S&P Global Ratings affirmed its "A+" rating on Anderson, S.C.-based AnMed Health's series 2009A, 2009D, 2010 and 2016 bonds.
The affirmation was a result of AnMed's strong market position and healthy debt coverage.
The outlook was revised to negative from stable, reflecting AnMed Health's weak financial performance in fiscal year 2017 and modest unrestricted reserves.