S&P Global Ratings affirmed its long-term 'A+' rating on series 2018 and 2020 taxable bonds issued for the Hospital for Special Surgery (HSS), N.Y. The outlook is stable. Securing the bonds is a gross receivables pledge from the obligated group. The 'A+' rating reflects HSS' clinical reputation, unique surgical and treatment capabilities, expanding ambulatory presence, and broad and economically diverse service area that has supported a return to near pre-pandemic operating margins. In addition, although down from 2021's high, HSS' unrestricted reserves currently remain adequate relative to operating expenses and debt balances. However, we view rating pressure as possible given management's anticipated spend down of unrestricted reserves and taxable bond proceeds as it completes its new patient tower and absorbs
