1. Altru Health System (Grand Forks, N.D.) — from “A-” to “BBB” (Fitch Ratings)
2. Excela Health (Greensburg, Pa.) — from “A3” to “Baa1” (Moody’s Investors Service)
3. Hospital Sisters Health System (Springfield, Ill.) — from “AA-” to “A+” (S&P Global Ratings)
4. Regional West Health Services (Scottsbluff, Neb.) — from “BBB” to “BB+” (Fitch Ratings)
5. Southeastern Regional Medical Center (Lumberton, N.C.) — from “A-” to “BBB+” (Fitch Ratings)
6. Tower Health (West Reading, Pa.) — from “A” to “BBB” (Fitch Ratings)
7. Winkler County Memorial Hospital (Kermit, Texas) — from “AA” to “BB+” (S&P Global Ratings)
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