The Standard&Poor's underlying rating (SPUR) on North Carolina Medical Care Commission's bonds, issued for Scotland Memorial Hospital, reflects: The system's strong financial performance, despite serving a large number of indigent patients, including liquidity; Increased leverage; The hospital's dominant market position within its primary service area (Scotland County), tempered somewhat by the outmigration of patients seeking services at competing facilities; and The hospital's small size (124-beds), which makes it vulnerable to the potential loss of one or more of its physicians. The hospital is a member of the Scotland Health Care System and is owned and operated by Scotland Memorial, Inc. (the Corporation). The Corporation also operates five rural health clinics, a physician practice and several office buildings. The
