S&P Global Ratings revised the outlook to negative from stable and affirmed the "A+" long-term and underlying ratings on St. Louis-based SSM Health Care System.
"The negative outlook revision and ratings reflect our view of SSM Health's comparatively higher debt levels relative to medians," said S&P analyst Kevin Holloran. "It also reflects our expectation of additional debt and balance sheet pressure related to funding in order to complete a merger with [Oklahoma City-based] OU Medicine, anticipated in 2017, and a possible debt issuance for construction of a new St. LouisUniversityHospital inpatient facility that will be considered for 2018."