The affirmation is a result of several factors, including BHS' strong market position, solid financial profile and modest debt burden. Moody's acknowledged the health system's weaker-than-expected margins in fiscal year 2017, upcoming EMR implementation and uncertainty of work stoppages as the nurses' union strikes over a new contract. The outlook was revised to negative from stable, reflecting Moody's expectation that the health system's margins will remain suppressed and under pressure over the next several years. More articles on healthcare finance: Donations to USC medical school fall 55% after dean, faculty scandals U of Texas Health renames cancer center after donors of $25M gift 10 recent hospital, health system outlook and credit rating actions