Standard & Poor's revised its outlook on St. Louis-based St. Anthony's Medical Center's A-plus rating to negative from stable due to operating losses.

"The outlook revision reflects our view of SAMC's unanticipated operating losses in fiscal 2012 and a weak operating margin in fiscal 2013 to date," said Standard & Poor's credit analyst Avanti Paul.

The rating reflects the hospital's stable and leading 30% market share and relatively stable utilization, a good primary care network and a focus on better aligning its medical staff. The hospital has low debt levels resulting in good maximum annual debt service coverage and solid cash to debt ratios. The hospital has limited capital needs and no debt issuance plans.

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