...S&P Global Ratings assigned its 'A-' rating to The Hospital Authority of the City of DuBois, Pa.'s $158.41 million revenue bonds, series 2018, issued on behalf of Penn Highlands Healthcare (PHH). The outlook is stable. The rating reflects our view of PHH's enterprise profile, including a dominant market position as the sole provider of many acute care services in its primary service area (PSA), with a robust and growing network of outpatient and ambulatory sites. However, we view PHH's PSA as somewhat limited, given its declining population and weak economic indicators. The rating also incorporates our view of PHH's markedly improved financial profile, with year-over-year revenue and income growth generating healthy pro forma maximum annual debt service (MADS) coverage. This improvement is largely the result of strategic plans executed by the system's management team, which, while relatively new, has proven successful at developing and implementing a solid and ongoing growth strategy for...