The following hospital and health system rating and outlook changes and affirmations took place in the last week, starting with the most recent.
1. Moody's assigns 'Baa3' rating to Iraan General Hospital District's bonds
Moody's Investors Service assigned a "Baa3" rating to Iraan (Texas) General Hospital District's $9.8 million of series 2016 bonds.
2. Moody's assigns 'Aa3' rating to Sutter Health's bonds
Moody's Investors Service assigned an "Aa3" rating to Sacramento, Calif.-based Sutter Health's proposed series 2016B and series 2016C revenue bonds, which are expected to have a par value of $744 million and $100 million, respectively.
3. S&P assigns 'BBB-' rating to Presence Health's bonds
S&P Global Ratings assigned a "BBB-" long-term rating to Chicago-based Presence Health's $970 million of series 2016 fixed rate bonds.
4. Fitch assigns 'AA' ratings to Harris County Hospital District
Fitch Ratings assigned an "AA" issuer default to rating to Houston-based Harris County Hospital District and an "AA" rating to HCHD's $60.7 million of series 2016 certificates of obligation.
5. Fitch upgrades St. Clair Hospital's rating to 'AA-' from 'A+'
Fitch Ratings upgraded the rating to "AA-" from "A+" on Mt. Lebanon, Pa.-based St. Clair Hospital's $19.7 million of series 2012 revenue bonds.
6. Fitch assigns 'AA-' rating to McLaren Health Care's bonds
Fitch Ratings assigned an "AA-" rating to Flint, Mich.-based McLaren Health Care's $154 million of series 2016 revenue bonds.
7. Fitch affirms Presence Health Network's 'BBB' rating
Fitch Ratings affirmed the "BBB" rating on Chicago-based Presence Health Network's $970 million of series 2016C revenue bonds.
8. Fitch affirms Greenwich Hospital's 'AA-' rating
Fitch Ratings affirmed the "AA-" rating on Greenwich (Conn.) Hospital's $35.1 million of series 2008C bonds.
9. Moody's revises Lifespan Rhode Island Obligated Group's outlook to stable
Moody's Investors Service revised Providence-based Lifespan Rhode Island Obligated Group's outlook to stable from negative.
10. Moody's assigns 'Baa3' rating to St. Joseph Healthcare System's bonds
Moody's Investors Service assigned a "Baa3" rating to Paterson, N.J.-based St. Joseph Healthcare System's proposed $250 million of series 2016 bonds.
11. Fitch downgrades Catholic Health Initiatives' bond rating to 'BBB+'
Fitch Ratings downgraded the rating to "BBB+" from "A+" on Englewood, Colo-based Catholic Health Initiatives' $6 billion of outstanding debt.
12. S&P assigns 'A+' rating to Lehigh Valley Health Network's bonds
S&P Global Ratings assigned an "A+" long-term rating to Allentown, Pa.-based Lehigh Valley Health Network's $150 million of series 2016A bonds
13. S&P upgrades Methodist Le Bonheur Healthcare's rating to 'AA-'
S&P Global Ratings raised the long-term and underlying ratings on Memphis, Tenn.-based Methodist Le Bonheur Healthcare and Affiliates to "AA-" from "A+."
14. Fitch assigns 'A-' rating to Monroe Clinic's bonds
Fitch Ratings assigned an "A-" to Monroe (Wis.) Clinic's $42.9 million of series 2016 revenue bonds.
15. Moody's affirms Valley Health System's 'A1' rating
Moody's Investors Service affirmed the "A1" rating on Winchester, Va.-based Valley Health System's $184 million of revenue bonds.
16. Moody's assigns 'Baa' rating to Presence Health's bonds
Moody's Investors Service assigned a "Baa3" rating to Chicago-based Presence Health's proposed series 2016C revenue bonds and affirmed Presence's "Baa3" issuer rating.
17. Moody's assigns 'A3' rating to Monroe Clinic's bonds
Moody's Investors Service assigned an "A3" rating to Monroe (Wis.) Clinic's proposed $45 million of series 2016 revenue bonds.
18.Moody's assigns 'Aa1' rating to Harris County Hospital District
Moody's Investors Service assigned an "Aa1" rating to Houston-based Harris County Hospital District's $70 million of series 2016 combination tax and revenue certificates of obligation.
19. S&P affirms St. Joseph Healthcare System's 'BBB-' rating
S&P Global Ratings affirmed the "BBB-" rating on Paterson, N.J.-based St. Joseph Healthcare System's series 2008 bonds.
20. S&P assigns 'AA-' rating to Sutter Health's bonds
S&P Global Ratings assigned an "AA-" rating to Sacramento, Calif.-based Sutter Health's $743.9 million of series 2016B bonds and $100 million of 2016C bonds.