NEW YORK - Moody's Investors Service said it has upgraded Heartland Regional Medical Center, Mo.'s (HRMC) underlying bond rating to A1 from A2.

The action affects approximately $160.5 million of rated revenue bonds outstanding issued through the St. Joseph Industrial Development Authority. The outlook is stable at the higher rating level.

The rating upgrade and stable outlook reflect a history of consistently strong operating profitability and cash flow generation with notably elevated levels over the past several years despite dependence on a high government payer mix and growth in uncompensated care.

Furthermore, HRMC's balance sheet has strengthened with growth in unrestricted cash and investments. Moody's believes HRMC is strategically well positioned given its dominant market share, comprehensive regional strategy, and capital investments in its facilities and information technology to continue to produce favorable cash flow and maintain solid leverage and balance sheet measures.

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