Escondido, Calif.-based Palomar Health, the state's largest publicly owned health system, had its outlook relegated to negative from stable given "elevated risks" regarding meeting financial obligations, Moody's said June 13.
Bond ratings on approximately $709 of outstanding debt were affirmed at a "Baa3" level, but concerns over days of cash on hand and cash to debt levels led to the revised outlook.
Palomar's days of cash on hand totaled 41.6 as of March 31 with a waiver over not meeting related covenants possible, Moody's said.
The system, which operates hospitals in Escondido and Poway, had about 23,000 admissions in 2022.