S&P Global Ratings affirmed its 'A' long-term rating and underlying rating (SPUR), where applicable, on Franciscan Missionaries of Our Lady Health System, La.'s (FMOLHS) outstanding debt. The outlook is stable. The rating reflects our view of FMOLHS' improved operations based on internally prepared financial results for fiscal year-end 2018, driven by increased supplemental funding for its St. Francis facility; the completed installation of its information technology platform, which will help to lower the systems expense base; and various other initiatives. Thus, we further believe that FMOLHS will be able to sustain the operational improvements into fiscal 2019 and meet its budget of a slightly greater than 0.5% operating margin as calculated by the system. We note that FMOLHS is in