Standard & Poor’s has revised its outlook to negative from stable on Lake Region Healthcare Corp.’s A-minus rating due to strain on its balance sheet. Bonds for the provider were sold in 2002 through the Fergus Falls Housing and Redevelopment Authority.

“The outlook revision reflects our concerns that the balance sheet could come under pressure and lose flexibility due to possible additional debt within the next year, coupled with operations that have been under slightly more strain,” wrote analyst Suzie Desai.

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