Fitch Ratings on Monday affirmed the Southeast Missouri Hospital ­Association’s BBB-plus rating while revising its outlook to positive due to the hospital’s improved liquidity position.

The action affects $114 million of outstanding debt issued through the Cape Girardeau County Industrial ­Development Authority.

The hospital’s improved liquidity position was the result “of a sizable reduction of accounts receivable, investment appreciation, and cash flow from operations,” Fitch analysts wrote. Unrestricted cash and investments increased to $87 million at the close of last year, up from $46.2 million the year before.

Credit concerns remain the hospital’s location in a competitive service area, a high governmental payor mix, and a slow fill-up of its new medical office buildings. The 249-bed acute-care hospital is located about 100 miles south of St. Louis and had revenues of $306 million last year.

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