When S&P published its revised criteria for standalone hospitals last December, many became concerned they could end up downgraded –through no fault of their own. Instead, most actions based on the new criteria have been upgrades.

In December, S&P released its revised methodology and assumptions for rating standalone, not-for-profit hospitals.

The information was highly detailed and represented a major step toward increased transparency in the rating process.

S&P said about a quarter of the 400 standalone rated hospitals would be affected by the revised criteria; 15% could be downgraded, while 10% could be upgraded.

Ratings that could move up or down by two or more notches would get priority and would be reviewed by end of March 2015, regardless of the date of last review; hospitals that could move by one notch would be reviewed by end of June 2015.

But after reading the 47-page report, most borrowers were unable to determine where they would end up due to the numerous qualitative adjustments involved, which made it virtually impossible to predict how specific borrowers would be affected.

Four months later, it looks like the new criteria has made more winners than losers.

S&P says it has taken actions on 16 borrowers based on the revised criteria: 10 were solely the result of applying the new criteria; the remaining were a combination of the new criteria and changes in the borrower’s credit picture.

And now the good news: most actions were upgrades.


Some point out that S&P has reviewed less than a quarter of its standalone credits, so conclusions are premature.

It’s also possible that the rating agency is getting to upgrades first, and keeping downgrades for later in the year.

But if rating actions this year are any indication, hospitals may not have as much to worry about after all.