February 20, 2013 / 9:46 PM / in 5 years

TEXT - Fitch raises Georgia's St. Joseph/Chandler Health revs

Feb 20 - Fitch Ratings has upgraded the rating on the following Hospital
Authority of Savannah bonds issued on behalf of St. Joseph's/Candler Health

System (SJ/C):

--$11.5 million taxable revenue bonds, series 1998C, to 'A-' from 'BBB+';
--$37.8 million revenue bonds series 2003, to 'A-' from 'BBB+'.

The Rating Outlook is revised to Stable from Positive.

SJ/C has an additional $110.2 million in floating-rate direct placement debt, 
which Fitch does not rate.


The bonds are secured by a pledge of gross revenues.


SUSTAINED OPERATING IMPROVEMENT: The rating upgrade to 'A-' from 'BBB+' reflects
SJ/C's sustained strong operating performance. SJ/C has maintained healthy 
results through the six-month interim period ended Dec. 31, 2012 with a 4.1% 
operating margin and 9.9% operating EBITDA margin, in line with Fitch's 'A' 
respective category medians of 2.8% and 9.8%.

MODERATE DEBT LEVEL: At Dec. 31, 2012, SJ/C had $159.5 million in long-term 
debt, equal to 46.6% of capitalization and 3.2x of EBITDA, both in line with 
Fitch's 'A' respective category medians of 40.7% and 3.4x. Good cash flow has 
resulted in consistent coverage of maximum annual debt service (MADS) equal to 
3.0x by EBITDA through Dec. 31, 2012. In addition, SJ/C's debt portfolio has a 
short average life of 7.1 years.

COMPETITIVE MARKET: SJ/C operates in a competitive primary market area, and 
SJ/C's inpatient market share was steady at 47.8% in 2012 against its 
competitor's 52.2%.  SJ/C's regional growth strategy via hospital alignment, 
physician alignment and ambulatory service expansion across a wider geography 
from South Carolina down to the Florida border has produced good growth.  Growth
in outpatient and other revenue is a main focus, and equaled 46.5% of total 
revenue in fiscal 2012.

SUFFICIENT LIQUIDITY: Liquidity metrics continue to improve modestly, with days 
cash on hand (DCOH) of 145.5 and 98.7% cash-to-debt at Dec. 31, 2012 against 
Fitch's 'A' category medians of 191 DCOH and 116.4% cash-to-debt.  Liquidity 
growth has been supported primarily by healthy cash flow against modest capital 


MAINTAINED CASH FLOW: Fitch expects SJ/C to sustain current levels of cash flow 
via physician alignment and regional growth, which should maintain coverage 


The upgrade to 'A-' reflects SJ/C's maintenance of strong cash flow through 
fiscal 2012 and the six-month interim period ended Dec. 31, 2012, supported by 
expense management and a successful regional growth strategy.

SJ/C returned to revenue growth in fiscal 2012, producing $399 million in net 
patient revenue, ahead of the $392 million produced in fiscal 2011. Revenue 
growth has come from successful alignment with area independent physicians, 
ambulatory service expansion, and fostering clinical relationships with area 
rural hospitals. Further revenue growth should be supported by solid managed 
care rate increases that have been secured with the major payors for the next 
three years, in addition to retaining its exclusive contract with Savannah 
Business Group, which has over 40,000 covered lives.  SJ/C expects to grow its 
exclusive contracts with small employers in the area.

Strong expense management resulted in sustained operating cash flow strength, 
with SJ/C generating 11.9% and 11.2% EBITDA margins through fiscal 2012 and the 
six-month interim period. Solid cash flow has produced sufficient 3.0x coverage 
of MADS by EBITDA.  Fitch notes that MADS of $16.5 million reflects the 
front-loaded amortization of SJ/C's debt portfolio, which has a short average 
life of 7.1 years.

Total debt equaled $159.5 million at Dec. 31, 2012, of which $110.2 million 
(69%) was variable-rate direct placement loans. SJ/C has two fixed payor swaps 
and four basis swaps outstanding with a total mark to market of negative 
$288,000 (negative $3 million on fixed payor swaps and positive $2.7 million on 
basis swaps). As of Dec. 31, 2012, SJ/C had posted $2.3 million in collateral.  
SJ/C may issue a modest amount of new money debt sometime this year, which Fitch
believes SJ/C has debt capacity for, especially due to its front-loaded debt 

SJ/C's liquidity metrics remain somewhat low for Fitch's 'A' rated category; 
however, cash levels have consistently improved from $118.7 million at fiscal 
2009 to $158.3 million at Dec. 31, 2012. Future capital needs are modest, 
averaging nearly $23 million annually (approximating depreciation expense) and 
funded from cash flow.

The Stable Outlook is supported by Fitch's expectation that SJ/C will sustain 
its operating cash flow levels and preserve liquidity. SJ/C budgeted for a 3.5% 
operating margin in fiscal 2013, which is reasonable against its current 

SJ/C is a two-hospital system with 636 licensed beds in Savannah, GA, serving 
coastal Georgia and the low country of South Carolina. Total revenue in fiscal 
2012 was $428.7 million. SJ/C covenants to provide an annual audit and quarterly
financial statements. Disclosure has been excellent with the submission of 
timely audits and quarterly statements to the Municipal Securities Rule-Making 
Board's EMMA system. Annual disclosure includes an audit, utilization 
statistics, payor mix data, covenant calculations, and other data items. 
Quarterly disclosure includes consolidated and consolidating balance sheet, 
income statement, statement of cash flows, and utilization statistics.
0 : 0
  • narrow-browser-and-phone
  • medium-browser-and-portrait-tablet
  • landscape-tablet
  • medium-wide-browser
  • wide-browser-and-larger
  • medium-browser-and-landscape-tablet
  • medium-wide-browser-and-larger
  • above-phone
  • portrait-tablet-and-above
  • above-portrait-tablet
  • landscape-tablet-and-above
  • landscape-tablet-and-medium-wide-browser
  • portrait-tablet-and-below
  • landscape-tablet-and-below