ATLANTA -- In a review last Thursday of South Carolina uninsured hospital revenue bonds, Moody's Investors Service upgraded one rating and confirmed four others.

The Moody's action, which covered a total of $133 million of debt, lifted the rating or $13.8 million of bonds from the Carolina Hospital System, a group of three hospitals based in Florence, to Baal from Baa.

The hospitals with confirmed ratings were: Conway Hospital System in Horry County, with $21.6 million of bonds at Baal; Kershaw Memorial Hospital in Camden, with $3.4 million at Baa; Mary Black Memorial Hospital in Spartanburg, with $7.2 million at A; and Medical University Hospital in Charleston, with $78.8 million of bonds at A.

In conjunction with the review, Moody's withdrew its Ba rating on $7.7 million of Hilton Head Hospital bonds, following its sale to a for-profit joint venture partnership, which set up an escrow account for early debt retirement.

Moody's said the ratings action reflected "general operating stability resuiting from modest managed-care pressures, favorable market position of most of these providers and, in some cases, historically favorable Medicaid disproportionate share payments.

"Additionally, most providers continue to benefit from the state's steadily improving economy, despite the ongoing closure of the majority of the Charleston naval installations," the ratings agency said.

At the same time, however, Moody's warned that hospitals in the state will face an "increasingly competitive health care environment as providers reposition themselves in anticipation of managed health-care penetration."

Moody's said it expects to soon publish a fuller analysis of the issues affecting health care in South Carolina.

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