• S&P drops Silver Cross Health System, Ill., revenue bonds to BBB-

• S&P lifts University of Maryland Medical System series 2008A bonds to AAA/A-1

• S&P cuts Elliot Hospital, N.H., bonds to BBB

• Moody's gives Baa1 to Puerto Rico Government Development Bank 2011G-H senior notes

• Fitch rates Puerto Rico Public Building Authority 2011T school construction bonds BBB+

• S&P applies AA to North Carolina 2011, 2012 grant anticipation revenue vehicle bonds

• Moody's assigns A2 to Municipal Electric Authority of Georgia series 2011 revenue bonds

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