S&P Global Ratings lowered the long-term rating on Honolulu-based Kuakini Health System to "B+" from "BB."
"The downgrade reflects Kuakini's vulnerable enterprise and financial profiles," said S&P analyst Martin Arrick. "More specifically, the downgrade reflects persistent and widening operating losses with coverage of maximum annual debt service at well under one time, a competitive environment, declining utilization, a weakening payer mix characterized by a large and growing Medicare percentage and dependence on a narrow group of physicians for a majority of admissions."
The outlook is stable, reflecting the lower rating and Kuakini's lack of a permanent CFO.