Fitch downgrades Ascension’s credit rating despite operating improvement

Fitch downgraded Ascension’s credit rating to “AA” from “AA+” despite the St. Louis-based system cutting its operating loss by $1.3 billion in fiscal 2025.  Ascension reported a $490.9 million operating loss (-1.6% operating margin) for the fiscal year ended June 30, an improvement from an operating loss of $1.8 billion (-6.3% margin) in 2024. 

Fitch said in a Sept. 17 report that the downgrade reflects Ascension’s improving but still rebounding operating results. The ratings agency noted that Ascension’s performance materially improved in 2025 and is trending favorably, but not at the level it deems adequate for the higher rating.  Additionally, Fitch said it expects Ascension to issue up to $4.2 billion of additional debt, which will “constrain cash-to-debt to a level more consistent wi