Not-for-profit healthcare

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.

The action affects about $312 million of debt. The outlook, previously positive, is stable at the new, higher rating.

Attacks pose acute financial threats and longer term reputational and legal risks, analysts said.

Moody's dropped Sparrow Health's rating a notch as it's not yet factoring in the financial and operational benefits of its acquisition by UM Health, which won't extent to a debt guarantee.

Balance sheet damage from labor costs, the pandemic and a cybersecurity breach triggered covenant violations for Capital Region Medical Center.

Moody's downgraded $651 million of Main Line Health Services revenue bond debt to A1 from Aa3.

University of Michigan Health will acquire Sparrow Health System in a move that provides a fiscal infusion for Sparrow's operational and capital ailments.