S&P Global Ratings affirmed its 'BB-' long-term rating on Ward County, N.D.'s series 2017C fixed-rate revenue bonds, issued for Trinity Health. The outlook is negative. The 2017C bonds are secured by gross revenue of the obligated group and a mortgage on certain hospital property. The rating reflects our view of Trinity's very weak balance-sheet metrics resulting from a continued decline in unrestricted reserves. Furthermore, unrestricted reserves have continued to diminish following last year's multi-notch downgrade to 'BB-' from 'BB+', which reflected unrestricted reserves that declined by half since 2022. In addition, Trinity maintains significant debt outstanding that was used for a replacement hospital project that opened in April 2023, which further contributes to balance sheet weakness. Trinity's debt-related metrics also
