SAN FRANCISCO -- Hospital ratings will continue their 10-year-long migration away from the A category for several more years, increasing the number of both speculative-grade and double-A facilities, health-care analysts predicted this week.

"This is survival of the fittest, health-care style," said Joan Pickett, a senior vice president at Standard & Poor's Corp. "The stronger hospitals have been able to build on their strengths, usually at the expense of weaker ones."

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