Standard&Poor's Ratings Services revised its outlook to negative and affirmed its 'BBB-' rating on Ward County, N.D.'s series 1996B and series 2006 revenue bonds, issued for the Trinity Health. The negative outlook reflects our view of Trinity Health's very weak unrestricted cash and investments, which resulted in a violation of the hospital's debt covenant at the end of fiscal 2012. Operations remained weak during fiscal 2012, in our opinion, despite strategic initiatives targeted at operational improvements. Furthermore, there are ongoing problems with the patient accounting system. Management expects future operational gains from continued implementation of strategic initiatives and continued improvement in days' cash on hand, which is up slightly for the year-to-date period. More specifically, the outlook revision
