The Houston-based Texas Children's Hospital system had its outlook revised to negative amid ongoing costs for its $485 million Austin campus project and declining days of cash on hand, S&P Global said July 12.
The system had its default rating and that on a series of bonds affirmed at "AA."
Expected losses for the new Austin campus are expected to peak in fiscal 2024 at $95 million, S&P said.
Meanwhile, days of cash on hand are more than 100 days fewer since 2021, and the level of 227.8 as of March 31 compares with a 350 median figure for "AA" rated systems. Days' cash on hand are expected to continue to decline into fiscal 2025, the note added.
Management is forecasting a negative 3 percent operating margin in 2024.
The system, which had revenues of $3.2 billion for the six months ending March 31, also received an affirmed "AA" rating with a stable outlook from Fitch July 13.