Cape Girardeau, Mo.-based Saint Francis Healthcare System has had its "AA" rating affirmed both on specific bonds and for its default rating.
The March 8 report from Fitch Ratings also said the outlook for the system was stable as it enjoys robust operational performance and a strong local market share as well as manageable capital plans.
Saint Francis Health, which operates a 306-bed acute hospital and a health insurance plan, maintains a 48 percent market share in the Cape Girardeau area and serves a total of 25 counties in a five-state region with a population of 476,000, Fitch said.
The system's operating results have significantly improved as fiscal 2023 has progressed with reduced labor spending and the implementation of cost management initiatives, Fitch said.
Saint Francis also completed major capital projects in 2016 and no other significant capital expenditure is planned in the near-term.
"The fiscal 2023 budget incorporates $20 million of capex, which Fitch believes is very manageable given the low capital needs and solid cash flow," according to the research note.
The system has 468 days of cash on hand with operating revenues totaling $553 million in fiscal 2022.