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. Standard&Poor's Ratings Services' speculative-grade rating on Franklin, Tenn.-based Community Health Systems Inc. reflects the company's significant debt leverage and industry difficulties 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 constrain the ratings over the near term. The company's diversified hospital portfolio, good local market positions, and management's experience operating a large hospital portfolio do not mitigate these risks but
