...The 'AA¡' IDR and the upgrading of CHS's revenue bonds to 'AA¡' from 'A' reflect the application of Fitch's revised criteria "U.S. Not-For-Profit Hospitals and Health Systems Rating Criteria," (January 2018), which places an emphasis on net leverage position through the rating cycle. CHS's adjusted leverage metrics are consistent with the 'AA' rating category given CHS's strong operating risk profile, with operating EBITDA margins at approximately 10%, and its midrange revenue defensibility, with CHS having a 60% market share in Calvert County. Fitch's forward looking analysis shows CHS maintaining its adjusted leverage metrics under a stress scenario as CHS completes a patient tower project being funded out of cash flow and closes out its defined benefit pension plan....
