Hospitals and clinics

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

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.

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.

ProMedica's senior living division has suffered deep pandemic-related fiscal wounds while its hospitals' recovery was set back by the Omicron variant.

Oregon State Hospital's Junction City campus has three months to correct problems after an investigation revealed lax supervision.

Tax-exempt bonds issued for a private hospital system in Honolulu fell further into junk territory with S&P Global Ratings downgrading the bonds to CCC from B-minus.

S&P says Trinity's efforts to shed the fiscally struggling Mercy poses benefits and risks but the hospital is a small piece of the national not-for-profit's overall portfolio.

Federal CARES Act grants and loans, and bond market access, have helped mitigate the financial damage to hospitals caused by the pandemic.

Paul Herman and Adam Mason of HIP Investor examine environmental, social and governance risks, ratings disconnects, transparency needs and HIP's deep dive into hospital systems. Paul Burton hosts. Recorded Dec. 14. (25 minutes).

Philip Howard, chairman of nonprofit Common Good, calls on the incoming Biden administration to improve public agencies, schools and hospitals by reducing cumbersome red tape. Paul Burton hosts. (18 minutes)

The deal helped pave the way for the reopening of the capital markets for not-for-profit health systems amid the then-insurgent COVID-19 pandemic.