Moody's Investors Service assigned its "A1" rating to Sioux Falls, S.D.-based Avera Health's proposed $2.17 million series 2017 revenue bonds.
Additionally, Moody's affirmed the "A1" rating on Avera Health's parity debt.
The affirmation and assignment are a result of several factors, including Avera Health's strong market position, historically stable operating results, wide array of clinical offerings and numerous integrated locations. Moody's also acknowledged the health system's increased debt load, modest balance sheet metrics, significant competition and upcoming capital spending.
The outlook was revised to stable from positive, reflecting the health system's 39 percent increase in debt last year.