S&P Global Ratings affirmed its "BBB-" rating on Montrose (Colo.) Memorial Hospital's series 2003 bonds.
The outlook was revised to negative from stable.
"The outlook revision reflects our view of MMH's weakened operating performance in 2016 and through interim 2017, with operations sharply turning negative, as well as the hospital's potential debt plans," said Ashley Henry, an S&P Global Ratings credit analyst