Hospitals and clinics

The 17 struggling hospitals awarded loans through the program serve low-income and elderly patients or are located in underserved areas.

Eskaton, a northern California-based not-for-profit, is spinning off the trio of healthcare facilities to stem fiscal bleeding, and focus on its strengths in the senior-living sector.

Trinity Regional Hospital Sachse filed for Chapter 11 bankruptcy after problems left it unable to pay municipal bond debt service or cover operating expenses.

The upgrade to "reflects the durability of margins and liquidity, which will be supported by higher property tax receipts under the authorized levy and NBHD's efforts to grow and diversify revenue," Moody's said.

"Weaker performance is in part driven by higher permanent labor costs," Moody's said. "These elements highlight rising human capital and financial strategy risks under Moody's ESG classification and are key drivers of this rating action."

Mercy Hospital plans to sell facilities and other assets to the University of Iowa, which approved $20 million for the acquisition.

American Advanced Management signed a letter of intent for a lease-to-buy agreement for Hazel Hawkins Memorial Hospital in Hollister.

Attorney General Rob Bonta faces criticism for restrictions that caused the collapse of a proposed buyout of a troubled Central Valley hospital.

The hospitals are facing higher costs amid dwindling pandemic-related federal aid, although urban facilities are faring better than those in rural areas.

The downgrade of Kaweah Delta Health Care District's revenue bonds to Ba1 affected $218 million of debt.