S&P Global Ratings' long-term rating on the Hospital for Special Surgery (HSS), N.Y.'s series 2018 and 2020 taxable bonds is 'A+'. The outlook is stable. The rating reflects HSS' clinical reputation, unique surgical and treatment capabilities, expanding ambulatory presence, and broad and economically diverse service area that we believe supports demand for services and a likely return to healthy margins and cash flow. We view improved financial performance, relative to less than a 1% operating margin in fiscal years 2020 and 2021, and sustained healthy margins as important for future rating maintenance given HSS' moderately high leverage, anticipated reduction in many balance-sheet metrics during the outlook period, and substantial planned increase in operating leases in mid-2024. HSS is already heavily
