NEW YORK (Standard&Poor's) Feb. 26, 2010--Standard&Poor's Ratings Services revised its rating outlook to negative from stable on Salem Hospital Regional Health Services, Ore.'s debt issued by Salem Hospital Facility Authority. At the same time, Standard&Poor's affirmed its 'A+' long-term and underlying ratings (SPURs) and 'AAA/A-1+' and 'AAA/A-2' ratings on Salem Hospital's series 2008B and 2008C variable-rate demand bonds, respectively. The negative outlook reflects the increased pressure on profitability given a shift in Salem's payor mix due to the economic environment and weaker projected operating performance versus original expectations. However, management is in the process of implementing several cost-reduction initiatives, which should offset the impact of the shift in payor mix. Credit strengths supporting the
