The North Carolina Medical Care Commission is expected to sell $46 million of fixed-rate revenue bonds for FirstHealth of the Carolinas on Tuesday. The Series 2009A bonds are the first of two tranches that will finance construction costs for a new heart hospital.

FirstHealth also expects to sell $46 million of variable-rate Series 2009B bonds on April 14.

The bonds are rated Aa3 by Moody’s Investors Service, AA-minus by Standard & Poor’s, and AA by Fitch Ratings.

Moody’s and Standard & Poor’s also revised their outlook on FirstHealth to negative, citing concerns as declining cash on hand, an increase in debt, a portfolio with 75% of outstanding debt in variable-rate mode, as well as a single counterparty on its five outstanding swaps, which is Citi.

As of Jan. 31, the mark-to-market value of the swaps was a negative $23.3 million, requiring FirstHealth to post collateral of $3.5 million, according to Fitch.

Citi will serve as lead underwriter on next week’s sale. BB&T Capital Markets, Edward Jones, and Wachovia Bank NA will act as co-underwriters. Ponder & Co. is FirstHealth’s financial adviser. Robinson, Bradshaw & Hinson PA will serve as bond counsel.

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