1. Boone Hospital Center (Columbia, Mo.) — from “A-” to “BBB” (Fitch Ratings)
2. Covenant Health (Tewksbury, Mass.) — from “BBB+” to “BBB” (Fitch Ratings)
3. Delta (Colo.) County Memorial Hospital — from “BB+” to “BB” (S&P Global Ratings)
4. Fairfield Medical Center (Lancaster, Ohio) — from “Baa3” to “Ba2” (Moody’s Investors Service)
5. Indiana (Pa.) Regional Medical Center — from “Ba1” to “Ba2” (Moody’s Investors Service)
6. Mercy Medical Center (Des Moines, Iowa) — from “A” to “A-” (S&P Global Ratings)
7. OSF HealthCare (Peoria, Ill.) — from “A2” to “A3” (Moody’s Investors Service)
8. Regional West Medical Center (Scottsbluff, Neb.) — from “BBB+” to “BBB” (Fitch Ratings)
9. South Nassau Communities Hospital (Oceanside, N.Y.) — from “Baa1” to “Baa2” (Moody’s Investors Service)
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