Standard & Poor's last week revised its outlook to negative from stable on the Henry Ford Health System, one of Michigan's largest providers, while affirming its A rating.

The rating action affects just under $700 million of bonds issued in 2006 and 2009 through the Michigan State Hospital Finance Authority.

"The outlook revision reflects our view of HFHS' significantly softer financial performance thus far in fiscal 2012 and a balance sheet that, because of some recent strategic spending activity, leaves very little financial flexibility for the rating," analyst Kevin Holloran said in a statement.

On the positive side, the system has a light debt burden, at 1.4% of revenues, and a "sound business position" in the competitive southeast Michigan market, Holloran said.

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