Standard & Poor's Ratings Services affirmed its 'BBB+' rating on Ward County, N.D.'s revenue bonds, issued for the Trinity Obligated Group (Trinity Health System). The rating affirmation reflects: Strong market position serving as the main tertiary provider and only level 2 trauma center in northwest North Dakota; Sustained operating profitability that has generated adequate coverage for the rating category; Improved liquidity resulting from stronger excess margins and reduced days in accounts receivable; and Volume stability, despite Trinity's rural location, provided through employment of virtually the entire medical staff. Offsetting factors include a high level of debt for the rating, a payor mix dominated by government payors, and a somewhat local economy. Trinity Health System operates as the only tertiary healthcare
