CHICAGO -Capital spending is expected to remain heavy across the nonprofit health care sector amid mounting financial pressures and the fallout from the collapsed auction-rate securities market, according to a pair of reports released this week by Moody's Investors Service and Standard & Poor's.

Downgrades are likely to outpace upgrades through 2009, said Standard & Poor's in its report "Tough Times Take a Toll on Credit Quality of U.S. Not-for-Profit Health Care Sector." Many of those downgrades will be aimed at stand-alone, lower-rated credits, but higher-rated systems are not immune from the sector's problems, analysts said.

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