Standard&Poor's Ratings Services affirmed its 'BBB' long-term rating and underlying rating (SPUR) on Garfield County, Colo., and the Colorado Health Facilities Authority's bonds, issued for the Valley View Hospital Association (VVHA). The outlook is positive. The rating and positive outlook reflect the hospital's: Strong market position as the only hospital in the area with a stable 62% market share in its primary service area; Excellent payer mix, with good commercial revenues and low levels of Medicaid; and Eight years of robust operating margins generating solid maximum annual debt service (MADS) coverage of 3.6x in fiscal 2009. A higher rating is currently precluded by a high debt burden, as evidenced by MADS of 6.1% of revenue, debt to capital
