S&P Global Ratings upgraded the rating to "A+" from "A-" on Orange, Calif.-based Children's Hospital of Orange County's series 2011 and 2009A as well as its underlying rating on series 2009B-D.
In addition, S&P raised the long-term component of its dual rating on series 2009B-D to "AA+/A-1+" from "AA/A-1+."
"The rating action reflects our view of CHOC's growing volumes and sharply improved balance sheet, coupled with increased operating income and cash flow over the past year generating over 4 times maximum annual debt service coverage," said Suzie Desai, an S&P Global Ratings credit analyst.
The long term component upgrade is a result of S&P's joint-criteria methodology.
The outlook is stable, reflecting CHOC's strong enterprise profile and improved financial performance.