The following hospital and health system rating and outlook changes and affirmations have taken place in the last month.
1. S&P downgrades rating on St. John Health System's bonds to 'AA-'
S&P Global Ratings downgraded the long-term rating on Tulsa, Okla.-based St. John Health System's series 2012 and series 2007 bonds to "AA-" from "AA."
2. Moody's affirms 'Baa1' rating on Mountain States Health Alliance's debt
Moody's Investors Service affirmed the "Baa1" rating on Johnson City, Tenn.-based Mountain States Health Alliance's $448 million of outstanding rated debt.
3. S&P assigned an 'A+' rating to Hackensack Meridian Health's bonds
S&P Global Ratings assigned an "A+" long-term rating on Neptune, N.J.-based Hackensack Meridian Health's $620 million of series 2017A tax-exempt revenue bonds and $300 million of series 2017 taxable revenue bonds.
4. Moody's affirms 'A1' rating on MidMichigan Health's bonds
Moody's Investors Service affirmed the "A1" rating on Midland-based MidMichigan Health's $168.9 million of outstanding bonds.
5. Moody's affirms 'A1' rating on Novant Health's bonds
Moody's Investors Service affirmed the "A1" rating on Winston-Salem, N.C.-based Novant Health's bonds, affecting approximately $800 million of rated debt.
6. Moody's assigns 'A1' to Methodist Le Bonheur Healthcare's bonds
Moody's Investors Service assigned an "A1" rating to Memphis, Tenn.-based Methodist Le Bonheur Healthcare's proposed $138 million of series 2017A tax-exempt, fixed-rate revenue bonds.
7. Fitch assigns 'AA-' rating to Allina Health System's bonds
Fitch Ratings assigned an "AA-" rating to Minneapolis-based Allina Health System's bonds.
8. Fitch upgrades rating for Catholic Health Services of Long Island's bonds to 'A-'
Fitch Ratings upgraded the rating on New York-based Catholic Health Services of Long Island's bonds to "A-" from "BBB-."
9. Fitch places DeKalb Medical Center's certificates on Rating Watch Negative
Fitch Ratings placed Decatur, Ga.-based DeKalb Medical Center's "BBB-" rated $177.6 million of series 2010 revenue anticipation certificates on Rating Watch Negative.
10. S&P raises rating on Rogers Memorial Hospital to 'A-'
S&P Global Ratings raised the long-term rating on Oconomowoc, Wis.-based Rogers Memorial Hospital's series 2014A and 2014B bonds to "A-" from "BBB+."
11. S&P assigns 'AA-' rating to Allina Health System's bonds
S&P Global Ratings assigned an "AA-" long-term rating to Minneapolis-based Allina Health System's series 2017 taxable revenue bonds and series 2017A tax-exempt revenue refunding bonds.
12. Moody's downgrades rating on CHI's debt to 'Baa1'
Moody's Investors Service downgraded the long-term debt rating on Englewood, Colo.-based Catholic Health Initiatives to "Baa1" from "A3" and downgraded CHI's variable-rate demand bonds backed by self-liquidity to "Baa1/VMIG2" from "A3/VMIG2," affecting approximately $5.7 billion of rated debt.
13. Moody's affirms 'A3' rating on Torrance Memorial Medical Center's bonds
Moody's Investors Service affirmed the "A3" rating on Torrance (Calif.) Memorial Medical Center's revenue bonds, affecting approximately $235 million of rated debt.
14. Moody's assigns 'Aa3' rating to Allina Health System's bonds
Moody's Investors Service assigned an "Aa3" rating to Minneapolis-based Allina Health System's proposed $150 million of series 2017 fixed-rate taxable bonds and $76 million of proposed series 2017A fixed-rate healthcare system revenue refunding bonds.
15. Moody's withdraws rating on Edward-Elmhurst Healthcare's bonds
Moody's Investors Service withdrew the "A2" rating on Naperville, Ill.-based Edward-Elmhurst Healthcare's debt.
16. Moody's downgrades Peninsula Regional Medical Center's rating to 'A3'
Moody's Investors Service downgraded the rating on Salisbury, Md.-based Peninsula Regional Medical Center's revenue bonds to "A3" from "A2," affecting $124 million of outstanding revenue bonds.
17. Moody's withdraws rating on Conway Medical Center's bonds
Moody's Investors Service withdrew its ratings on Conway (S.C.) Medical Center's series 2011A and 2011B bonds.
18. Fitch affirms 'A+' rating on Palomar Health's bonds
Fitch Ratings affirmed the "A+" rating on Escondido, Calif.-based Palomar Health's bonds. The bonds were also placed on rating watch evolving.
19. Fitch affirms 'A' rating on Dignity Health's debt
Fitch Ratings affirmed the "A" rating on Sacramento, Calif.-based Dignity Health's approximately $3.3 billion of outstanding debt.
20. S&P assigns 'AA-' rating to Methodist Le Bonheur Healthcare & Affiliates' bonds
S&P Global Ratings assigned an "AA-" rating to Memphis, Tenn.-based Methodist Le Bonheur Healthcare & Affiliates' series 2017 revenue bonds.
21. Moody's affirms 'A2' rating on Lee Memorial Health System's bonds
Moody's Investors Service affirmed the "A2" rating on Fort Myers, Fla.-based Lee Memorial Health System's $307 million of outstanding bonds.
22. S&P affirms 'BBB' rating on Jackson Hospital & Clinic's bonds, revises outlook to negative
S&P Global Ratings revised Montgomery, Ala.-based Jackson Hospital & Clinic's outlook to negative from stable.
23.Moody's assigns 'A1' rating to Medical University of South Carolina's bonds
Moody's Investors Service assigned an "A1" rating to Charleston-based Medical University of South Carolina's proposed $24 million of series 2017 revenue refunding bonds.
24. Moody's affirms 'Aa2' rating on Monongahela Valley Health System's LOC-backed bonds
Moody's Investors Service affirmed the "Aa2" long-term joint support letter of credit backed rating on Monongahela (Pa.) Valley Health System's series 2011A and series 2011B hospital revenue bonds.
25. Moody's assigns 'Baa1' rating to Washington Township Health Care District's bonds
Moody's Investors Service assigned a "Baa1" rating to Fremont, Calif.-based Washington Township Health Care District's $36.4 million of series 2017A fixed-rate revenue bonds.
26. Moody's affirms 'Aa3' rating on Virginia Commonwealth University Health System's bonds
Moody's Investors Service affirmed the "Aa3" rating on Richmond-based Virginia Commonwealth University Health System's bonds, affecting approximately $315 million of rated debt.
27. Fitch affirms 'B' rating on Snohomish County Public Hospital District No. 1's bonds
Fitch Ratings affirmed the "B" rating on Monroe, Wash.-based Snohomish County Public Hospital District No. 1's $1.5 million of series 2004 limited tax general obligation bonds.
28. Fitch affirms 'AA-' rating on Sarasota County Public Hospital District's bonds
Fitch Ratings removed Sarasota (Fla.) County Public Hospital District from rating watch evolving and affirmed the "AA-" ratings on the hospital district's $78.9 million of series 2009A fixed-rate hospital revenue bonds.
29. Moody's downgrades ProMedica Health System's rating to 'A1'
Moody's Investors Service downgraded the rating on Toledo, Ohio-based ProMedica Health System to "A1" from "Aa3," affecting approximately $775 million of debt.
30. Fitch affirms 'BBB' rating on Martin County Hospital District's bonds
Fitch Ratings affirmed the "BBB" rating on Stanton, Texas-based Martin County Hospital District's $19.5 million of series 2011A and series 2011B combination limited tax and revenue bonds.
31. Fitch affirms 'AA-/F1+' on MemorialCare Health System's bonds
Fitch Ratings affirmed the "AA-/F1+" rating on Fountain Valley, Calif.-based MemorialCare Health System's outstanding debt.
32. S&P raises rating on Baptist Health's bonds to 'AA'
S&P Global Ratings upgraded the rating on Jacksonville, Fla.-based Baptist Health's series 2007A tax-exempt hospital revenue bonds to "AA" from "AA-."
33. Moody's affirms 'Baa2' rating on Jupiter Medical Center's bonds
Moody's Investors Service affirmed the "Baa2" rating on Jupiter (Fla.) Medical Center's series 2013A bonds, affecting $40.1 million of debt.
34. Moody's affirms 'Aa3' rating on Mercy Health's bonds
Moody's Investors Service affirmed the "Aa3" rating on St. Louis-based Mercy Health's $872 million of outstanding fixed-rate and auction-rate revenue bonds.
35. Fitch upgrades Karnes County Hospital District's rating, removes ratings watch evolving
Fitch Ratings upgraded the rating on Kenedy, Texas-based Karnes County Hospital District's $46 million of series 2014 hospital revenue bonds to "A" from "BBB" and removed the hospital district from ratings watch evolving.
36. Fitch downgrades Dallas County Hospital District's rating to 'AA'
Fitch Ratings downgraded the rating on Dallas (Texas) County Hospital District's bonds to "AA" from "AA+."
37. S&P affirms 'CCC' rating on Verity Health System's bonds, revises outlook to positive
S&P Global Ratings affirmed the "CCC" rating on Redwood City, Calif.-based Verity Health System's $273 million of series 2005A, 2005F, 3005G and 2005H fixed-rate bonds.
38. Fitch assigns 'AA' rating to Seattle Children's Hospital's bonds
Fitch Ratings assigned an "AA" rating to Seattle Children's Hospital's $114 million of series 2017A fixed-rate revenue bonds, which are expected to price the week of March 13. The bonds will provide approximately $125 million for future capital expenditures.
39. Moody's assigns 'Aa2' rating to Seattle Children's Healthcare System's bonds
Moody's Investors Service assigned an "Aa2" rating to Seattle Children's Healthcare System's proposed $114 million of series 2017A fixed-rate revenue bonds.
40. Moody's downgrades rating on Monongahela Valley Hospital bonds to 'Ba1'
Moody's Investors Service downgraded the underlying rating assigned to Monongahela (Pa.) Valley Hospital's series 2011A and 2011B variable-rate demand bonds to "Ba1" from "Baa2," affecting approximately $23.7 million of rated debt.
41. Moody's assigns 'A1' rating to El Camino Hospital's bonds
Moody's Investors Service assigned an "A1" rating to Mountain View, Calif.-based El Camino Hospital's proposed $286 million of series 2017 fixed-rate revenue bonds and maintained the "A1" rating on ECH's parity revenue bonds.
42. S&P raises rating on University of Wisconsin Hospitals and Clinics Authority's bonds to 'AA-'
S&P Global Ratings raised the long-term rating to "AA-" from "A+" on Madison-based University of Wisconsin Hospitals and Clinics Authority's series 2013 healthcare revenue bonds.
43. S&P assigns 'A+' rating to TriHealth's bonds
S&P Global Ratings assigned an "A+" long-term rating to Cincinnati-based TriHealth's $300 million of series 2017A hospital facilities revenue bonds.
44. Fitch affirms 'BB+' rating on Beatrice Community Hospital & Health Center's bonds
Fitch Ratings affirmed the "BB+" rating on Beatrice (Neb.) Community Hospital & Health Center's $30 million of series 2010B healthcare facilities revenue bonds.
45. Fitch affirms 'BBB+' rating on Jupiter Medical Center's bonds
Fitch Ratings affirmed the "BBB+" rating on Jupiter (Fla.) Medical Center's $43.6 million of series 2013A bonds.
46. Moody's affirms '#Aaa' rating to CentraCare Health System's bonds
Moody's Investors Service assigned an "#Aaa" rating to St. Cloud, Minn.-based CentraCare Health System's series 2010A revenue bonds.
47. Moody's affirms 'Baa2' rating on Aspen Valley Hospital District's bonds
Moody's Investors Service affirmed the "Baa2" rating on Aspen (Colo.) Valley Hospital District's $10 million of outstanding bonds.
48. S&P affirms 'A' rating on Dignity Health's bonds, outlook remains negative
S&P Global Ratings affirmed the "A" long-term rating on several of San Francisco-based Dignity Health's tax-exempt and taxable bonds.
49. S&P revises Memorial Hospital and Health Center's outlook to negative
S&P Global Ratings revised Jasper, Ind.-based Memorial Hospital and Health Center's outlook to negative from stable.
50. Moody's revises Integris Health's outlook to negative
Moody's Investors Service revised Oklahoma City-based Integris Health's outlook to negative from stable.
51. Fitch affirms 'AA-' rating on Lakeland Hospitals' bonds
Fitch Ratings affirmed the "AA-" long-term rating on St. Joseph, Mich.-based Lakeland Hospitals' bonds issued for the health system's Niles, Mich., and St. Joseph, Mich., locations.
52. S&P lowers rating to 'BBB+' on St. Anthony's Medical Center's bonds
S&P Global Ratings lowered the long-term rating to "BBB+" from "A-" on St. Louis-based St. Anthony's Medical Center's series 2015B bonds and lowered the medical center's issuer rating to "BBB+" from "A-."
53. S&P lowers CHI's bond rating, but expects financial performance to improve
S&P Global Ratings lowered its long-term and underlying ratings Wednesday on debt issued by and for Englewood, Colo.-based Catholic Health Initiatives to "BBB+" from "A-" and removed the ratings from CreditWatch with negative implications.
54. Moody's Investors Service affirms 'A1' rating on Huntsville Health Care Authority's bonds
Moody's Investors Service affirmed the "A1" long-term ratings and "P1" short-term ratings on Huntsville (Ala.) Health Care Authority's bonds and commercial paper program, affecting $160 million of rated debt.
55. Moody's affirms 'Baa2' rating on Pacific County Public Hospital District's debt
Moody's Investors Service affirmed the "Baa2" underlying rating on South Bend, Wash.-based Pacific County Public Hospital District's $1.9 million in outstanding general obligation bond debt.