Standard&Poor's Ratings Services affirmed its 'BBB' rating, with a stable outlook, on Surry County Northern Hospital District (NHDSC), N.C.'s revenue debt. 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. We believe two years of decreasing volume and a poor payor mix, with a heavy reliance on disproportionate share payments to generate operating profitability, somewhat offset these strengths. We will likely continue to monitor volume. If volume continues to decrease such that operating performance and DSC were to decrease considerably, we could consider lowering the rating; to date, however, we believe management
