Hospitals continued to suffer more rating downgrades than upgrades during the first half of 1992, but credit analysts say there are signs the situation may be stabilizing.
Moody's Investors Service lowered its assessments of 22 facilities during the first six months of the year and raised nine, while Standard & Poor's Corp. dropped 22 and raised seven.
Fitch Investors Service left all of its roughly 150 hospital ratings untouched during the period
"Even though the upgrade/downgrades are fairly negative, the overall financial ratios seem to be more positive," said John Goetz, manager of health care finance at Moody's Mr. Goetz said hospitals' 1991 financial statements show comparatively healthier profitability and cash-reserve levels.
Robert Fuller, a managing director at Standard & Poor's, agreed there might be signs of a bottoming out. "I think in general it looks like the health-care industry is getting a bit of a respite," Mr. Fuller said, pointing to increased strength on income statements.
But Fred Martucci, senior vice president of Fitch's health care and higher education group, said he sees no signs of stabilization yet. "The weak are going to get weaker and the strong are going to get stronger, but I think it's anything but stable," he said.
Fitch has had fewer rating actions than the other two agencies because most of its hospital ratings were issued within the last three years, meaning the current fiscal pressures have already been factored into rating assignments, Mr. Martucci explained.
Most of Moody's downgrades are for rural or inner-city facilities, Mr. Goetz said, reflecting their particular vulnerability to increased competition in the industry.
Detroit Osteopathic Hospital, an example of an inner-city facility, saw its rating from Moody's drop to Ba from Ba 1 in May. The rural Greenville Regional Hospital in Greenville, Pa., fell to Baa from A in March.
But Mr. Fuller said Standard & Poor's has seen more signs of weakness at suburban hospitals. He acknowledged that a lot of rural facilities are in trouble, but added that the majority have very little public debt outstanding so they are not a big rating concern.
Despite signs of improved financial results, the never-ending problem of inadequate reimbursement levels will continue to plaque hospitals for the foreseeable future, hospital analysts say.
In addition, states' attempts to deal with the problem of health care for the poor are coming under fire despite the lack of alternatives. A federal judge in New Jersey, for example, recently struck down that state's policy of tacking a 19% surcharge on hospital bills to finance an uncompensated care trust fund.