The rating assignment and affirmation on the bonds issued on behalf of the Cleveland Clinic Foundation's obligated group (CCF), reflects a strong business position in the greater Cleveland market highlighted by revenue growth, increasing inpatient and outpatient utilization in a physician driven organization, and a still sound financial profile despite weak financial performance in 1998. The rating also incorporates the rapid consolidation among healthcare providers in the Cleveland market leaving CCF along with University Hospitals as the two leading systems in the region. With this issue Fairview Health System and Marymount Hospital are included in the CCF's obligated group for the first time, joining the Meridia Health system, which was incorporated into the obligated group in 1998. CCF's expanding Florida
