The 'AA-' rating on Montgomery County, Md.'s bonds, issued for Trinity Health, is based on management's success thus far in achieving a merger of two very different organizations—a geographically disperse national health-care system and a more centralized regional health-care system. The resulting organization has significant geographic dispersion of risk, improved operating performance, and a healthy balance sheet. However, management will be challenged to improve performance in the long-term-care and managed-care divisions, which posted operating losses in 2001. Trinity has provider locations in seven states. There is a significant concentration of facilities in Michigan and Iowa (originally Mercy Health Services) and more dispersed locations in Indiana, Ohio, Maryland, Idaho, and California (originally the Holy Cross Health System). Trinity providers offer services
