Fitch Ratings affirmed the "BBB+" rating on Knoxville, Tenn.-based University Health System's series 2017 and series 2016 bonds, affecting $233.4 million of debt.
The affirmation is a result of several factors, including the health system's growing market share, light debt burden and expansion project to grow capacity. Fitch also acknowledged the UHS' modest balance sheet metrics and weakened operating performance.
The outlook was revised to negative from stable; reflecting the health system's recently diluted operating results.