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Who's up and who's down

Up
Mountain States Health Alliance, Johnson City, TN
Rating: Baa1
Outlook: Stable
Affected debt: $667 million
Agency: Moody's Investors Service
Remarks: Rating upgrade from Baa2 attributed to continued generation of strong cash flow with a material increase in liquidity over the past decade.

Up
Halifax Hospital Medical Center, Daytona Beach, FL
Rating: BBB+
Outlook: Positive
Affected debt: $350 million
Agency: Standard & Poor's
Remarks: Outlook revised from stable based on continuing improvement in the system's financial profile, including sustained growth in operations and cash flow.

Up
Lake Forest Hospital Foundation, Lake Forest, IL
Rating: A3
Outlook: Stable
Affected debt: $74 million
Agency: Moody's Investors Service
Remarks: Revised outlook to stable based on significantly improved operating performance and liquidity ratios over the past two years.

Down
Community General Hospital, Syracuse, NY
Rating: BB
Outlook: Negative
Affected debt: $8 million
Agency: Standard & Poor's
Remarks: Weaker than expected financial performance in fiscal years 2005 and 2006 along with a decline in unrestricted cash that significantly weakens the liquidity position of the hospital.

-Philip Betbeze