...+ S&P Global Ratings lowered its long-term rating on the DuBois Hospital Authority, Pa.'s series 2021, 2020, and 2018 hospital revenue bonds, issued for Penn Highlands Healthcare (PHH) to '###' from 'A-' and placed these bond ratings on CreditWatch with negative implications. + The lower rating reflects continually weakening unrestricted reserves and ongoing negative operating performance through the nine-month interim period ended March 31, 2024. + The CreditWatch placement reflects there is at least a one-in-two likelihood of a further negative rating action pending receipt of the June 30, 2023, audited financial statements that have not yet been finalized. PHH changed auditing firms and we had expected a final audit within 90 days. The longer the auditing process takes, the more uncertainty we have in the internal statements that we are using for this review. Furthermore, it is possible that PHH will violate its debt service covenant in fiscal 2023, which would lead to a consultant call...