Fitch Ratings downgraded Elk City, Okla.-based Great Plains Regional Medical Center's series 2007 revenue bonds to "B+" from "BB-," affecting $32.8 million of debt.
The downgrade is a result of several factors, including the medical center's weak financial performance in fiscal 2017, reimbursement pressures and declining patient population. Fitch also acknowledged GPRMC's adequate liquidity measures.
The outlook is negative, reflecting the challenges the medical center will face to improve its operating margins over the next few years.