Money Talk

Who's up and who's down

Down
St. Anthony's Medical Center, St. Louis, MO
Rating: A2
Outlook: Stable
Affected debt: $152 million
Agency: Moody's Investors Service
Remarks: Outlook revised from positive because of softening operating performance in 2007 and the unaudited 2008 fiscal year and competition from larger systems in the St. Louis metro area.

Up
Spectrum Health, Grand Rapids, MI
Rating: AAA/A1+
Outlook: Stable
Affected debt: $67.2 million
Agency: Standard & Poor's
Remarks: Outlook revised from negative to stable based on maintenance of cash flow and ongoing improvement to the balance sheet.

Up
Adena Health System, Chillicothe, OH
Rating: A3
Outlook: Positive
Affected debt: $140 million
Agency: Moody's Investors Service
Remarks: Outlook revision from stable based on expectation that Adena will continue to grow cash flow over the next two years in order to improve debt measures.

Up
Clarian Health, Indianapolis, IN
Rating: Aaa
Outlook: Stable
Affected debt: $74.825 million
Agency: Moody's Investors Service
Remarks: Upgraded rating from A2 based on letter of credit from Branch Banking & Trust Co., which means the bonds would default only in the event of a default by both entities.

—Philip Betbeze