S&P Global Ratings' long-term rating on the Salem Hospital Facility Authority, Ore.'s bonds, issued for Salem Health, is 'A+'. The outlook is stable. The rating reflects our view of Salem's excellent and dominant market position, beneficial strategic investments that have resulted in greater patient access and a strong demand for services, expanding primary care base, and a well-tenured leadership team with a keen focus on lean methodologies. The rating also reflects our view of Salem's well-established execution of rolling targets, history of positive and sustained operating performance, robust and growing balance sheet, and very strong debt metrics. Sustained operating performance is attributed to strong demand as well as favorable investment returns and supplemental funding. We believe management has responded well
