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Memorial Hermann Healthcare System, Houston, TX
Rating:
A+
Outlook: Stable
Affected debt: $1.1 billion
Agency: Standard & Poor’s
Remarks: Recent purchase of Town & Country
Hospital and renegotiated lease on Memorial City facility placed stress on rating, but capital programs will begin adding financial and balance sheet strength over the medium term.

Down

Lee Memorial Health System, Ft. Myers, FL
Rating:
A
Outlook: Stable
Affected debt: $400 million
Agency: Standard & Poor’s
Remarks: Lowered rating reflects “sizable” debt issuance of
$275 million that adds stress to key income statement and balance sheet ratios, including debt service coverage and liquidity.

Up

Beebe Medical Center, Lewes, DE
Rating:
Baa1
Outlook: Positive
Affected debt: $89 million
Agency: Moody’s Investors Service
Remarks: Commanding 67 percent market share as the only acute-care provider in its primary service area. Fourth full year of operating improvement.

Down

Kuakini Health System, Honolulu, HI
Rating:
Baa3
Outlook: Negative
Affected debt: $30 million
Agency: Moody’s Investors Service
Remarks: Significant operating losses, a notable reduction in unrestricted liquidity from historical levels, and a continued decline in admissions.

—Philip Betbeze