S&P Global Ratings affirmed its "A" long-term rating on Lumberton, N.C.-based Southeastern Regional Medical Center's bonds.
Concurrently, S&P revised SRMC's outlook to negative from stable.
"The outlook revision reflects our view of SRMC's declining market share and weakened operations, which followed the significant impact from Hurricane Matthew in October 2016," said S&P credit analyst Kelsey Thomas.
In addition, the outlook revision is supported by the health system's decreasing financial flexibility as a result of a $42 million bond to fund capital projects.