SAN FRANCISCO--(BUSINESS WIRE)--Fitch Ratings has affirmed its 'BBB+' rating on Palmetto Health's outstanding debt, as listed at the end of the press release. The Rating Outlook is Stable. SECURITY Debt payments are secured by a pledge of the gross revenues and a leasehold mortgage. KEY RATING DRIVERS LEADING MARKET SHARE IN VERY COMPETITIVE SERVICE AREA: Palmetto maintains a leading market position in a very competitive market that drives the need for constant focus on physician relationships.