Moody's Investors Service has assigned an "A1" rating to ProHealth Care's $129.97 million of revenue refunding bonds.
The system's strengths, including its healthy operating performance, were considered for the rating assignment. In fiscal year 2014, ProHealth had a 2.1 percent operating margin and a 13 percent operating cash flow margin.
The system also faces some challenges, which were considered for the rating assignment, such as being highly leveraged and facing a multi-year decline in revenue.
ProHealth's negative financial outlook "reflects pressure to rebuild momentum, after two years of operational softening, to generate ample cash flow to cover a high and rising debt load," according to Moody’s.