OREANDA-NEWS. Fitch Ratings has assigned an 'AA' rating to the expected issuance of $850 million of The New York and Presbyterian Hospital (NYP) taxable bonds, series 2016). In addition, Fitch also affirms the 'AA' rating on $750 million of NYP series 2015.

The Rating Outlook is Stable.

The $850 million of taxable bonds will be issued as fixed-rate and be structured as a bullet maturity. The maturity terms are still to be determined. Proceeds from the bonds are for general corporate purposes, but NYP plans to use the proceeds to refund various series of debt, including debt of its regional hospitals, and may provide funding for New York Methodist's (NYM) outpatient capital project. Maximum annual debt service (MADS) of $199.5 million was provided by the underwriter and assumes full amortization of both the 2015 and 2016 taxable debt. Bonds are expected to sell via negotiation the week of June 20.

SECURITY: The series 2016 taxable bonds will be an unsecured obligation of NYP and will not be secured by a pledge of or lien on any revenue or property of the Obligated Group (OG), of which NYP is the only member.

KEY RATING DRIVERS

LARGE ACADEMIC MEDICAL CENTER: Fitch views NYP's sizable clinical footprint, strong reputation, and solid market position as key credit strengths that support a stable operating platform and help NYP compete in a very fragmented New York City health care market. NYP has two main tertiary campuses in Manhattan, two Ivy League academic affiliations, over 2,500 licensed inpatient beds across six NYP campuses, a large outpatient platform, and three regional hospitals managed under an active parent model.

BENEFITS FROM LARGER HEALTH SYSTEM: The 'AA' rating takes into account the benefits of the larger non-obligated NYP Health System (NYPHS), of which NYP is part of, as well as other supporting organizations, which add to NYP's clinical presence across the region and provide additional financial resources. These entities include three real estate companies, a network of approximately a dozen other affiliate, sponsored, or subsidiary hospitals and healthcare organizations, and the New York-Presbyterian Fund, Inc. (the Fund), which is a related organization that held approximately $512 million in unrestricted cash and investments and $1.2 billion in temporarily restricted funds as of March 31, 2016.

GOOD FINANCIAL PROFILE: NYP's sizable revenue base (approximately $6 billion in net patient service revenue in 2015) and financial profile are consistent with the rating category. Over the last four audited years, NYP has generated operating EBITDA margins of between 10.3% and 12.5%, which compare well to the 'AA' category median of 11.5%. Pro forma maximum annual debt service (MADS) was 3.4x in fiscal 2015 and 4.3x through the three-month interim period ended March 31, 2016, below the median of 5.7x.

FLEXIBLE CAPITAL POSITION: With this second taxable bond issuance, NYP is positioning itself to refund its Federal Housing Administration (FHA) debt as individual series become callable. As a result, pro forma MADS of $199.5 million is frontloaded and will steadily decline leveling off at $95.1 million in 2024. This coupled with NYP's ability to secure strong philanthropic support for large capital projects, including support from its board, should keep the need for debt manageable. NYP has raised $1.6 billion of a $2 billion capital campaign.

REGIONAL HOSPITAL STRATEGY: Since Fitch last rated NYP, Hudson Valley Hospital Center (HVHC) and New York Hospital Queens (Queens) have been consolidated into NYP (for financial reporting purposes), after Lawrence Hospital was added in July 2014. These hospitals are being managed under an active parent model and are not part of the OG. Fitch anticipates NYM joining the consolidated group by the end of the calendar year. NYP has been executing on a longer-term strategy focused on service lines, community physician alignment, quality and patient satisfaction, and capital needs at these regional hospitals.

RATING SENSITIVITIES

CONTINUED FINANCIAL STRENGTH: Fitch expects stable performance from New York and Presbyterian Hospital (NYP) as it continues to integrate the regional hospitals, with continued support from the New York-Presbyterian Fund and NYP's real estate entities.