S&P Global Ratings affirmed the "AA" rating on Evanston, Ill.-based NorthShore University HealthSystem's series 2010 revenue refunding bonds, issued by the Illinois Finance Authority.
S&P also affirmed its "AA/A-1+" rating on NorthShore University HealthSystem's series 1995 and series 2001C bonds, and its "AA/A-1" rating on the health system's series 1996 and 2001B bonds.
The short-term rating is a result of upcoming expirations of bond purchase agreements from JPMorgan Chase Bank and Wells Fargo Bank. The rating also reflects $75 million of unrated commercial paper expiring November 2019.
The outlook was revised to stable from positive.
"The outlook revision reflects our view of NorthShore as it faces systematic challenge in the face of the changing health care landscape," said Brian Williamson, an S&P Global Ratings credit analyst.