Standard&Poor's Ratings Services lowered its long-term and underlying rating (SPUR) to 'A+' from 'AA-' on Salem Hospital Facility Authority, Ore.'s $163.4 million health revenue bonds, issued for Salem Hospital. Standard&Poor's assigned its 'A+' rating to the Salem Hospital Facility Authority's $120 million 2006 bonds. While the organization continues to benefit from a strong market position and a good management team, which together have contributed to sound operating performance, growing cash flow, and a strengthening of the balance sheet, the considerable issuance will materially change the hospital's credit profile. Capital demands due to the growing marketplace are straining balance sheet measures. Although a planned replacement tower will help the hospital cement its strong market position in Salem,
