Summary: Ascension Health Alliance, Missouri Michigan State Hospital Finance Authority; CP; System

S&P Global Ratings revised its outlook to negative from stable and affirmed its 'AA+' long-term rating and underlying rating (SPUR) on all senior revenue bonds issued by various issuers for Ascension Health Alliance (Ascension), Mo. At the same time, S&P Global Ratings revised its outlook to negative from stable and affirmed its 'AA' long-term rating on Ascension's series 2005A subordinated revenue bonds. S&P Global Ratings also affirmed its 'AA+/A-1+' and 'AA/A-1+' dual ratings (by various issuers and various modes) on Ascension's senior and subordinated revenue bonds, respectively. The 'AA+' and 'AA' long-term component of our dual ratings is based on our view of Ascension's senior and subordinated credit quality, while the 'A-1+' short-term component is based on our view of

...+ S&P Global Ratings revised its outlook to negative from stable and affirmed its '##+' long-term rating and underlying rating (SPUR) on all senior revenue bonds issued by various issuers for Ascension Health Alliance (Ascension), Mo. + At the same time, S&P Global Ratings revised its outlook to negative from stable and affirmed its '##' long-term rating on Ascension's series 2005A subordinated revenue bonds. + S&P Global Ratings also affirmed its '##+/A-1+' and '##/A-1+' dual ratings (by various issuers and various modes) on Ascension's senior and subordinated revenue bonds, respectively. The '##+' and '##' long-term component of our dual ratings is based on our view of Ascension's senior and subordinated credit quality, while the 'A-1+' short-term component is based on our view of Ascension's self-liquidity. + The outlook revision to negative reflects Ascension's multiyear trend of operating volatility, coupled with a sizable $1.35 billion operating loss (as per S&P Global Ratings' calculation)...

Summary