S&P Global Ratings' rating on Greenwood County, S.C.'s series 2017, 2021, and 2022 tax-exempt revenue refunding bonds, issued for Self Regional Healthcare, is 'A+'. The outlook is stable. The rating reflects our view of Self Regional's solid finances; excellent balance sheet; and sound volume growth, all of which have improved through fiscal 2021 despite COVID-19 and limitations presented with a payor mix concentrated with governmental payers and a smaller service area. The rating also incorporates Self's leading position as a referral center in a seven-county service area with a moderately sized population. Interim fiscal 2022 performance through the first eight months ended May 31 has begun to soften due largely to ongoing staffing and labor challenges, as well as pressure