Moody's Investor Service downgraded Einstein Healthcare Network's credit rating by one notch, to just above junk bond status, citing the nonprofit system's large and unexpected loss of $23 million on an operating basis in the year ended June 30, a decline in liquidity, and uncertain state funding.

Einstein said in a statement that it "remains committed to providing high-quality care while balancing the demands of today's challenging health-care environment. There are initiatives already underway which we believe will put the organization in a stronger financial position moving forward while increasing access to care."

Pluses at Einstein, Moody's said, include initiatives at Einstein Medical Center Montgomery, in East Norriton, which has gained market share since opening five years ago and is working on an alliance with the Children's Hospital of Philadelphia to provide neonatal, newborn, pediatric inpatient, and pediatric emergency services at the facility.

Among the challenges for Einstein, which had $1.2 billion in total revenue in fiscal 2017, include lower reimbursements from insurers at Moss Rehab, which Moody's described as "a well-regarded neck and spinal injury rehabilitation facility."

The new credit rating, which was announced Friday and affected $447 million in debt, is Baa3, down from Baa2. Einstein's largest facility is the Einstein Medical Center Philadelphia, in the city's Logan neighborhood.