The rating on Rhode Island Health and Education Facility Building Corp.'s bonds, issued for Roger Williams General Hospital (RWGH), reflects improving utilization, and a good liquidity position within an increasingly consolidating and competitive service area. The negative outlook reflects a decline in the revenue base and a significant drop in operating performance. During fiscal 1998, admissions and outpatient visits increased by 5.8% (7,215) and 2.8% (50,420), respectively. However, a 6.0% shift in the payor mix from Medicare to Medicare managed care plans and a decline in the case mix index to 1.25% from 1.35% in 1997 caused a 6.8% decline in net patient revenues in fiscal 1998. Overall improvements during fiscal 1996 and 1997 reflect management's initiatives to reverse declines
