Standard&Poor's Ratings Services revised its outlook to negative from stable and affirmed its 'BBB+' long-term rating on Missouri Health&Educational Facilities Authority's $22.2 million series 2012 and $23.9 million series 2010 fixed-rate revenue bonds, issued for Lake Regional Health System (LRHS), formerly known as Lake of the Ozarks General Hospital. The series 2012 bond proceeds refunded the series 2003 bonds. The negative outlook reflects our view of LRHS's deficit operations, which was well below budgeted operating performance in fiscal 2013, as well as weak, albeit improved, operating results in the six-month interim period of fiscal 2014, ended Oct. 31, 2013 (unaudited). The operating deficit in fiscal 2013 was caused by a sharp decline in volumes stemming from
