S&P Global Ratings affirmed its 'BB' long-term rating on the California Statewide Communities Development Authority's series 2018, 2016A, 2014A, and 2014B fixed-rate revenue bonds issued for the Loma Linda University Medical Center (LLUMC) obligated group. The outlook is stable. The obligated group's gross receivables, a mortgage, and a deed of trust secure the bonds. The deed of trust consists of LLUMC; LLUCH; LLUMC's East Campus Hospital, Outpatient Rehabilitation Center, and Surgical Hospital, and LLUMC--Murrieta. References to LLUMC throughout the report cover the consolidated system. The 'BB' rating reflects our view of LLUMC's light financial profile characterized by high debt as a result of the Campus Transformation Plan (CTP; new hospital opened August 2021), continued operating losses in 2023 of 3.6%
