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���������ֳ�-New York-20 April 2011: On the effective date of April 26, 2011, ���������ֳ� will confirm the short-term rating at 'F1+' on County of Montgomery, Ohio revenue bonds (Miami Valley Hospital), consisting of $28,830,000 series 2008B and $27,000,000 series 2008C (bonds). The rating action is in connection with the provision of standby bond purchase agreements (SBPAs) for liquidity support for the bonds which was previously provided by Miami Valley Hospital/MedAmerica Health Systems Corp.'s (MedAmerica) internal liquidity. On April 26, 2011, the 'F1+' rating for the series 2008B bonds will be based on the SBPA to be provided by Barclays Bank PLC (rated 'AA-/F1+', Stable Outlook by ���������ֳ�) and the 'F1+' rating for the series 2008C bonds will be based on the SBPA to be provided by Wells Fargo Bank, National Association (rated 'AA-/F1+', Stable Outlook by ���������ֳ�). The long-term 'AA-' rating for each series of bonds will continue to be based on the rating that ���������ֳ� has assigned to MedAmerica's revenue bonds. For information about the MedAmerica's rating, see ���������ֳ�'s rating action commentary dated March 17, 2011 available at ''.

Each SBPA provides for the payment of the principal component of purchase price plus an amount equal to 34 days of interest calculated at a maximum rate of 12%, based on a year of 365 days for tendered bonds during the daily and weekly interest rate modes in the event that the proceeds of a remarketing of the bonds are insufficient to pay the purchase price following an optional or mandatory tender. Each SBPA will expire on the earliest of: April 25, 2014, the stated expiration date, unless such date is extended; conversion of the bonds to other than a daily or weekly interest rate mode; the occurrence of certain events of default which result in a mandatory tender; or the occurrence of termination events related to the credit of MedAmerica which result in immediate termination of the SBPA. The short-term 'F1+' rating will expire on the expiration or prior termination of the SBPAs. The short-term rating may be adjusted upward or downward in conjunction with the long-term rating of the bonds or the short-term rating of bank providing the SBPA. Barclays Capital is the remarketing agent for the series 2008B bonds; and Wells Fargo Securities is the remarketing agent for the 2008C bonds.

Contact:
Primary Analyst:
Mary Jane Ziga
Senior Director
+1-212-908-0529
���������ֳ�, Inc.
One State Street Plaza
New York, NY 10004

Secondary Analyst:
Mario Civico
Senior Director
+1-212-908-0796

Committee Chair:
Linda Friedman
Senior Director
+1-212-908-0727


Media Relations: Cindy Stoller, New York, Tel: +1 212 908 0526, Email: cindy.stoller@fitchratings.com.

Additional information is available at .

Applicable Criteria and Related Research:
--'U.S. Municipal Structured Finance Rating Criteria', Aug. 26, 2010;
--'Rating Guidelines for Variable-Rate Demand Obligations Issued with External Liquidity Support', Feb. 28, 2011.

Applicable Criteria and Related Research: