S&P Global Ratings affirmed its 'BBB-' long-term rating on Montgomery County Higher Education&Health Authority, Pa.'s revenue bonds, issued for Holy Redeemer Health System, dba Redeemer Health (RH). The outlook is negative. The rating reflects persistently high operating losses that have been weaker than anticipated, which continued into fiscal 2020 as RH weathered the impact of COVID-19. Fiscal 2020 losses were driven by weaker volumes leading up to the pandemic, as well as the COVID-19 shutdown through May 2020. Because of the multi-year trend of significant operating losses, RH has been reliant on nonoperating revenue to produce just adequate debt service coverage (DSC) for the rating. Offsetting the weak operating performance has been RH's stable unrestricted reserves that have
