S&P Global Ratings assigned its 'BBB+' rating to Montgomery County Higher Education&Health Authority, Pa.'s series 2016A revenue debt, issued for Holy Redeemer Health System (HRHS), The outlook is stable. At the same time, S&P Global Ratings affirmed its 'BBB+' rating and stable outlook on HRHS's existing debt. We assess the enterprise profile as adequate, characterized by the system's low market share and location in a competitive service area. However, the extremely strong economic fundamentals in the market where the system operates offsets this somewhat. We assess the system's financial profile as adequate, with positive operating results and good levels of unrestricted reserves, although weaker pro forma debt metrics offset these somewhat. While operating performance remains positive, margins are