S&P Global Ratings revised its outlook to negative from stable and affirmed its 'A' rating on bonds issued by various authorities for Thomas Jefferson University (TJU), Pa. and on TJU's taxable bonds. The negative outlook reflects persistent operating losses through the pandemic that resulted in thin debt service coverage, in part also due to high leverage. Furthermore, unrestricted reserve metrics have weakened as the expense base grew with recent acquisitions and are light for the rating level particularly considering high capital spending plans. Securing the bonds is a joint and several general obligation and a pledge of gross revenue from TJU and other members of the TJU obligated group. Jefferson Health Plans (JHP; formerly known as Health Partners Plan) is
