Standard & Poor’s last week revised its outlook to negative from stable on St. Louis-based SSM Health Care’s AA-minus rating on $1 billion of debt due to ongoing economic strains on its balance sheet.

“The negative outlook reflects SSMHC’s balance sheet concerns relating to market performance, pension issues, and pent-up capital demands going forward,” said analyst Brian Williamson. “Management is taking steps within its control to minimize further damage to the balance sheet including but not limited to cutting back on capital spending.”

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