Not-for-profit healthcare

S&P expects improvement although for some borrowers that simply means a reduction in losses, or breakeven to just slightly positive margins.

Clare Oaks' history of fiscal struggles resulted in two bankruptcy filings, the most recent leading to a bond exchange in 2020.

The system is incorporating some floating-rate risk into its fixed-rate debt portfolio to allow for strategic flexibility after its new hospital campus opens.

BJC HealthCare and Saint Luke's Health System signed a letter of intent to form an integrated not-for-profit Missouri-based health system.

Inflation joined supply chain struggles, wage pressures, and the labor shortage — most acutely felt with nursing staff — dragging down the sector's margins.

The system's turnaround efforts include using proceeds of a proposed $710 million deal to sell hospice and home health assets to pay off direct placement debt.

Lawmakers passed a stopgap $150 million loan fund for hospitals in fiscal distress, and will discuss longer-term solutions as the session progresses.

Harris Health System is asking Harris County to place a bond proposition on the November ballot.

Several Midwest hospital mergers that are in the works will contribute to the 2023 numbers while one announced in 2022 just closed.

Moody's Investors Service downgraded Providence St. Joseph Health a notch to A2, following similar moves by S&P Global Ratings and Fitch Ratings.

The acquisition closed Friday and all nine employees, who provide municipal and healthcare advisory services and treasury consulting services, joined PFM.

The Kaiser Family Foundation's report drew the ire of the American Hospital Association, which said it excluded many community benefits from its analysis.

Each would preserve their individual brands with a new organization functioning as the parent company with the aim of cutting administrative costs.

A stronger 2021 aided hospital balance sheets for those whose fiscal years end on June 30 based on a review of hospital operating medians

One public hospital district violated a debt service covenant and was downgraded to junk; the other declared a fiscal emergency and seeks an outside partner.

The state's flagship university said its proposal to acquire its healthcare facilities from Fairview, which is preparing to merge with an out-of-state healthcare system, requires state help.

Moody's and S&P also warn of the potential for further downgrades; UC Health has begun to implement financial turnaround strategies amid operating losses.

Mergers and acquisition dropped to 55 last year from 73 in 2021, continuing on a downward course since 2017, according to a review published by Ponder & Co.

Moody's lowered Fairview Health Services by one notch to Baa1 and assigned a negative outlook, but a pending merger and expected sale of some facilities could help its bottom line.

Hospital margins ticked up in November, but 2022's bruising will linger well into this year straining some ratings.