Baptist gets a fiscal.

• Position: TRIAD REGION

Wake Forest Baptist Health's credit rating is under review for a downgrade by Moody's Investors Service, underscoring the financial pressure facing hospitals as governments and insurers limit payments and patient stays. In the first nine months of its fiscal year, the Winston-Salem-based health system lost $116.7 million, writing off about $104 million of payments it couldn't collect. "That shouldn't happen, and as we saw, heads rolled," says David Meyer, an industry consultant at Keystone Planning Group in Durham. He is referring to a management shuffle in which Chief Operating Officer Karen "Bobbi" Carbone replaced President Thomas Sibert, who held the job four years, and C. Michael Rutherford replaced Edward Chadwick as chief financial officer. In the fiscal year that ended June 30, 2013, the system lost $4.5 million, citing the cost of a new electronic records system. Other health systems face similar pressures--New York-based Moody's has negative outlooks on Chapel Hill-based UNC Health Care and Raleigh-based WakeMed Health & Hospitals, where the cash-flow margin was about 7% last year, nearly a third lower than historic levels. Little improvement is likely the next five years, Meyer says. "Hospitals haven't been as responsive as they need to be in reducing costs and changing the way they are doing things." Wake Forest Baptist, which has cut about 1,000 jobs in two years, remains Winston-Salem's largest employer, with more than 12,000 people on its payroll. Annual revenue totals about $1.9 billion. "The financial setbacks are fixable, and we are committed to restoring the medical center to improved levels of financial performance going forward," Rutherford says. One thing that will help: San Antonio-based Kinetic Concepts agreed in July to pay the system $280 million through 2017 to settle a lawsuit over royalties for a wound-treatment device university researchers invented. "It's manna from heaven," Meyer says.

WINSTON-SALEM -- Hanesbrands will acquire Paris-based DB-Apparel from Boca Raton, Fla.-based Sun Capital Partners for about $550 million. DBA makes intimate apparel, hosiery and underwear. The companies were owned by Chicago-based Sara Lee until 2006, when Sun Capital bought DBA and Hanesbrands became a public company. About 3,200 of Hanesbrands' 49,700 workers are in North Carolina.

HIGH POINT -- BNC Bancorp agreed to acquire Charleston, S.C.-based Harbor Bank Group, holding company for Harbor National Bank, for about $50.6...