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Who's up and who's down

Up
Meriter Hospital, Madison, WI
Rating:
A1
Outlook: Stable
Affected debt: $110 million
Agency: Moody's Investor's Service
Remarks: Upgraded from A2 thanks to a material increase in cash flow generation in 2005, 2006 and the first half of 2007, as well as a track record of generating good operating margins.

Down
H. Lee Moffitt Cancer Center and Research Institute Inc., Tampa, FL
Rating:
A-
Outlook: Stable
Affected debt: $47.9 million
Agency: Standard & Poor's
Remarks: Downgrade from A because of requirements of increased internal subsidies for Moffitt's growing research mission as well as reduced operating margins.

Up
Self Regional Healthcare, Greenwood, SC
Rating:
A2
Outlook: Positive
Affected debt: $124 million
Agency: Moody's Investors Service
Remarks: Revised outlook from stable because of dominant market share of 92 percent in primary service area and an eight-year trend of increasing cash flow.

Down
Resurrection Health Care, Chicago
Rating:
A-
Outlook: Stable
Affected debt: $217.9 million
Agency: Standard & Poor's
Remarks: Downgrade from A because of heightened and more persistent operating losses in recent years, though losses moderated in 2007.

-Philip Betbeze