The rating affirmation was supported by the health system’s strong market and solid investment position. St. John’s investments have grown, and the health system had 187 days cash on hand as of June 30. In addition, the health system’s debt structure risks are modest, as it has mostly fixed rate debt.
The affirmation of St. John’s rating was also supported by its integration with St. Louis-based Ascension Health — the largest Catholic health system in the U.S. In April 2013, Ascension completed its acquisition of Marian Health System, a Tulsa, Okla.-based provider with three regional health systems, including St. John.
St. John also faces some challenges, such as its location in a very competitive market with other large systems, which were considered for the rating affirmation.
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