Standard&Poor's Ratings Services affirmed its 'BBB+' long-term and underlying (SPUR) ratings on Colorado Health Facilities Authority's series 2006, 2007, and 2008 hospital revenue bonds issued for the Valley View Hospital Association. (VVHA). The outlook is positive. Since we revised the outlook to positive in August 2012, VVHA completed and opened its $65 million cancer center. VVHA's equity contribution to the project, which was built entirely with cash, resulted in lower unrestricted reserves, as expected. Reserves remain strong on a days' cash basis and commensurate with the rating as a percentage of debt. Operating performance, while still good by national standards, has softened considerably since 2011. Formerly rapid revenue growth has turned slightly negative year-to-date, and patient volumes have