Community Health Systems Inc. is acquiring Health Management Associates Inc. in a cash and stock transaction valued at $7.6 billion, including the assumption of HMA's existing $3.7 billion of debt. Standard&Poor's Ratings Services is affirming its 'B+' corporate credit rating and revising the rating outlook to negative. At the same time, we are placing our rating on the company's senior debt on CreditWatch with negative implications and the rating on its unsecured debt on CreditWatch with developing implications. While we expect the combined entities to generate modest synergies, the continuation of recently weak operating performance by both companies may limit the company's ability to reduce leverage to near its present level within 12 to 18 months post transaction,
