Fitch Ratings, a financial services company based in New York, has revised a rating for Butler Health System’s $79 million revenue bonds to negative, after the system breached its rolling 12-month debt service coverage covenant with Truist Bank.

Financial results through Dec. 31 suggest that operating challenges persist, and inflationary pressures on labor and supplies are adding financial strain to the system.

Additionally, patient volumes have yet to rebound to pre-pandemic levels, according to a Wednesday, Feb. 22, news release from Fitch.

At this point, Truist has not declared a default for the BHS bond.

“The ratings agency’s report is a straightforward review of the situation and is reflective of the challenges all providers are facing in today’s health care economics,“ Melissa Forster, Butler Health System spokeswoman, said in a statement. ”We are addressing the matter in a prudent and productive manner for the sustained benefit of our new organization.“

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