The following nine hospital credit rating downgrades occurred in the last month. They are listed below in alphabetical order.
1. Boone Hospital Center (Columbia, Mo.) — from "A" to "A-" (Fitch)
2. Dignity Health (San Francisco) — from "A" to "A-" (Fitch)
3. El Paso (Texas) County Hospital District — from "AA-" to "A-" (Fitch)
4. Infirmary Health System (Mobile, Ala.) — from "A-" to "BBB+" (S&P)
5. King's Daughters Medical Center (Ashland, Ky.) — from "A-" to "BBB-" (Fitch)
6. Lafayette (La.) General Health System — from "A-" to "BBB+" (Fitch)
7. Lahey Health System (Burlington, Mass.) — from "A" to "BBB+" (Fitch)
8. Lexington Medical Center (West Columbia, S.C.) — from "A+" to "BB+" (Fitch)
9. MedStar Health (Columbia, Md.) — from "A" to "A-" (Fitch)
10. Parkland Health and Hospital System (Dallas) — from "AA" to "AA-" (S&P)
11. Spartanburg (S.C.) Regional Health Services District — from "A" to "BBB" (Fitch)
12. St. John's Riverside Hospital (Yonkers, N.Y.) — from "BB-" to "B-" (S&P)
13. University Hospital (Newark, N.J.) — from "BBB" to "BB-" (Fitch)
With the slew of downgrades from Fitch, it is important to note that the agency updated its credit rating criteria Jan. 9, 2018, for U.S. nonprofit hospitals and health systems. Under the updated criteria, the credit agency places a heightened emphasis on leverage and liquidity ratios and also considers operating leases and net pension liabilities debt equivalents.
Fitch reviewed 138 credit ratings, or about half of its portfolio of hospitals and health systems, due to the criteria changes. During the review, 25 hospitals (about 9 percent) were downgraded. Fitch does not believe the slew of downgrades is indicative of a wider, downward trend.