Moody's Investors Service has downgraded Iowa City, Iowa-based Mercy Hospital's rating to "Baa2" from "A3," affecting $76 million of outstanding debt.
The downgrade is based on a number of factors, including a decline in fiscal year 2015 operating performance.
The hospital faces numerous challenges, including a competitive service area with a sizable academic medical center.
The outlook is stable, reflecting Moody's expectation that Mercy will maintain its strong balance sheet position, giving it a cushion as management focuses on improving operations.
More hospital outlook and credit rating actions:
Moody's revises Erlanger Health System's outlook to positive
Moody's downgrades Mission Hospital's rating to 'Ba2'
Moody's affirms Stormont-Vail HealthCare's 'A2' rating