Standard & Poor’s revised its outlook to negative on two series of outstanding debt issued by Ward County on behalf of Trinity Health, the main tertiary provider in northwest North Dakota.

The negative outlook and BBB-plus long-term rating affect $83 million of revenue bonds issued in 2006 and $9.8 million of revenue bonds issued in 1996.

Trinity is suffering from decreasing liquidity, a high debt burden, and deteriorating operating results, analysts said.Despite strong market share as the sole provider and Level 2 trauma center in the area, operations weakened in 2009.

Management predicts that the system will improve in 2010 , largely driven by Medicaid rate increases, analysts said. All of its debt is fixed rate.

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