U.S.-based acute-care hospital operator Community Health Systems Inc. preannounced third-quarter operating results that were meaningfully below our expectations, which we last lowered in August. Community has also recently announced that it is pursuing strategic alternatives, the result of which could be a sale of the company or a substantial portion of its assets. We believe credit risk has escalated over the past few months as a result of operating underperformance, and see greater uncertainty around Community's prospects to generate cash flow or to reduce its very high debt burden. We are affirming our 'B' corporate credit rating and revising the outlook to negative from stable. Our negative rating outlook on Community reflects our view that credit risk has escalated over
