Fitch Ratings downgraded the rating on Elk City, Okla.-based Great Plains Regional Medical Center's $33.7 million of series 2007 bonds to "BB-" from "BB."
The downgrade is based on a number of factors, including GPRMC's weak financial performance in fiscal year 2016, small revenue base and ongoing operating challenges.
Fitch also removed GPRMC from rating watch negative, but the rating outlook on the bonds is still negative.