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MONEY TALK

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Down Lakeland Regional Health Systems, Lakeland, Fla.

Rating: A2

Outlook: Stable

Affected debt: $210.6 million

Agency: Moody’s Investors Service

Remarks: Leading market share in area and above average liquidity, but depends heavily on a large multispecialty group that represents 53 percent of annual admissions. Outpatient competition from that group has increased in recent years.

Even BJC HealthCare, St. Louis

Rating: AA

Outlook: Stable

Affected debt: $244 million

Agency: Standard & Poor’s

Remarks: BJC is well-positioned to weather an industry downturn with its low debt levels and strong cash cushion. Leading, but not dominant, market share.

Up Lancaster General Hospital, Lancaster, Pa.

Rating: A+

Outlook: Stable

Affected debt: $66.7 million

Agency: Standard & Poor’s

Remarks: Generation of robust cash flow levels over the past two and a half years from growing volumes, strong multipayor relationships and universal pricing strategy.

Down Trinity Health System, Steubenville, Ohio

Rating: A3

Outlook: Negative

Affected debt: $44 million

Agency: Moody’s Investors Service

Remarks: Sustaining better operating performance will be difficult given challenges with weak demographic trends and physician competition that is pressuring patient volumes.

—Philip Betbeze