S&P Global Ratings affirmed its 'A-' long-term rating on the DuBois Hospital Authority, Pa.'s series 2021, 2020, and 2018 hospital revenue bonds, issued for Penn Highlands Healthcare (PHH). The outlook is negative. Securing the bonds is a pledge of gross revenue from the obligated group, which encompasses most of PHH's revenues and assets. The rating reflects our view of PHH's enterprise profile, with maintenance of its dominant market position and a continually growing network of services and providers as acquisitions are integrated into the system. With recent growth, including the acquisition of Monongahela Valley Health Resources (Mon Valley) on Oct. 1, 2021, we now consider PHH to be a health care system under our criteria. That said, we believe PHH
