Standard&Poor's Ratings Services' speculative-grade rating on Franklin, Tenn.-based Community Health Systems Inc. reflects the company's significant debt leverage and industry difficulties that the company faces, such as uncertain third-party reimbursement, significant bad debt expense, and relatively weak industry patient volume trends. We expect these factors to continue to constrain the ratings over the near term. The company's diversified hospital portfolio, good local market positions, and management's experience operating a large hospital portfolio do not mitigate these risks but do lessen downside business risk when compared with peer companies with a more concentrated portfolio. Community had a solid third-quarter 2009 performance; revenues were up 11% because of same-store growth and acquisitions. Bad debt expense increased 50 basis points to
