While it had an "A-" rating affirmed on a series of bonds June 16, Chillicothe, Ohio-based Adena Health saw its outlook revised from stable to negative, according to S&P Global.
The negative categorization reflects continued weakening operating performance, with the four-hospital system recording a further $8 million operating loss in the first four months of the year, S&P said.
With a management focus on a "robust" improvement plan, the system is expected to break even by the end of fiscal 2023. Adena Health also has a "conservative debt profile," S&P Global said.
Adena Health eliminated 69 positions in January as part of a cost-cutting initiative.