Standard&Poor's Ratings Services revised its outlook on Ward County, N.D.'s $83.0 million series 2006 and $9.8 million series 1996B revenue bonds, issued for the Trinity Obligated Group (Trinity Health), to negative from stable. The negative outlook revision reflects a trend of decreasing liquidity, relatively high leverage, and a deterioration to a near break-even operating margin for fiscal 2009 (unaudited), down from the improvement attained in fiscal 2008 operating results. At the same time, Standard&Poor's affirmed its 'BBB+' long-term rating on the bonds. The 'BBB+' rating reflects: Trinity's strong market position as the main tertiary provider and only Level 2 trauma center in northwest North Dakota; Trinity's status as a sole community provider; and Management's budget for