The 'AA-' rating on North Carolina Medical Care Commission's bonds, issued for Pitt County Memorial Hospital, reflects the hospital's market dominance, service essentiality, and a strong financial profile that offset risks surrounding an aggressive and debt-funded strategic plan. Bond proceeds will be used to purchase Heritage Hospital from Columbia/HCA Healthcare Corp. Pitt is the largest and only tertiary provider for 29 counties serving 1.2 million people in eastern North Carolina. The hospital enjoys an 87% market share in its primary service area, a 24% share in its secondary service area, and a 7% share in its tertiary service area. The secondary service area market share is expected to rise to over 35% once Pitt purchases nearby Heritage Hospital. Pitt also