Regional Health, the dominant health care provider in western South Dakota, will enter the market Thursday with $181 million of bonds.

Ahead of the sale, Moody’s Investors Service affirmed its A1 rating on the system and revised its outlook to positive from stable, noting that it is enjoying its second year of strong operating results and an improving balance sheet.

“If expected operating results continue to be achieved, and there is an absence of other adverse developments, Moody’s would anticipate upgrading the rating to the Aa3 level,” analyst Bradley Spielman wrote in a recent report on the sale.

Headquartered in Rapid City, the six-hospital nonprofit system dominates the local market with a large network of facilities and the only tertiary-care facility in a 350-mile area.

The transaction features a $29 million refunding and $30 million of new-money debt. Proceeds from the new money will be used to finance a new clinic in Rapid City, among other projects.

Piper Jaffray & Co. is the underwriter and Jones Day is bond counsel.

The South Dakota Health and Educational Facilities Authority is the conduit.

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