Moody's Investors Service has affirmed the "Baa2" rating on Upland, Calif.-based San Antonio Regional Hospital's series 2011 fixed rate certificates of participation, affecting $115 million of rated debt.
Moody's also revised the system's outlook to stable from negative.
The rating affirmation and outlook revision are based on several factors, including improved operating performance measures in fiscal year 2014 and the maintenance of adequate debt measures.
The system's challenges include significant competition and a construction project that continues to undergo delays, which Moody's expects to further stress operations once completed.