The rating on the outstanding debt issued for Trinity Health, Mich., is based on the significant geographic dispersion of risk, a healthy balance sheet, and management's success in strategically directing the recently merged organization while continuing to improve operations. However, management will be challenged to effectively manage substantial system-wide capital plans and handle a large pension-fund liability. Trinity has provider locations in seven states. There is a significant concentration of facilities in Michigan and Iowa (originally Mercy Health Services) and more dispersion of locations in Indiana, Ohio, Maryland, Idaho, and California (originally the Holy Cross Health System). Trinity providers offer services that include acute care, skilled nursing, long-term care, and psychiatric care. The system has 5,860 acute-care staffed beds, and
