The rating on Hamilton County, Ohio's debt, issued for Bethesda Hospital reflects its strong liquidity, good utilization, strong excess margins providing good coverage of debt service, and its joint operating agreement with Good Samaritan Hospital under the TriHealth umbrella. The positive outlook is changed to stable to reflect two years of significant operating losses at Bethesda Hospital located in the highly competitive Greater Cincinnati market. Fiscal 1997 and 1998 produced significant operating losses of $10 million, each year, and largely reflect significant pricing reductions under managed care contracts. In addition, Bethesda converted its Oak Street hospital, a multi-specialty, acute-care hospital to an outpatient center, which resulted in approximately $50 million of lost revenues. Utilization remains good, and the hospital recorded
