The following hospital and health system credit rating and outlook changes and affirmations took place in the last week, beginning with the most recent.
1. Fitch affirms 'A+' rating on Gwinnett Hospital System's revenue bonds
Fitch Ratings affirmed its "A+" rating on Lawrenceville, Ga.-based Gwinnett Hospital System's series 2007A-D revenue bonds, affecting $132 million of debt.
2. Moody's affirms 'Baa1' rating on CentraState Medical Center's bonds
Moody's Investors Service affirmed its "Baa1" rating on Freehold, N.J.-based CentraState Medical Center's revenue bonds, affecting $38 million of outstanding debt.
3. Fitch affirms 'BBB+' rating on Frederick Memorial Hospital's revenue bonds
Fitch Ratings affirmed its "BBB+" rating on Frederick (Md.) Memorial Hospital's series 2012A revenue bonds, affecting $97.1 million of debt.
4. Fitch affirms 'BBB+' on NYU Winthrop Hospital's bonds
Fitch Ratings affirmed the "BBB+" rating on Mineola, N.Y.-based NYU Winthrop Hospital's series 2012 revenue bonds, affecting $130 million of debt.
5. Fitch downgrades Lahey Health System's bonds to 'A'
Fitch Ratings downgraded Burlington, Mass.-based Lahey Health System's series 2015F revenue bonds to "A" from "A+," affecting $262 million of debt.
6. Fitch affirms 'B' rating on Tenet Healthcare
Fitch Ratings affirmed its "B" issuer default rating on Dallas-based Tenet Healthcare, affecting $15.4 billion of debt.
7. Fitch affirms 'BB+' rating on Palomar Health's revenue bonds
Fitch Ratings affirmed its "BB+" issuer default rating on Escondido, Calif.-based Palomar Health and affirmed the "BB+" rating on the system's outstanding revenue bonds.
8. Moody's assigns 'A1' to Avera Health's bonds
Moody's Investors Service assigned its "A1" rating to Sioux Falls, S.D.-based Avera Health's proposed $2.17 million series 2017 revenue bonds.
9. S&P affirms 'A' rating on Boulder Community Health
S&P Global Ratings affirmed its "A" rating on Boulder (Colo.) Community Health.
10. Fitch assigns 'AA-' rating to Banner Health's series 2017 bonds
Fitch Ratings assigned its "AA-" rating to Phoenix-based Banner Health's proposed series 2017A, 2017B, 2017C and 2017D bonds, which will total approximately $452 million.
11. Moody's affirms 'A3' rating on St. Luke's Health System's bonds
Moody's Investors Service affirmed the "A3" rating on Boise, Idaho-based St. Luke's Health System's bonds, affecting $531 million of debt.
12. Moody's upgrades PinnacleHealth System to 'A1'
Moody's Investors Service upgraded Harrisburg, Pa.-based PinnacleHealth System's debt rating to "A1" from "A3," affecting $287 million of debt.