Healthcare industry

Moody's Ratings cited low liquidity as a reason for the downgrade.

The 116% surge in healthcare bond sales from 2023 marked "a splash back from depressed issuance the few years prior," said Matt Fabian, partner at Municipal Market Analytics.

The deal will refinance some debt and take out new debt to fund an electronic records transition, renovate spaces and buy equipment.

California and federal officials  reached a $10 million settlement with the owners of a chain of non-profit health clinics and a laboratory in a case involving Medi-Cal and Medicare fraud.

Something less than $400 million of the bonds will be taxable bonds.

The county commission gave final approval to a nonprofit hospital bond and preliminary approval to a county government bond.

While the number is high, the par amount affected is less than the first quarter of 2023 figures.

More organizations are planning bond sales, although technical factors related to the election may mean deals come early in the year.

The rating agency cited traction on its financial turnaround in revising the outlook on the junk-rated hospital to stable from negative.

Labor costs that continue to squeeze operating margins remain the biggest obstacle for the nonprofit healthcare sector.

Escalating operating losses led to bond rating downgrades for Wise Health System ahead of its potential acquisition this quarter.

"Patrick has an excellent ability for not only understanding the complexities of the healthcare sector but connecting with our customers and telling the credit story in a way that provides meaningful and value-driven analysis to the market," said S&P Senior Director Stephen Infranco.

Labor costs and inflation weigh on hospitals, but improvement may be on the horizon.

Healthcare and transportation had the biggest contraction in issuance volume.

Nonprofit assisted living and nursing home bonds continue to be under stress, with defaults and impairments on the rise.

The acquisition of Cancer Treatment Centers of America in February was cited for the downgrade along with City of Hope's financial weakness over the past two years.

Despite the pandemic, operating revenues increased 7.6% from 2019 to 2020 and 8.25% from 2020 to 2021.

North Carolina Treasurer Dale Folwell talks with The Bond Buyer's Chip Barnett about how the state's economy has remained in financially good health despite dealing with the COVID-19 pandemic as well how the state deals with troubled municipalities. As chair of the debt affordability commission, he chats about bond issuance. He also discusses the ways to reform healthcare and increase transparency. (15 minutes)

The number of hospital mergers and acquisitions dropped last year and the pandemic and federal government's actions may influence the 2022 picture

Much of the Oregon Health & Science University deal funds a hospital expansion, but it also includes a tender exchange and a privately placed forward refunding.