While its "AA-" long-term credit ratings were affirmed, Urbana, Ill.-based Carle Health saw its outlook revised to negative as operating income continues to be under pressure, S&P Global said July 27.
The outlook revision applies to the Carle Foundation, which oversees the now eight-hospital system, an insurance arm and outpatient sites.
The system's debt-related metrics are seen as healthy for the current rating, S&P said. Still, declining days of cash on hand and persistent operating losses are reflected in the outlook, it said.
Carle Health added three Peoria, Ill.-area hospitals to the system April 1.