Salisbury, Md.-based TidalHealth had a debt rating outlook revised from stable to negative as the healthcare system continues to navigate operating losses, S&P Global said.
The negative outlook accompanied an affirmed "A" rating on a series of revenue bonds, the rating group said.
"The negative outlook further reflects TidalHealth's declining unrestricted reserves, weakening balance sheet metrics and limited flexibility at the current rating level," said Chloe Pickett, S&P Global Ratings credit analyst.