We expect Community Health Systems Inc. operations to continue to improve, with a steady increase in admissions and margin growth from reduced costs, such as labor and supply. As such, we project its performance and cash flow will improve in 2024. However, with adjusted leverage still over 8x and an inability to sustain positive free cash flow, we continue to view the company's capital structure as unsustainable. We therefore raised our rating on Community Health to 'CCC+' from 'SD' (selective default). We also raised our ratings on the senior secured first loan notes to 'B-' from 'D' and the secured junior priority notes to 'CCC-' from 'D'. The outlook is negative, reflecting the risk of further distressed exchanges in the
