San Gorgonio Memorial Healthcare District, CA -- Moody's assigns Baa3 to San Gorgonio Memorial Healthcare District, CA's 2020 GO Refunding Bonds; outlook is negative

Rating Action: Moody's assigns Baa3 to San Gorgonio Memorial Healthcare District, CA's 2020 GO Refunding Bonds; outlook is negative

Global Credit Research - 10 Aug 2020

New York, August 10, 2020 -- Moody's Investors Service has assigned a Baa3 rating to San Gorgonio Memorial Healthcare District, CA's $18.3 million 2020 General Obligation Refunding Bonds. Moody's maintains a Baa3 rating on the district's $106.6 million in outstanding general obligation (GO) bonds. The outlook is negative.

RATINGS RATIONALE

The rating reflects the district's weak financial performance, which will continue to be challenged by the impacts of the coronavirus pandemic. Operating deficits are projected for both fiscal 2020 and 2021, with a narrow ending cash position in fiscal 2020 equal to 17 days, exclusive of a line of credit and Medicare advance. Positively, the district has received assistance under the Coronavirus Aid, Relief and Economic Security (CARES) Act, consisting of $5 million in grants in fiscal 2020, an additional $2.8 million received in July 2020, and a $2.5 million Medicare advance loan. However patient volumes and utilization metrics will remain constrained as long as bed and staff capacity are required for Covid-19 patients. The district projects an ending cash balance of just over $3.8 million for fiscal 2020 exclusive of a $2.5 million Medicare advance and a $6 million draw against a $12 million line of credit. This represents a 9.8% decline from an ending cash balance of closer to $4.2 million in fiscal 2019.

The district has cared for around 55 Covid-19 patients and has resumed some medically important surgeries. But the suspension of elective procedures during April and continuing staffing constraints have reduced patient volumes and revenues. For example, year-to-date outpatient surgeries through the end of June are down by close to 46%, dropping to 397 from 740, and falling far short of a budgeted figure of 660. Discharges are similarly down by 5.6%, patient days are off by 8.5%, and emergency department visits are down by 6.4% from the prior year but have recently begun to increase.

For fiscal 2020, the district projects an operating deficit of $2.4 million followed by a $1.4 million operating deficit in fiscal 2021, assuming increases in patient volumes. This assumption may be challenged should the number of Covid-19 cases and admissions increase.

The rating also takes into consideration the district's close to $9.5 billion tax base, which continues to demonstrate growth, although future increases may be slowed by the impacts of the coronavirus pandemic. The rating also factors in the strength of California GO bonds.