Multiple hospitals and health systems have suffered downgrades to their financial ratings this year amid rising expenses, ongoing operating losses and challenging work environments.
Here are 16 hospitals and health systems that received credit rating downgrades from Fitch Ratings or Moody’s Investors Service in 2026:
Boston Medical Center’s credit rating was downgraded to “Baa3” from “Baa2” by Moody’s. The downgrade reflects weak system-level liquidity, with days cash on hand expected to remain around 45 to 70 without meaningful state support, Moody’s said. Reliance on state payments, together with losses at its community hospitals and volatility at its WellSense health insurance arm, constrains the system’s ability to rebuild liquidity in the near term.
Children’s Hospital Los Angeles’ credit rating was downgraded to “Ba2” from “Ba1” by Moody’s. The downgrade reflects the system’s challenged operations and weak liquidity, driven by its heavy reliance on state funding due to its significant Medicaid exposure, Moody’s said.
Connecticut Children’s credit rating was downgraded to “A” from “A+” by Fitch. The Hartford-based system’s downgrade reflects an operating loss and weakened unrestricted liquidity in fiscal 2025, which ended Sept. 30, Fitch said.
Dana-Farber Cancer Institute’s credit rating was downgraded to “A2” from “A1” by Moody’s. The downgrade reflects a significant increase in leverage and the anticipation that a portion of the Boston-based cancer institute’s liquidity will be allocated toward capital expenditures for the construction of a new hospital tower, Moody’s said. Dana-Farber Cancer Institute and Beth Israel Deaconess Medical Center on April 7 began construction on an estimated $1.68 billion cancer hospital in Boston.
Emanate Health’s rating was downgraded to “A” from “A+” by Fitch. The downgrade reflects debt issuance and an operating loss in fiscal 2025 for the Covina, Calif.-based system, Fitch said. The slight operating loss in 2025 was driven by continued physician acquisitions and other growth investments.
Fairfield Medical Center’s credit rating was downgraded to “B1” from “Ba3” by Moody’s. The downgrade reflects the Lancaster, Ohio-based hospital’s challenging financial performance and headwinds to material improvement, Moody’s said. The hospital signed a definitive agreement in September to be acquired by Columbus-based OhioHealth. Moody’s did not incorporate the potential acquisition into the rating due to uncertainty around the lengthy regulatory approval process and the hospital’s credit deterioration.
Hannibal (Mo.) Regional Healthcare System’s rating was downgraded to “BB+” from “BBB-” by Fitch. The downgrade reflects the system’s persistently weak operating performance and declining liquidity despite funding from the Federal Emergency Management Agency, Fitch said.
HonorHealth’s credit rating was downgraded to “A” from “A+” by Fitch. The downgrade reflects the Scottsdale, Ariz.-based system’s higher-than-expected strategic spending and weaker operating results during the integration of assets it acquired from Dallas-based Steward Health Care in 2024, Fitch said.
John Fitzgibbon Memorial Hospital’s credit rating was downgraded to “D” from “C” by Fitch. The downgrade stems from the Marshall, Mo.-based hospital’s failure to make required debt payments. Fitch withdrew the hospital’s issuer and bond ratings following the payment default.
Mary Greeley Medical Center’s rating was downgraded to “A3” from “A2” by Moody’s. The downgrade is driven by the negative impact of the opening of an ASC joint venture between the hospital and an independent physician group, which will continue to significantly reduce hospital surgeries and materially impact operating revenue, Moody’s said.
MemorialCare’s credit rating was downgraded to “A+” from “AA-” by Fitch. The downgrade reflects the Fountain Valley, Calif.-based system’s weak operating performance over the past several years, Fitch said. In fiscal 2025, which ended June 30, the system reported an operating loss of nearly $170 million, compared to an operating loss of $75.6 million in fiscal 2024.
Naples (Fla.) Comprehensive Health’s credit rating was downgraded to “BBB+” from “A-” by Fitch and to “Baa1” from “A3” by Moody’s. The downgrades reflect slower-than-expected margin improvement. The system’s high leverage and ongoing capital needs also limit balance sheet flexibility, even with the system’s leading market position and strong philanthropy.
Parkview Health’s credit rating was downgraded to “A1” from “Aa3” by Moody’s. The Fort Wayne, Ind.-based system’s downgrade reflects a lower level of normalized operating performance and increasing capital spending that will likely require additional borrowing, Moody’s said.
Presbyterian Healthcare Services’ credit rating was downgraded to “AA-” from “AA” by Fitch. The downgrade reflects several years of weak operating performance at the Albuquerque, N.M.-based integrated health system, Fitch said.
Oaklawn Hospital’s credit rating was downgraded to “BB+” from “BBB-” by Fitch. Through the first three quarters of fiscal 2026 — ended Dec. 31 — the Marshall, Mich.-based hospital recorded an operating loss of about $6.5 million, Fitch said. Financial pressures have been driven by losses in some service lines, payment issues stemming from rising denials and bad debt and more expensive external support for operations.
Washington Regional Medical Center’s credit rating was downgraded to “Ba1” from “Baa3” by Moody’s. The downgrade reflects the Fayetteville, Ark.-based system’s sustained operating losses and resulting liquidity pressure, Moody’s said.
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