Chillicothe, Ohio-based Adena Health saw its outlook revised downward for the second time in recent weeks amid a decline in cashflow.
It could take the four-hospital system "several years" to restore such cashflow to prior numbers and have more robust days' cash on hand totals, according to a July 27 Moody's report.
The stable outlook reflects "solid" days of cash on hand, likely to stay close to 180, though the system faces some pressure from plans to break ground on a replacement hospital by 2026, Moody's said.
The revision follows a similar move by S&P Global, which lowered its outlook for Adena Health from stable to negative June 16.