Downgrades

The San Diego County-based healthcare district is at risk of "breaching financial covenants which, absent lender cooperation, could lead to acceleration of all of Palomar's outstanding revenue debt," Moody's Ratings analysts wrote.

The trifecta of sports team exits, homelessness and city leadership turnover has placed the San Francisco Bay area city on shaky fiscal ground.

After lowering the city's issuer rating a notch to A1, the rating agency warned of a possible further downgrade or withdrawal of the rating.

An outlook revision to positive for the state's Aa2 general obligation rating comes as a methodology update led to downgrades for certain revenue bonds.

Houston-based Texas Children's Hospital plans to sell about $222 million of tax-exempt, fixed-rate revenue bonds this week.

The one-notch general obligation and certificates of participation rating downgrades resulted from the application of Fitch's updated criteria.

Agency cites growing debt levels and midrange demographic and economic factors.

"We withdrew the rating because we have determined we do not have sufficient information to maintain a forward-looking credit opinion on the city," S&P said.

The criteria should result in a nearly equal number of upgrades and downgrades in the next half year, according to the rating agency.

The Washington state island hospital's financial turmoil brought rating downgrades from Moody's Ratings.