Not-for-profit healthcare

The nation's largest not-for-profit health system returns to the market with a mix of new money and refunding debt offering tax-exempts and taxables.

The El Paso County Hospital District is evaluating options, including other debt proposals, to address capacity constraints at its facilities.

The financial advisory firm is adding to its fold a specialty firm that focuses on aiding the hospital sector on clinical documentation, revenue cycle, hospital operations, and technology.

The healthcare chain won breathing room as its letter of credit provider waived a rating covenant and removed an event of default provision for junk downgrades.

"The labor noise is probably a little louder and is probably going to be with us for longer than we expected in late 2021 and is probably going to result in lower margins for a bit of time," S&P's Suzie Desai said.

COVID-19 worsened the fiscal picture for the senior care, insurance, and hospital operator, but it faced rating pressure before the pandemic.

Inflation and labor struggles are pounding hospital balance sheets and the pressures could damage ratings.

Hospitals can expect more than $2.6 billion of in additional payments under the Centers for Medicare and Medicaid Services program, but some say that is not enough.

The Democrats' reconciliation bill has been whittled down to a pair of health care provisions, including one that carries implications for nonprofit hospital credit quality.

Inflationary-driven challenges pose a drag on hospitals’ fiscal recovery from the pandemic with short-, mid-, and long-term action needed.