Standard&Poor's Ratings Services affirmed its 'A-' long-term rating and underlying ratings (SPURs) on various series of Maryland Health&Higher Educational Facilities Authority's health care revenue bonds, issued for University of Maryland Medical System (UMMS). The outlook on the ratings is stable. Standard&Poor's also affirmed the authority's 'AAA/A-1+' and 'AAA/A-1' ratings on the series 2008D and 2008E variable-rate bonds, respectively, reflecting the application of Standard&Poor's low-correlation joint criteria. We based the long-term rating components jointly on the bank-supported letters of credit (LOCs) and the 'A-' SPUR on UMMS. We based the short-term rating component on the bonds on TD Bank N.A. and Bank of Montreal, respectively. UMMS reported negative operating income in 2013, primarily