Press Release|Public Finance
KBRA Affirms A- Long Term Rating on El Paso County Hospital District (TX) Revenue Refunding Bonds; Stable Outlook
25 Sep 2025 | New York
KBRA affirms A- long-term rating with a Stable Outlook on the El Paso County Hospital District Revenue Refunding Bonds.
Key Credit Considerations
The rating was affirmed because of the following key credit considerations:
Credit Positives
- The District’s role as the only safety net healthcare provider in the County and critical role within the County’s public health mission.
- Adequate, stable operating cash flows supporting repayment of debt.
- Manageable future capital needs.
Credit Challenges
- Macroeconomic environment has placed upward pressure on both wages and supplies/pharmaceuticals.
- Considerable reliance on governmental payors and charity care, which somewhat constrains the District’s ability to improve margins.
- Weak, though stable, unencumbered liquidity.
Rating Sensitivities
For Upgrade
- Significantly strengthened, sustained improvement in operating performance leading to increased liquidity and moderating leverage.
- While not expected, fundamental changes in how governmental payors reimburse providers for care.
For Downgrade
- Declining patient volumes that reduce the District’s ability to maximize net patient revenues.
- Additional debt issuance without a commensurate increase in resources available for repayment.
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