Moody's Investors Service downgraded Ashland , Ky.-based King's Daughters' Medical Center's revenue bond rating to "Baa3" from "Baa2," affecting $177 million of rated debt.
The rating reflects lower-than-expected financial results in fiscal year 2017 and a 2018 performance that continues to be below budget, a trend Moody's expects will continue. The hospital's margins will be pressured by physician staffing and expense challenges.
The rating outlook remains negative.