Healthcare

The transaction, which supports the Navajo community in Ganado, Arizona, represents a major landmark in furthering Native American health care infrastructure, overcoming hurdles tribal governments typically face in issuing municipal debt to open a replicable path to market other indigenous health systems can follow.

Ten winners across five regions and five additional categories will be celebrated Dec. 2 in New York City, where one will be crowned the overall Deal of the Year.

Fitch cited the system's operating performance and plans for up to $4.2 billion in addional debt.

The Minnesota Health and Education Facilities Authority will help nonprofit healthcare organizations finance capital projects.

Two Midwest nonprofit healthcare organizations that have run into financial difficulty this month illustrate the role of Medicare and Medicaid reimbursements.

The state will charge active employees higher salary-based health plan premiums to avoid a near-term $1.3 billion deficit.

Up to $505 million of bonds could be issued.

Hospital spreads have widened as investors wait to see how the One Big Beautiful Bill will impact providers.

The Montana Facility Finance Authority can directly issue debt for a broader array of organizations following a legislative change.

Charlotte will sell $330 million of bonds and Duke Health will offer $540 million.

S&P noted volume growth and solid operating margins at the large Florida-based healthcare system.

The commission also approved converting a GO bond sale from competitive to negotiated.

Another big deal from a major borrower is moving forward after Rochester's City Council last week approved a conduit bond sale for the Mayo Clinic.

Fitch Ratings cited the San Diego-area health district's ongoing fiscal woes in dropping its rating to B-minus from B and revising its negative watch to a negative outlook.

The Federal government's long-term budget challenges could mean dramatic changes for hospitals and health systems nationwide, derailing the post-COVID credit recovery that helped turn the healthcare sector into the fastest-growing segment of the municipal market in 2024.

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 Bond Buyer's Deal of the Year awards will mark the 23rd year it has recognized outstanding achievement in municipal finance. The event, to be held Dec. 3 in New York City, will also include the presentation of the Freda Johnson Awards for Trailblazing Women in Public Finance.

When Ohio's Community Memorial Hospital shuttered on Aug. 31, it became the latest small-town Midwest hospital to hit insurmountable financial troubles.

While BayCare has meaningful competition, Fitch believes it will maintain or grow its market position given its investment in facilities, expansion of clinical services and continued increase in access points.

The bankruptcy saga of Mercy Hospital continues, with trustee Computershare Trust filing a notice about the distribution of cash to bondholders.