S&P Global Ratings affirmed its 'BBB+' long-term rating on the Missouri Health and Educational Facilities Authority's series 2012 and series 2010 fixed-rate revenue bonds, issued for Lake Regional Health System (LRHS), formerly known as Lake of the Ozarks General Hospital. The outlook is stable. We assessed LRHS' enterprise profile as adequate, characterized by leading market share and stable payor mix in a small market. We assessed LRHS' financial profile as strong, with steady margins and healthy reserves. Also contributing to this rating decision was LRHS' management team, which has successfully controlled the hospital's costs while maintaining profit margins in fiscal 2016 and through the first nine months of fiscal 2017. We think these combined credit factors lead to an indicative