S&P Global Ratings affirmed its 'AA+ ' long-term rating and underlying rating (SPUR) on all senior revenue bonds issued for Ascension Health Alliance (Ascension), Mo. by various issuers. At the same time, S&P Global Ratings affirmed its 'AA' long-term rating on Ascension's series 2005A subordinated revenue bonds. S&P Global Ratings also affirmed its 'AA+/A-1+' and 'AA/A-1+' dual ratings (by various issuers and various modes) on Ascension's senior and subordinated revenue bonds, respectively. The 'AA+' and 'AA' long-term component of our dual ratings is based on our view of Ascension's senior and subordinated credit quality, while the 'A-1+' short-term component is based on our view of Ascension's self-liquidity. The outlook is negative. Ascension is the sole corporate member of Ascension Healthcare.