S&P Global Ratings affirmed its "AA-" rating on Macon, Ga.-based Navicent Health's series 2016 and series 2009 bonds issued by the Macon-Bibb County Hospital Authority.
The affirmation is a result of several factors, including the health system's strong market position and solid balance sheet metrics.
The outlook was revised to negative from stable.
"The negative outlook reflects our view that the multiyear negative operating trend, if not reversed, could pressure Navicent's operating profile and debt service coverage to levels no longer consistent with the more robust metrics typical of 'AA-' rated issues," said Aamna Shah, a S&P Global Ratings credit analyst.