The speculative-grade ratings on Community Health Systems Inc., an operator of non-urban hospitals, reflect Standard&Poor's concern about the company's somewhat aggressive acquisition activity and the uncertain reimbursement levels it can expect to receive from the government and other third-party payors. Brentwood, Tenn.-based Community Health is an owner and operator of 72 hospitals in 22 states, primarily in small, non-urban markets with stable or growing populations of 20,000 to 100,000 people. 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 approach to acquiring hospitals, focusing on the possibilities of physician recruitment and service enhancement. The company's revenues have more than doubled
