Fitch Ratings affirmed its "BBB+" rating on Scottsbluff, Neb.-based Regional West Health Services' series 2016A bonds, affecting $73.3 million of debt.
The affirmation is a result of RWHS' strong market position.
The outlook was revised to negative from stable, reflecting RWHS' negative operating margin in fiscal year 2016, upcoming EHR replacement project, increased debt burden and weakened liquidity metrics.