The following hospital and health system rating and outlook changes and affirmations took place in the last month.
1. Moody's affirms 'A1' rating on Children's Hospital of Alabama's bonds
Moody's Investors Service affirmed the "A1" rating on Birmingham-based Children's Hospital of Alabama's revenue bonds, affecting $153 million of rated debt.
2. Fitch upgrades rating on Olmsted Medical Center's bonds to 'A'
Fitch Ratings upgraded the rating on Rochester, Minn.-based Olmsted Medical Center's $20.4 million of series 2010 healthcare facilities revenue bonds and $16.8 million of series 2013 healthcare facilities revenue bonds.
3. Fitch affirms 'BBB' rating on Parrish Medical Center's bonds
Fitch Ratings affirmed the "BBB" rating on Titusville, Fla.-based Parrish Medical Center's $29.6 million of series 2008 revenue refunding bonds and removed the medical center from rating watch evolving.
4. Moody's assigns 'Aa2' rating to Geisinger Health System's bonds
Moody's Investors Service assigned an "Aa2" rating to Danville, Pa.-based Geisinger Health System's series 2017A fixed-rate bonds and series 2017B index floating-rate bonds.
5. S&P assigns 'A+' rating to SSM Health's bonds
S&P Global Ratings assigned an "A+" long-term rating to St. Louis-based SSM Health's $500 million of series 2017A taxable fixed-rate revenue bonds.
6. Fitch assigns 'AA-' rating to SSM Health's bonds
Fitch Ratings assigned an "AA-" rating to St. Louis-based SSM Health's $500 million of series 2017A taxable revenue bonds.
7. Fitch affirms 'AA' rating on Scripps Health's outstanding debt
Fitch Ratings affirmed the "AA" long-term rating on San Diego-based Scripps Health's outstanding debt.
8. Fitch affirms 'BB+' rating on Wise Health System's bonds
Fitch Ratings affirmed the "BB+" rating on Decatur, Texas-based Wise Health System's $93.7 million of series 2014A revenue bonds.
9. Moody's assigns 'Ba1' rating to Gainesville Hospital District's bonds
Moody's Investors Service assigned a "Ba1" rating to Gainesville (Texas) Hospital District's $19.54 million of series 2017 limited tax refunding bonds.
10. Moody's affirms 'A2' rating on Bellin Health System's debt
Moody's Investors Service affirmed the "A2" rating on Green Bay, Wis.-based Bellin Health System's approximately $57 million of rated debt issued for Bellin Hospital Green Bay (Wis.).
11. Fitch downgrades Owensboro Health's debt to 'BBB'
Fitch Ratings downgraded the rating on Owensboro (Ky.) Health's $575.7 million in outstanding debt to "BBB" from "BBB+."
12. Fitch affirms 'BB+' rating on Loma Linda University Medical Center's debt
Fitch Ratings affirmed the "BB+" rating on Loma Linda (Calif.) University Medical Center's approximately $1.7 billion of outstanding debt.
13. Moody's affirms 'A2' rating on Greater Baltimore Medical Center's bonds
Moody's Investors Service affirmed the "A2" and "A2/VMIG1" ratings on Greater Baltimore Medical Center's $30.6 million of outstanding revenue bonds.
14. Moody's affirms 'Ba1' rating on Saint Peter's University Hospital's debt
Moody's Investors Service affirmed the "Ba1" rating on New Brunswick, N.J.-based Saint Peter's University Hospital's $149 million of outstanding debt.
15. Moody's affirms 'Aa3' rating on Baylor Scott & White Health's bonds
Moody's Investors Service affirmed the "Aa3" long-term rating and the "Aa3/P-1" short-term rating on Dallas-based Baylor Scott & White Health's bonds, affecting $2.1 billion of debt.
16. S&P assigns 'AA-' rating to Kansas Hospital Authority's bonds
S&P Global Ratings assigned an "AA-" rating to Kansas City-based Kansas Hospital Authority's $198.78 million of series 2017A health facilities improvement revenue bonds.
17. Fitch affirms 'BBB+' rating on Valley Medical Center's bonds
Fitch Ratings affirmed the "BBB+" rating on Renton, Wash.-based Valley Medical Center's outstanding revenue bonds and removed the bonds from rating watch evolving.
18. Fitch places Meridian Health System's bonds on rating watch positive
Fitch Ratings placed the "A+" rating on Neptune, N.J.-based Meridian Health System's bonds on rating watch positive.
19. Fitch upgrades rating on Children's Hospital Medical Center of Akron to 'AA-'
Fitch Ratings upgraded the rating to "AA-" from "A+" on Children's Hospital Medical Center of Akron (Ohio)'s bonds.
20. S&P downgrades rating on Covenant Health's bonds to 'BBB+'
S&P Global Ratings lowered the rating on Tewksbury, Mass.-based Covenant Health's bonds to "BBB+" from "A-."
21. S&P assigns 'AA-' rating to Kaiser Permanente's bonds
S&P Global Ratings assigned an "AA-" long-term rating to Oakland, Calif.-based Kaiser Permanente's $1.5 billion series A-1 and series A-2 fixed-rate tax-exempt bonds and its $500 million of series 2017B-E floating-rate notes.
22. Moody's affirms 'A3' rating on Vanderbilt University Medical Center's bonds
Moody's Investors Service affirmed the "A3" rating on Nashville, Tenn.-based Vanderbilt University Medical Center's approximately $926 million of outstanding bonds.
23. S&P downgrades rating on MetroHealth System's bonds to 'BBB-'
S&P Global Ratings downgraded the long-term rating on Cleveland-based MetroHealth System's series 2009B taxable hospital revenue bonds to "BBB-" from "A-."
24. S&P assigns 'AA' rating to Presbyterian Health Services' bonds
S&P Global Ratings assigned an "AA" long-term rating to Albuquerque, N.M.-based Presbyterian Health Services' $236.82 million of series 2017A fixed-rate revenue bonds and $65.66 million of series 2017B taxable fixed-rate bonds.
25. Moody's assigns 'A3' rating to Ochsner Clinic Foundation's bonds
Moody's Investors Service assigned an "A3" rating to New Orleans-based Ochsner Clinic Foundation's $408.4 million of series 2017 revenue and refunding revenue bonds.
26. Moody's assigns 'Baa1' rating to Maple Grove Hospital's bonds
Moody's Investors Service assigned a "Baa1" rating to Maple Grove (Minn.) Hospital's proposed $120 million of series 2017 fixed-rate revenue refunding bonds.