Action affects $737 million of outstanding debt
New York, June 15, 2012 -- Moody's Investors Service has affirmed West Penn Allegheny Health System's
(WPAHS) (PA) Caa1 bond rating, affecting $737 million of
Series 2007 fixed rate bonds issued through the Allegheny County Hospital
Development Authority. The outlook remains negative.
SUMMARY RATING RATIONALE
The Caa1 rating reflects the severity of the financial status of the system
and our belief that, without the financial support of Highmark (Baa2/negative),
the system would have been forced to restructure within the last year,
which without such support, may have resulted in a bond payment
default as Moody's has seen in other similar circumstances. While
a new affiliation agreement with Highmark has provided significant cash
to WPAHS to remain viable, the affiliation is expected to close
in fall 2012 and, therefore, we are only partly incorporating
the benefit of the Highmark affiliation at this time. Highmark
has committed a total of $400 million in unrestricted payments
or loans to WPAHS over a period starting June 2011 to April 2014 and $75
million in financial support for medical education. While Highmark
has not currently committed more funding beyond $475 million,
we believe WPAHS will need more capital and/or operating support over
the next two years and our current rating incorporates our belief that
Highmark will be willing and motivated to provide further support.
Through nine months of fiscal year 2012 (ended March 31, 2012),
the system reported a large operating loss of $88 million,
exceeding the full fiscal year 2011 operating loss of $75 million
(excluding approximately $23 million in a non-recurring
positive item included in operating revenue). Year-to-date
discharges were down 8%; including observation cases,
inpatient volumes were down 5%, due to the reduction of services
at West Penn Hospital. Unrestricted cash (excluding project funds)
as of March 31, 2012 was $203 million, down $38
million since fiscal yearend 2011, even though the system received
$100 million of payments from Highmark during this period.
The system's overall strategy in the affiliation with Highmark has changed
from one of downsizing to targeted expansion, which creates a high
degree of uncertainty and execution and financial risks. Quarterly
performance indicates a reduction in the operating loss between the second
and third quarter but losses are still high and a fiscal year 2013 budget
was not provided for Moody's to evaluate.
CHALLENGES
*Uncertainty related to the viability of a new strategy to expand
rather than downsize; risks relate to reversing the strategy to regain
volumes and investing in recruiting physicians while reducing financial
losses
*Very large operating loss through nine months of fiscal year 2012
of $88 million, exceeding the fiscal year 2011 operating
loss of $75 million (excluding a large non-recurring positive
item); revenue declined 1% in the interim period, which
includes eight months of West Penn Hospital's reduced services.
*Continued decline in acute discharges of 8% through nine months
of fiscal year 2012 (5% including observation cases), largely
due to the closure and downsizing of services at West Penn Hospital and
inability to retain some volumes within the system
*Weak unrestricted cash position of 45 days of cash on hand as of
March 31, 2012 (excluding trustee-held project funds),
which represented a $38 million decline from fiscal yearend 2011;
Highmark has provided $100 million in payments since fiscal yearend
2011 through March and another $50 million in April 2012;
without further support from Highmark, we expect cash to continue
to decline at a fairly rapid rate until operating losses are stemmed
*As of fiscal yearend 2011, underfunded status of pension plan
was large at almost $200 million, even though decreasing
from $300 million at fiscal yearend 2010; the system made
its required pension payments in fiscal year 2011 and 2012.
*Heavy competition from UPMC Health System (Aa3/positive), which
is the largest health system in the region and owns a large managed care
plan, enabling UPMC to influence health plan membership and volumes;
UPMC will be opening a new hospital to compete with WPAHS's Forbes
Hospital
*High leverage relative to operating performance with 54% debt-to-operating
revenues; peak debt service coverage is zero based upon Moody's
methodology of annualizing nine-month results.
*Challenging demographic service area with declining population trends
in the primary service area and an aging patient base
STRENGTHS
*Affiliation agreement with Highmark, executed October 31,
2011, which provides significant financial support to the system
as noted above
*Favorable debt structure with all fixed rate debt and no interest
rate derivatives
*System's prominence as the second largest healthcare system in Pittsburgh
with 56,000 acute discharges (nine months annualized)
Outlook
Maintenance of the negative outlook reflects the substantial execution
and financial risks as the system reverses strategy, and a weak
operating performance and cash position that leave little flexibility
to absorb any unexpected challenges, such as continued volume declines.
WHAT COULD MAKE THE RATING GO UP
With a negative outlook, a rating upgrade in the near-term
is not likely. Long-term, an upgrade would be considered
with significant and sustained improvement in operating cash flow for
several years, at least stability in volumes, significant
growth in unrestricted cash, stability or growth in medical staff
and closing of the Highmark affiliation.
WHAT COULD MAKE THE RATING GO DOWN
Decline in unrestricted cash (excluding project funds), continued
large operating losses and volume declines; failure to close the
Highmark affiliation
The principal methodology used in this rating was Not-For-Profit
Healthcare Rating Methodology published in March 2012. Please see
the Credit Policy page on www.moodys.com for a copy of this
methodology.
REGULATORY DISCLOSURES
The Global Scale Credit Ratings on this press release that are issued
by one of Moody's affiliates outside the EU are endorsed by Moody's
Investors Service Ltd., One Canada Square, Canary Wharf,
London E 14 5FA, UK, in accordance with Art.4 paragraph
3 of the Regulation (EC) No 1060/2009 on Credit Rating Agencies.
Further information on the EU endorsement status and on the Moody's
office that has issued a particular Credit Rating is available on www.moodys.com.
For ratings issued on a program, series or category/class of debt,
this announcement provides relevant regulatory disclosures in relation
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or category/class of debt or pursuant to a program for which the ratings
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this announcement provides relevant regulatory disclosures in relation
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this announcement provides relevant regulatory disclosures in relation
to the provisional rating assigned, and in relation to a definitive
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Lisa Martin
Senior Vice President
Public Finance Group
Moody's Investors Service, Inc.
250 Greenwich Street
New York, NY 10007
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Lisa Goldstein
Associate Managing Director
Public Finance Group
JOURNALISTS: 212-553-0376
SUBSCRIBERS: 212-553-1653
Releasing Office:
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Moody's affirms West Penn Allegheny Health System's (PA) Caa1 bond rating; Outlook remains negative