Honolulu-based Kuakini Health System, which has a "CCC" long-term rating, has been placed on CreditWatch with negative implications, S&P Global said April 14.
The move reflects the system's sustained operating challenges with no foreseeable major changes and questions about its long-term viability, the agency said, describing the system's "precarious financial position."
"The CreditWatch with negative implications reflects our view of Kuakini's unsustainable rate of decline in unrestricted reserves, with extremely limited cushion remaining for operating needs or any unexpected challenges," S&P said.
Kuakini Health reported an operating loss of $10.45 million for fiscal 2022 compared with a loss of $22.2 million in fiscal 2021. Such challenges are ongoing, S&P said.
"We anticipate fiscal 2023 performance will remain negative, possibly comparable to the prior year," the research note said.