S&P Ratings affirmed the "A" rating on Lebanon, N.H.-based Dartmouth-Hitchcock Health's series 2009 and 2010 bonds, as well as Dartmouth-Hitchcock Keene (N.H) Cheshire Medical Center's series 2012 bonds.
The outlook is negative.
"The negative outlook reflects Dartmouth-Hitchcock's weak financial performance in fiscal 2016 and some uncertainty about its ability to recover in fiscal 2017," said S&P analyst Jennifer Soule.