Negative New sale; rating maintained Credit quality consistent with existing rating

Greater Baltimore Medical Center

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

Jennie Stuart Medical Center

KY BBB- Stable Rating raised from 'BB+'; previous outlook stable Financial profile growth

Long Island Community Hospital

NY BBB- Positive Rating maintained; outlook revised from stable Affiliation agreement with NYULH (A)

Memorial Hospital of Sweetwater County

WY BB+ Stable Rating maintained; outlook revised from negative Improved balance sheet and sound MADS coverage

Mercy Health Services

MD BBB+ Stable Rating maintained Credit quality consistent with existing rating

Oroville Hospital

CA B+ Negative Rating lowered from 'BB'; previous outlook negative Financial profile deterioration and execution risks with a new hospital

Samaritan Medical Center

NY BB Stable Rating lowered from 'BBB-'; previous outlook negative Operating losses and balance sheet weakness

Southeast Georgia Health System

GA BBB+ Stable Rating maintained Credit quality consistent with existing rating

Southwest Louisiana Hospital Association

LA BB Stable Rating lowered from 'BB+'; previous outlook negative Elevated environmental risk and weak operating performance

St. Lukes Hospital of Duluth

MN BBB- Stable New sale; rating initially assigned Rating initially assigned

Stamford Hospital

CT BBB+ Stable New sale; rating maintained Credit quality consistent with existing rating

Southeastern Regional Medical Center

NC BBB+ Stable New sale; rating maintained Credit quality consistent with existing rating

TidalHealth Inc.

MD A Stable Rating maintained Credit quality consistent with existing rating

United Health Services Hospitals Inc.

NY BBB Negative Rating maintained; outlook revised from stable Balance sheet weakness and interim losses
Health systems

Infirmary Health System

AL A- Stable New sale; rating raised from 'BBB+'; previous outlook stable Financial profile improvement, balance sheet de-risking

Northeast Georgia Health System

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

Piedmont Healthcare Inc.

GA AA- Negative New sale; rating maintained; outlook revised from stable Additional debt and growing expense base

Sisters of Charity of Leavenworth Health System

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

SSM Health Care System

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

Wellforce

MA BBB+ Stable Rating maintained; outlook revised from negative Strong financial results and healthy investment returns
Long term care and human service providers

Elwyn

PA BB Stable Rating maintained; outlook revised from negative Trend of improving cash flow and balance sheet metrics

Front Porch Communities and Services

CA A- Stable New sale; rating maintained; outlook revised from negative Improved enterprise profile

Kendal at Oberlin

OH A Stable Rating maintained Credit quality consistent with existing rating
*This list excludes a new Issuer Credit Rating assigned to Covenant Health Systems in Massachusetts. Covenant also includes existing series debt based ratings that will be reviewed over the next several months.

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, Augusta + 1 (212) 438 2035;
cynthia.keller@spglobal.com
Suzie R Desai, Chicago + 1 (312) 233 7046;
suzie.desai@spglobal.com

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