The following hospital and health system rating, outlook changes and affirmations took place in May, starting with the most recent.
1. Fitch upgrades Columbia Memorial Hospital to 'A-'
Fitch Ratings upgraded Astoria, Ore.-based Columbia Memorial Hospital's series 2012 and series 2016 revenue bonds to "A-" from "BBB-," affecting $45.7 million of debt.
2. Fitch affirms 'A+' on Midland County Hospital District
Fitch Ratings affirmed its "A+" rating on Midland (Texas) County Hospital District's bonds, affecting $95.5 million of rated debt.
3. Moody's affirms 'Baa3' rating on The MetroHealth System
Moody's Investors Service affirmed its "Baa3" rating on The MetroHealth System, based in Cleveland. The rating action affects about $1 billion of debt.
4. Moody's affirms 'Aa3' rating on Rady Children's Hospital
Moody's Investors Service affirmed its "Aa3" rating on San Diego-based Rady Children's Hospital, affecting $366 million of rated debt.
5. S&P upgrades Wise Health System's bond rating to 'BBB-'
S&P Global Ratings upgraded its rating to "BBB-" from "BB+" on Decatur (Texas) Hospital Authority's series 2014 hospital revenue bonds. The hospital authority does business as Wise Health System.
6. S&P assigns 'AA' rating to McLeod Regional Medical Center
S&P Global Ratings assigned its "AA" long-term rating to Florence, S.C.-based McLeod Regional Medical Center's $147.3 million series 2018 revenue bonds.
7. S&P assigns 'A-' rating to Evangelical Community Hospital
S&P Global Ratings assigned its "A-" rating to Lewisburg, Pa.-based Evangelical Community Hospital's series 2018B and 2018C revenue bonds.
8. S&P upgrades Beaumont Health's rating to 'A+'
S&P Global Ratings upgraded Southfield, Mich.-based Beaumont Health's long-term rating to "A+" from "A."
9. Moody's affirms 'A3' rating on Henry Ford Health System
Moody's Investors Service affirmed its "A3" rating on Detroit-based Henry Ford Health System's series 2016 bonds, affecting $849 million in debt.
10. Fitch downgrades Covenant Health to 'BBB+'
Fitch Ratings downgraded Tewksbury, Mass.-based based Covenant Health's bond rating to "BBB+" from "A-."
11. Fitch downgrades Adventist HealthCare to 'BB+'
Fitch Ratings downgraded Gaithersburg, Md.-based Adventist HealthCare's bond rating to "BB+" from "BBB-."
12. Fitch affirms 'A' rating on Northeast Georgia Health System
Fitch Ratings affirmed its "A" rating on Gainesville-based Northeast Georgia Health System's revenue anticipation notes, affecting $448.8 million of debt.
13. Fitch affirms 'A' rating on St. Francis Regional Medical Center
Fitch Ratings affirmed its "A" rating on Shakopee, Minn.-based St. Francis Regional Medical Center's series 2014 revenue bonds, affecting $38 million of debt.
14. Moody's affirms 'Aa2' on Texas Health Resources
Moody's Investors Service affirmed its "Aa2" rating of Arlington-based Texas Health Resources' revenue bonds.
15. Moody's downgrades Lake Health's rating to 'Baa1'
Moody's Investors Service downgraded Concord Township, Ohio-based Lake Health's rating to "Baa1" from "A3," affecting $76 million of outstanding debt.
16. Fitch affirms 'AA-' rating on Mercy Health
Fitch Ratings affirmed its "AA-" rating on Cincinnati-based Mercy Health's bonds, affecting $1.5 billion of debt.
17. Fitch upgrades Berkshire Health System to 'AA-'
Fitch Ratings upgraded Pittsfield, Mass.-based Berkshire Health System's series 2012G revenue bonds to "AA-" from "A-," affecting $76.6 million of debt.
18. Moody's affirms 'Baa1' on Tallahassee Memorial HealthCare
Moody's Investors Service affirmed its "Baa1" rating on Tallahassee (Fla.) Memorial HealthCare, affecting about $352 million of rated debt.
19. Moody's affirms 'Baa1' rating on CHI, revises outlook to stable
Moody's Investors Service affirmed its "Baa1" rating on Englewood, Colo.-based Catholic Health Initiatives, affecting $6.3 billion of rated debt.
20. S&P downgrades Greenville Health System to 'A' after merger
S&P Global Ratings downgraded Greenville (S.C.) Health System to "A" from "A+."
21. S&P upgrades Palmetto Health's rating to 'A' after merger
S&P Global Ratings upgraded Columbia, S.C.-based Palmetto Health's rating to "A" from "BBB+."
22. Moody's revises South County Hospital's outlook to stable from negative
Moody's Investors Service affirmed its "Baa3" issuer rating on Wakefield, R.I.-based South County Hospital.
23. Moody's upgrades Agnesian HealthCare to 'A1' on SSM Health affiliation
Moody's Investors Service upgraded Fond du Lac, Wis.-based Agnesian HealthCare's rating to "A1" from "A2," affecting approximately $57 million of rated debt.
24. S&P revises Methodist Hospital's outlook to negative on declining operating performance
S&P Global Ratings affirmed its "BBB" long-term rating on Gary, Ind.-based Methodist Hospital's series 2014 revenue refunding bonds.
25. S&P upgrades St. John's Medical Center's rating to 'A-'
S&P Global Ratings upgraded its long-term rating on Jackson, Wyo.-based St. John's Medical Center to "A-" from "BBB+."
26. S&P downgrades Jefferson Regional Medical Center to 'A-', outlook negative
S&P Global Ratings downgraded Pine Bluff, Ark.-based Jefferson Regional Medical Center's underlying rating to "A-" from "A."
27. Fitch downgrades Eisenhower Medical Center to 'BBB-'
Fitch Ratings downgraded the rating on Rancho Mirage, Calif.-based Eisenhower Medical Center's series 2017A and 2017B revenue refunding bonds to "BBB-" from "BBB," affecting approximately $333.3 million of debt.
28. Fitch downgrades CHS to 'C' following debt exchange offer
Fitch Ratings downgraded Franklin, Tenn.-based Community Health System's issuer default rating to "C" from "CCC" after the company commenced a debt exchange offer on three series of unsecured notes due in 2019, 2020 and 2022.
29. Fitch downgrades Parkland Health & Hospital System to 'A+'
Fitch Ratings downgraded the rating on Dallas County Hospital District to "A+" from "AA," affecting approximately $718.5 million of debt. The district does business as Parkland Health & Hospital System.
30. Fitch affirms 'BB' rating on MaineGeneral Health
Fitch Ratings affirmed its "BB" rating on Augusta-based MaineGeneral Health's outstanding series 2011 revenue bonds, affecting $280.4 million of debt
31. S&P assigns 'A' rating to East Alabama Medical Center
S&P Global Ratings assigned its "A" rating to Opelika-based East Alabama Medical Center's proposed $31.7 million series 2018A revenue bonds.
32. S&P downgrades Hunt Memorial Hospital District to 'A-'
S&P Global Ratings downgraded its long-term rating on Greenville, Texas-based Hunt Memorial Hospital District's general obligation debt to "A-" from "A+."
33. S&P assigns 'A-' rating to St. Luke's University Health Network's bonds
S&P Global Ratings assigned its "A-" rating to Bethlehem, Pa.-based St. Luke's University Health Network's series 2018A and 2018B revenue bonds
34. S&P downgrades New Liberty Hospital District to 'BBB+'
S&P Global Ratings downgraded its long-term rating on New Liberty (Mo.) Hospital District to "BBB+" from "A-." The district does business as Liberty Hospital.
35. Fitch affirms 'A' rating on Good Shepherd Rehabilitation Network
Fitch Ratings affirmed its "A" rating on Allentown, Pa.-based Good Shepherd Rehabilitation Network.
36. Fitch places Centegra Health System on rating watch negative
Fitch Ratings placed its "BBB-" issuer default rating on Crystal Lake, Ill.-based Centegra Health System on rating watch negative, pending the acquisition by Chicago-based Northwestern Memorial HealthCare.
37. Moody's affirms 'Aa2' rating on Inova Health System
Moody's Investors Service affirmed its "Aa2" rating on Falls Church, Va.-based Inova Health System, affecting $1.15 billion of debt.
38. S&P assigns 'A+' rating to Memorial Hermann Health System
S&P Global Ratings assigned its "A+" rating to Houston-based Memorial Hermann Health System's series 2015A and 2015B revenue refunding bonds.
39. S&P revises Southeastern Regional Medical Center's outlook to negative
S&P Global Ratings affirmed its "A" long-term rating on Lumberton, N.C.-based Southeastern Regional Medical Center's bonds.
40. Fitch upgrades Kaiser Permanente's bond rating to 'AA-'
Fitch Ratings upgraded Oakland, Calif.-based Kaiser Permanente's revenue bond rating to "AA-" from "A+," affecting about $10 billion of outstanding debt.
41. Fitch upgrades University of Vermont Medical Center to 'A+'
Fitch Ratings upgraded Burlington-based University of Vermont Medical Center to "A+" from "A-."
42. Fitch affirms 'A-' on Beloit Health System, revises outlook to positive
Fitch Ratings affirmed its "A-" rating on Beloit (Wis.) Health System's revenue bonds, affecting $42.9 million of debt.
43. Fitch upgrades Peterson Regional Medical Center to 'A'
Fitch Ratings upgraded Kerrville, Texas-based Peterson Regional Medical Center's revenue bonds to "A" from "BBB+," affecting $51.2 million of debt.
44. Moody's affirms 'Baa1' rating on South Shore Hospital
Moody's Investors Service affirmed its "Baa1" rating on South Weymouth, Mass.-based South Shore Hospital's bonds, affecting about $115 million of rated debt.