Standard&Poor's Ratings Services revised the outlook to negative on the Nashville and Davidson County Metropolitan Government (Metro), Tenn.'s GO bonds. The 'AA' rating and underlying rating (SPUR) are affirmed. In addition, Standard&Poor's assigned its 'AA' rating to Metro's series 2008 GO bonds and its 'AA' SPUR to its public improvement and GO bonds. The outlook is negative. The outlook revision reflects the continued challenges to Metro's fiscal position, which is attributed mainly to financial support of Metro General Hospital. This support has constrained the budget in other areas of general government, greatly diminished the unreserved general fund balance, and will continue to challenge structural stability of the budget absent new revenue sources or expenditure controls beyond