A hospital trust which failed to see patients on time and has "deteriorating" finances must improve, a watchdog has said.
The Care Quality Commission (CQC) report found Morecambe Bay NHS Trust had gone £64.7m over budget in 2017-18 and had outstanding loans totalling £210m.
It was also not meeting targets for referral times, cancer care or A&E.
The trust's chief executive said it had a "relentless" focus on recruitment.
The trust runs Furness General Hospital in Barrow, Lancaster Royal Infirmary and Westmorland General Hospital in Kendal.
In 2015, an investigation found a "lethal mix" of failures led to the unnecessary deaths of 11 babies and one mother.
The trust came out of special measures in 2017 and the CQC later said it had made a "truly remarkable turnaround".
But in its latest report, inspectors downgraded its good rating to requires improvement.
Concerns were also raised over its finances after finding it had "a material and deteriorating deficit", with the trust forecast to go £69.4m over budget this year.
This has led to it being "not able to consistently meet its financial obligations and pay its staff and suppliers".
It was rated as inadequate for using its resources - the category covering its financial performance.
Across Furness General Hospital, emergency consultant cover was limited and patients faced "lengthy delays" in being admitted after arriving by ambulance.
In Westmorland General Hospital, inspectors saw training was out of date, meaning it could "expose some patients to risk".
At Royal Lancaster's urgent and emergency service, inspectors found nurse levels "were not always effective" and patients were not always checked on.
The chief inspector of hospitals, Ted Baker, said: "It is concerning that the three hospitals' urgent and emergency services were presenting significant challenges and some of the quality improvements across the trust have not been sustained.
"The trust has worked very hard in recent years to bring its performance up to standard and it needs to do that again now. We will be monitoring the trust's performance closely."
Trust chief executive Aaron Cummings said there were more doctors and nurses working there, but the most "relentless" problem was recruitment.
"Nationally we're just not in a position where we are selling the NHS well enough as a great place to work, to encourage people to train and develop and want to come into our services."