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Who's up and who's down

Up
Ascension Health, St. Louis, MO
Rating:
Aa1
Outlook: Stable
Affected debt: $4.3 billion
Agency: Moody's Investors Service
Remarks: Rating upgrade from Aa2 primarily because of fundamental strengths as the nation's largest nonprofit health system, leading to three years of higher operating cash flow margins.

Up
HealthEast Care System, St. Paul, MN
Rating:
BB
Outlook: Positive
Affected debt: $302.5 million
Agency: Standard & Poor's
Remarks: Outlook revised to positive because of yearly budget outperformance coupled with an ability to invest in its facilities.

Down
Flagler Health Care System, St. Augustine, FL
Rating:
A3
Outlook: Negative
Affected debt: $84.2 million
Agency: Moody's Investors Service
Remarks: Outlook revised to negative because of declining operating performance over the past three years and the opening of Baptist South Hospital, only 26 miles away, among other challenges.

Up
Oconee Regional Medical Center, Milledgeville, GA
Rating:
BB+
Outlook: Positive
Affected debt: $29.6 million
Agency: Standard & Poor's
Remarks: Outlook revised to positive because of sustained improvement in operating performance over the past three fiscal years coupled with growth in liquidity.

Philip Betbeze

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