Fitch Ratings downgraded Ashland, Ky.-based King's Daughters Medical Center's bonds to "BBB-" from "A-."
Concurrently, Fitch assigned the medical center an issuer default rating of "BBB-."
The downgrade and assignment are a result of several factors, including the medical center's ongoing operating challenges, weakening payer mix, service area population decline and limited revenue growth opportunities.
The bonds were removed from rating watch negative. The outlook is stable at the lower rating.