S&P Global Ratings lowered its long-term rating on Northern Hospital District of Surry County (NHDSC), N.C.'s (doing business as Northern Regional Hospital) series 2017 revenue bonds to 'CCC' from 'B' and removed it from CreditWatch with negative implications, where it was placed on Feb. 10, 2025. The outlook is negative. The downgrade reflects our view of NHDSC?s sustained operating cash flow losses, constrained liquidity position, and heightened potential for debt acceleration because of expected covenant violations relating to privately placed debt of NHDSC (unrated) over the next year. An acceleration of the privately placed debt would allow holders of the series 2017 bonds to accelerate as well. NHDSC?s majority bondholder across both series (by virtue of its holding all of
