S&P Global Ratings lowered its rating and underlying rating (SPUR) to 'A' from 'A+' on revenue bonds issued for Thomas Jefferson University (TJU), Pa., and Abington Memorial Hospital Obligated Group (Abington), Pa., by various authorities. At the same time we assigned our 'A' rating to Montgomery County Higher Education and Health Authority, Pa.'s $483 million series 2019 revenue bonds issued for TJU. The outlook is stable. The downgrade reflects challenges associated with rapid system growth since 2014 that have suppressed operating margins and resulted in debt service coverage metrics that are below median levels, particularly when considering this additional debt issuance which was not contemplated at the last review. The downgrade also reflects below-budget operating performance through the first nine
