...The 'AA-' Issuer Default Rating (IDR) reflects Novant Health Inc.'s consistently strong operating EBITDA margins and adjusted leverage metrics that are consistent with the rating level and supported by a sizable clinical footprint and good market position across four separate markets. Over the last four audited years, Novant Health's operating EBITDA margins have averaged 13.2%, with each of its markets generally performing at or exceeding budgeted expectations. Given market competition, capital spending at Novant Health has been robust over that time, including a major systemwide information technology installation project. Moving forward, Fitch Ratings expects capital spending to remain above depreciation and for operating EBITDA margins to remain above 10%. At Dec. 31, 2018, Novant Health had 150.1% adjusted cash to debt. Fitch's forward looking stress scenario shows this metric remaining consistent with the rating level through a moderate stress and as Novant Health continues to meet...
