S&P has revised its outlook to negative from stable on Humacao, Puerto Rico-based Ryder Memorial Hospital's $8.4 million of series 1994A bonds.
S&P has also affirmed the "BB-" long-term rating on the bonds.
"The negative outlook on Ryder reflects the tenuous financial situation in Puerto Rico overall and the uncertain future of government reimbursement for all Puerto Rico hospitals," said S&P credit analyst Jennifer Soule.
The "BB-" rating affirmation is based on several factors, including Ryder's thin balance sheet metrics, small revenue base and heavy reliance on government reimbursement.
More hospital outlook and credit rating actions:
Moody's revises Memorial Hermann Health System's outlook to positive
Moody's affirms Lancaster General Hospital's 'Aa3' rating
10 recent hospital outlook and credit rating actions