1. Holy Redeemer Health System (Meadowbrook, Pa.) — from “BBB+” to “BBB” (S&P)
2. Kuakini Health System (Honolulu) — from “B+” to “B” (S&P)
3. Memorial Hospital of Sweetwater County (Rock Springs, Wyo.) — from “BBB-” to “BB+” (S&P)
4. Ryder Memorial Hospital (Humacao, Puerto Rico) — from “B+” to “CCC+” (S&P)
5. South Nassau Communities Hospital (Oceanside, N.Y.) — from “A3” to “Baa1” (Moody’s)
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