Good position in small rural markets; and Large, diversified hospital portfolio. Highly leveraged; Vulnerable to legislative and economic changes in key markets; and Subject to potential reduction in government reimbursement for services. The ratings on Community Health Systems Inc. reflect Standard&Poor's Ratings Services' assessment of its business risk profile as "fair" and the financial risk profile as "highly leveraged," according to our criteria. The ratings reflect our expectation of high-single-digit revenue growth, supported by a mid-single-digit organic growth rate and modest acquisition activity. The company remains acquisitive, but we believe acquisitions will stay moderate, and expect management to extend its success in improving acquired underperforming hospitals. We expect a significant improvement in the EBITDA margin in 2012; however,
