The rating on $481.6 million of general obligation bonds issued by Palomar Pomerado Health was dropped one notch to A-plus on Dec. 23.

Fitch Ratings downgraded the bonds that are secured by an unlimited, voter-approved tax on all taxable property within the district boundaries. The district is required to pay the bond debt in the event that the property tax revenues are insufficient. Analysts gave the bonds a stable outlook.

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