S&P Global Ratings affirmed its "A+" rating on Little Rock, Ark.-based Baptist Health's bonds.
The affirmation is a result of Baptist Health's leading market position, favorable leverage ratio and light debt burden.
The outlook was revised to negative from stable.
"The negative outlook reflects Baptist's worsening financial performance the past two years, exemplified by a $30 million operating loss in fiscal 2017 — as measured by S&P Global Ratings and based on unaudited results," said S&P Global Ratings credit analyst Patrick Zagar.
However, Mr. Zagar noted that an extensive turnaround plan may improve Baptist Health's operating performance in fiscal year 2018.