The speculative-grade ratings on Community Health Systems Inc., an operator of non-urban hospitals, reflect Standard&Poor's Ratings Services' concern about the company's modestly aggressive acquisition activity and uncertain reimbursement levels by the government and other third-party payors. Brentwood, Tenn.-based Community Health is an owner and operator of 70 hospitals in 22 states, primarily in small, non-urban markets with stable or growing population bases of between 20,000 and 100,000. The company maintains strong market positions because the majority of its hospitals are the sole providers in their communities. Community Health also maintains an aggressive but disciplined acquisition approach, considering in its targets such factors as physician recruitment and service enhancement. Despite rapid growth during the past few years, the company's
