Community Health Systems Inc. 's operating performance continues to steadily improve, with increasing adjusted admissions and net revenue per admission. However, EBITDA margins, while benefiting from growing patient volumes, much lower utilization of contract labor, and moderating inflationary pressures, are still hampered by an unfavorable acuity mix and higher medical specialist fees. Furthermore, adjusted leverage remains stubbornly high, still more than 8x, and the company has yet to generate strong sustained positive free cash flows. S&P Global Ratings raised its rating on Community Health to 'CCC+' from 'SD' (selective default). We also raised our ratings on the senior unsecured notes to 'CCC-' from 'D'. At the same time, we assigned our ?B-? (one notch above the issuer credit rating) issue-level
