Fitch Ratings has revised Marshall, Mo.-based John Fitzgibbon Memorial Hospital's outlook to negative from stable.
The outlook revision is based on several factors, including JFMH's lagging profitability and vulnerability to governmental payers.
Fitch also affirmed the "BBB-" rating on JFMH's $9.9 million of series 2010 bonds.
More hospital outlook and credit rating actions:
Fitch assigns 'A+' rating to Holland Community Hospital's bonds
Moody's revises Doylestown Hospital's outlook to stable
Moody's assigns 'Aa3' rating to Providence St. Joseph Health's bonds