S&P Global Ratings assigned its 'AA-' long-term rating to North Carolina Medical Care Commission, N.C.'s $128 million series 2021 tax-exempt revenue bonds, issued for CaroMont Health. The outlook is stable. Bond proceeds will be used to finance the construction of a new Critical Care Patient Tower on its main campus in Gastonia, NC. A pledge of CaroMont Health's gross receipts will secure the bonds. The rating reflects CaroMont's dominant market position and healthy financial profile, highlighted by ample unrestricted reserves. While CaroMont primarily serves one county in a limited geographic region with a higher governmental payor mix, we believe some of its growth plans should improve that mix over time. The additional debt softens some of the pro forma debt