S&P Global Ratings affirmed its 'A-' issuer credit rating (ICR) on Huron Regional Medical Center (Huron), S.D. The ICR applies to Huron's general creditworthiness and is not specific to any bond issue. The outlook is stable. The rating reflects our expectation that Huron's strong operations will continue into 2019, providing modest growth in unrestricted reserves. Management plans to move forward on a master facility plan, likely starting in early calendar year 2020. As Huron's plans become increasingly firm in the next year, and the type and amount of debt is determined, we will assess how it may affect the rating. Because Huron has a very small amount of existing debt, and ample unrestricted reserves, we believe the organization may be