Moody's Investors Service last week announced it has downgraded two hospital ratings in the state and confirmed 15 others as part of a continuing state-by-state review of hospital credits.

The rating for Summit Medical Center in Oakland fell to Ba from Baa. San Bernardino Community Hospital also fell to Ba from Baa. The two facilities are the only non-investment-grade hospitals in the state.

California hospital ratings are generally higher than the nation's as a whole, Moody's said, with 76% at A or better compared with only 64% nationwide.

"However, this favorable distribution does not necessarily reflect a better operating environment in California, but rather can be partially explained by the use of the California Health Facility Construction Loan Insurance Program by financially weaker hospitals," Moody's said.

San Bernardino's problems stemmed from a failure to attract physicians, while Summit's downgrade resulted from high indigent care levels and a nursing strike that ended last week.

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