Standard & Poor's last week revised the rating outlook on Northwestern Memorial Hospital's AA-rated debt to negative from stable, saying that the hospital's "current sound market position and financial performance will be tested shortly due to increasing managed care penetration" in Chicago.

The outlook revision was issued in conjunction with a $148 million bond issue sold last week through the Illinois Health Facilities Authority. Part of the bond issue will be used to finance construction of a replacement hospital and new ambulatory care facility. Including the bond issue, the revision affects $280 million of debt rated AA.

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