CHICAGO -- Standard & Poor’s lowered St. Anthony’s Medical Center by two notches to A-minus over dents in its operating performance.

The action came on Oct. 9 in the rating agency’s review of the hospital’s upcoming sale through the Missouri Health & Educational Facilities Authority.

The outlook is stable.

“The lowered rating reflects the application of our criteria and weaker-than-expected operating performance for fiscal 2014, along with a decline in operations for fiscal 2015, which resulted in weak maximum annual debt service coverage for the rating category,” said Standard & Poor’s analyst Robert Dobbins.

The stable outlook reflects analysts’ view that the medical center’s balance sheet metrics remain good for the rating and management is currently in the process of implementing various operating initiatives that are supported by an affiliation with a larger health system.

SAMC is located southwest of the St. Louis metropolitan area.

It also operates outpatient diagnostic facilities and four urgent-care clinics in near the main campus of SAMC. The obligated group’s revenue includes the 569-staffed-bed hospital and a foundation.

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