Catholic Health Initiatives’ continuing financial struggles were made evident Tuesday when S&P Global Ratings warned that it may downgrade the Arapahoe County-based health system’s credit ratings.

The ratings agency already downgraded CHI’s long-term and underlying ratings in April from “A” to “A-minus” because persistent operating losses and a drop in unrestricted cash had created a negative outlook for the company.

In a report issued Tuesday, S&P said it now is placing that A-minus rating on CreditWatch with negative implications because of “continued on-going financial and operational problems” at the nonprofit organization.

CHI, which operates 103 hospitals and numerous critical-access facilities and living communities in 18 states, has struggled in recent years with decreased utilization of its hospitals as patients are steered more toward non-critical-care facilities for their lower-acuity health needs.

Read more at the Denver Business Journal: