S&P Global Ratings placed its "A" underlying rating on Duluth, Minn.-based Essentia Health on credit watch with negative implications.
The credit watch negative is a result of Essentia Health's upcoming $800 million capital project, which S&P expects will pressure the rating.
"While we recognize that the capital project may benefit Essentia's enterprise profile in the long term, we believe that flexibility at the current rating is limited given the size of the project and the likely significant capital spending and/or debt," said S&P credit analyst Aamna Shah.