...S&P Global Ratings affirmed its '###+' long-term rating on the Missouri Health and Educational Facilities Authority's series 2012 and 2010 fixed-rate revenue bonds, issued for Lake Regional Health System (LRHS; f/k/a Lake of the Ozarks General Hospital). The outlook is stable. The rating reflects our expectation that LRHS will maintain its average business position and healthy balance sheet while gradually improving its financial performance beginning in fiscal 2019. LRHS' sound business position is evidenced by a leading market share, stable utilization, and solid payor mix. LRHS has a healthy balance sheet highlighted by robust liquidity and low leverage, in our view. While its operating results in fiscal 2018 are a significant departure from prior years, management expects an improvement to positive margins in fiscal 2019; financial performance remains sufficient, in our view. We understand that year-to-date operating losses primarily reflected operating challenges associated with an...