Fitch Ratings said it has downgraded the following Dallas County Hospital District, Texas, bonds to AA-plus from AAA: $24.8 million limited tax bonds, tax-exempt series 2009A; $222.5 million limited tax bonds, taxable series 2009B (Build America Bonds - Direct Payment); and $457.7 million limited tax bonds, taxable series 2009C (Build America Bonds - Direct Payment).

The rating outlook is stable.

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