Standard & Poor's Ratings Services said it raised its long-term rating to AA-minus from A-plus on Avera Health's debt outstanding (series 2008B, 2008C, and 2012A) issued by the South Dakota Health and Education Facilities Authority.

At the same time, it raiseditsr long-term rating to A-plus from A on Estherville, Iowa's series 2012 bonds, issued for Avera Holy Family.

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