The hospitals and health systems receiving credit downgrades included the following:
1. Baptist Healthcare System (Louisville, Ky.) — from A+ to A (Fitch)
2. Centegra Health System (Crystal Lake, Ill.) — from BBB to BBB- (Fitch)
3. MaineGeneral Medical Center (Augusta, Maine) — from BBB- to BB (Fitch)
4. MetroHealth System (Cleveland) — from A- to BBB- (S&P); from A- to BBB- (Fitch)
5. Midland (Texas) County Hospital District — from AA to A+ (Fitch)
6. Nevada (Mo.) Regional Medical Center — from B to CCC (S&P)
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