Fitch Ratings has upgraded the rating on the following bonds issued by
the Butler County Hospital Authority on behalf of Butler Health System
(BHS) to 'A+' from 'A-': --$86,450,000 revenue bonds,
series 2015A (Butler Health System Project). Fitch has also assigned BHS
an Issuer Default Rating (IDR) of 'A+'. The Rating Outlook is Stable.
The series 2015A bonds are secured by a pledge of gross revenues of the
obligated group, which includes the hospital and is the vast majority
of the consolidated system's assets and revenues, and a lien of a
mortgage. The upgrade of the revenue bond rating to 'A+' from
'A-' reflects BHS's strengthened net adjusted capital related
ratios. Other favorable rating factors include a strong market position
in a stable service area and expectation of strong operating EBITDA margin
performance with manageable capital spending needs during the next several
years. The Stable Outlook reflects Fitch's expectation that BHS will
maintain favorable leverage and liquidity metrics throughout the cycle
even under a forward looking scenario where a moderate economic disruption
is applied.