Standard&Poor's Ratings Services affirmed its 'BBB' rating on Northern Hospital District of Surry County (NHDSC), N.C.'s revenue debt. The outlook is stable. The rating reflects our opinion of NHDSC's very healthy balance sheet, featuring strong unrestricted reserves and low leverage, coupled with stable and consistent operating performance that generates solid debt service coverage (DSC) for the rating. However, we believe the enterprise profile remains somewhat stressed, with continued pressure on business volumes in fiscal 2014, coupled with a challenging payer mix, with a heavy reliance on disproportionate share payments to generate operating profitability. While the decline in business volume, particularly admissions, has not affected operating profitability to date; it remains a credit risk, especially given the relatively limited
