The following hospital and health system rating and outlook changes or affirmations took place in September, starting with the most recent.
1. Fitch downgrades University Health System to 'BBB,' maintains negative outlook
Fitch Ratings downgraded its rating on Knoxville, Tenn.-based University Health System to "BBB" from "BBB+." At the same time, Fitch assigned the health system its "BBB" issuer default rating
2. Fitch upgrades Forrest Health's rating to 'A+'
Fitch Ratings upgraded Hattiesburg, Miss.-based Forrest Health's rating to "A+" from "A." Concurrently, Fitch assigned its "A+" issuer default rating to the health system.
3. Moody's assigns 'Aa3' rating to Atrium Health
Moody's Investors Service assigned its "Aa3" long-term rating to Charlotte, N.C.-based Atrium Health's proposed $464 million series 2018 bonds. Concurrently, Moody's affirmed its "Aa3" rating on about $1.7 billion of Atrium's outstanding debt.
4. Moody's assigns 'Aa3' to South Broward Hospital District
Moody's Investors Service assigned its "Aa3" rating to Hollywood, Fla.-based South Broward Hospital District's proposed $100 million series 2018 hospital revenue bonds. The district does business as Memorial Healthcare System.
5. Moody's revises Flagler Healthcare System's outlook to stable
Moody's Investors Service affirmed its "Baa1" issuer rating on St. Augustine, Fla.-based Flagler Healthcare System. Concurrently, Moody's affirmed its "Baa1" rating on $32.6 million of the health system's bonds.
6. Moody's assigns 'A2' rating, negative outlook to OSF Healthcare System
Moody's Investors Service assigned its "A2" rating to Peoria, Ill.-based OSF Healthcare System's proposed $472 million series 2018 bonds. Concurrently, Moody's affirmed its "A2" rating on the health system's existing debt, affecting about $1.15 billion.
7. Moody's assigns 'Aa3' rating to Parkview Health System
Moody's Investors Service assigned its "Aa3" rating to Fort Wayne, Ind.-based Parkview Health System's proposed $140.1 million series 2018 and $22 million series 2019A hospital revenue bonds.
8. Moody's affirms 'Aa3' rating on Atlantic Health System
Moody's Investors Service affirmed its "Aa3" rating to Morristown, N.J.-based Atlantic Health System, affecting $830 million of outstanding debt.
9. Moody's affirms 'Baa1' on Charleston Area Medical Center, maintains negative outlook
Moody's Investors Service affirmed its "Baa1" rating on Charleston (W.Va.) Area Medical Center, affecting $262 million of outstanding debt.
10. S&P downgrades Nash Health Care System to 'BBB' on deteriorating finances
S&P Global Ratings downgraded Rocky Mount, N.C.-based Nash Health Care System's long-term rating to "BBB" from "BBB+," affecting $67.5 million of debt.
11. S&P hits Verity Health System with downgrade, negative outlook after bankruptcy filing
S&P Global Ratings downgraded Redwood City, Calif.-based Verity Health System to "CC" from "CCC," affecting about $325 million of debt.
12. Fitch assigns 'BBB+' issuer rating to NYU Winthrop Hospital
Fitch Ratings assigned its "BBB+" issuer default rating to Mineola, N.Y.-based NYU Winthrop Hospital. In addition, the credit rating agency affirmed its "BBB+" rating on the hospital's series 2012 revenue bonds, affecting $130.2 million of debt.
13. Fitch affirms 'BBB-' rating on Oaklawn Hospital, assigns positive outlook
Fitch Ratings affirmed its "BBB-" rating on Marshall, Mich.-based Oaklawn Hospital's $63.5 million series 2016 revenue bonds. Concurrently, Fitch assigned the hospital an issuer default rating of "BBB."
14. Fitch upgrades Frederick Memorial Hospital to 'A-'
Fitch Ratings upgraded Frederick (Md.) Memorial Hospital's series 2012A revenue bonds to "A-" from "BBB+." Concurrently, Fitch assigned the hospital an "A-" issuer default rating.
15. Moody's affirms Cooper University Health Care's 'Baa1' rating
Moody's Investors Service affirmed its "Baa1" rating on Camden, N.J.-based Cooper University Health Care, affecting $236 million of outstanding revenue bonds.
16. Fitch assigns 'BB+' rating to John Fitzgibbon Memorial Hospital, issues rating watch negative
Fitch Ratings assigned its "BB+" issuer default rating to Marshall, Mo.-based John Fitzgibbon Memorial Hospital.
17. Moody's assigns 'Aa2' to Mayo Clinic's bonds
Moody's Investors Service assigned its "Aa2" rating to Rochester, Minn.-based Mayo Clinic's proposed $200 million series 2018 revenue bonds. Concurrently, Moody's affirmed its "Aa2" rating on the health system's $3 billion of outstanding debt.
18. Moody's affirms 'A2' rating on Renown Health
Moody's Investors Service affirmed its "A2" rating on Reno, Nev.-based Renown Health, affecting $448 million of rated debt.
19. Moody's downgrades South Georgia Medical Center to 'Baa3', maintains negative outlook
Moody's Investors Service downgraded the Hospital Authority of Valdosta (Ga.) and Lowndes County's revenue certificates to "Baa3" from "A3," affecting $48 million of debt. The hospital authority does business as South Georgia Medical Center.
20. Moody's assigns 'A3' rating to St. Luke's University Health Network's bonds
Moody's Investors Service assigned its "A3" rating to Bethlehem, Pa.-based St. Luke's University Health Network's proposed $100 million series 2018C revenue bonds. The credit rating agency also affirmed its "A3" rating on the health system's outstanding debt.
21. Moody's assigns 'Baa1' rating to AU Health System, maintains negative outlook
Moody's Investors Service assigned its "Baa1" rating to Augusta (Ga.) University Health System's proposed $76.8 million series 2018 revenue bonds. At the same time, Moody's affirmed the health system's "Baa1" issuer rating.
22. Fitch downgrades Essentia Health's bonds to 'A-'
Fitch Ratings downgraded Duluth, Minn.-based Essentia Health's outstanding bonds to "A-" from "A," affecting $240 million of debt.
23. Fitch upgrades Holland Community Hospital to 'AA-'
Fitch Ratings upgraded its rating on Holland (Mich.) Community Hospital to "AA-" from "A+," affecting $77.3 million of debt.
24. Fitch downgrades Southeastern Medical Center to 'A-', assigns negative outlook
Fitch Ratings downgraded Lumberton, N.C.-based Southeastern Medical Center's bonds to "A-" from "A," affecting $30 million of debt. Concurrently, the credit agency assigned the medical center its "A-" issuer default rating.
25. S&P assigns its 'A+' rating to Fairview Health Services
S&P Global Ratings assigned its "A+" long-term rating to Minneapolis-based Fairview Health Services' $252.3 million series 2018A. Concurrently, S&P affirmed its "A+" rating on the health system's existing debt.
26. S&P gives Palomar Health a 'BBB' rating
S&P Global Ratings upgraded its long-term rating on Escondido, Calif.-based Palomar Health's revenue bonds to "BBB" from "BBB-." At the same time, S&P Global ratings downgraded its long-term and underlying rating on Palomar Health's outstanding general obligation bonds to "BBB" from "A."
27. Moody's affirms 'Baa1' rating on Catholic Health System, maintains negative outlook
Moody's Investors Service affirmed its "Baa1" rating on Buffalo, N.Y.-based Catholic Health System and maintained its negative outlook.
28. Moody's revises Indiana Regional Medical Center's outlook to negative
Moody's Investors Service affirmed its "Ba1" rating of Indiana (Pa.) Regional Medical Center, affecting $23.6 million of debt. Concurrently, the medical center's outlook was revised to negative from stable.
29. Moody's revises Franciscan Missionaries of Our Lady Health System's outlook to stable
Moody's Investors Service revised Baton Rouge, La.-based Franciscan Missionaries of Our Lady Health System's outlook to stable from negative. Concurrently, the credit rating agency affirmed the health system's "A2" rating.
30. Moody's downgrades Integris Health to 'A1'
Moody's Investors Service downgraded Oklahoma City-based Integris Health one notch, to 'A1' from "Aa3." The action affects $226 million of outstanding debt.
31. S&P assigns 'BBB+' rating to CHI's bonds
S&P Global Ratings assigned its "BBB+" rating to Englewood, Colo.-based Catholic Health Initiative's $250 million series 2017A revenue bonds.
32. S&P assigns 'AA' rating to Mayo Clinic's bonds
S&P Global Ratings assigned its "AA" rating to Rochester, Minn.-based Mayo Clinic's $200 million series 2018 revenue bonds.
33. S&P affirms 'CCC' rating on Coalinga Regional Medical Center
S&P Global Ratings affirmed its "CCC" long-term rating on Coalinga (Calif.) Regional Medical Center's certificates of participation. The outlook is negative.