Honolulu-based Kuakini Health System, which was placed on CreditWatch with negative implications April 14, saw both its "CCC" ratings and credit watch affirmed by S&P Global July 11.
The low rating reflects Kuakini Health's "extremely limited financial position and downward cash trajectory," S&P said. The amount of days' cash on hand was just 9.3 as of March 31, which compares with 12 when S&P first put the system on CreditWatch.
"The CreditWatch reflects our view that Kuakini's liquidity position remains very strained and could stress management's ability to operate the hospital and remain current on debt service over the coming quarters," the report noted.
On a more positive note, the system has made progress on the sale of "certain assets" expected over the coming months, S&P said.