Largest nonurban U.S. hospital provider; Good position in small rural markets; and Diversified hospital portfolio. Highly leveraged; Significant bad debt expenses; Vulnerable to legislative and economic changes in key markets; and Subject to potential reduction in government reimbursement for services. The speculative-grade rating on Franklin, Tenn.-based Community Health Systems Inc. reflects its significant debt leverage as a result of its July 2007 debt-financed acquisition of Triad Hospitals Inc., and industry challenges that the company faces, such as uncertain third-party reimbursement, significant bad debt expense, and relatively weak industry patient volume trends. We expect these factors to continue to strain its highly leveraged financial risk profile. The company's diversified hospital portfolio, good local market positions, and management's experience operating a large
