The ratings on Community Health Systems Inc. reflect Standard&Poor's Ratings Services' assessment of its business risk profile as "fair" and the financial risk profile as "highly leveraged," according to our criteria. The ratings reflect our expectation of high-single-digit revenue growth, supported by a mid-single-digit organic growth rate and modest acquisition activity. The company remains acquisitive, but we believe acquisitions will stay moderate, and expect management to extend its success in improving acquired underperforming hospitals. We expect a significant improvement in the EBITDA margin in 2012; however, this is entirely on the upcoming adoption of an accounting change regarding the provision for bad debt. On a comparable basis, we expect reimbursement pressure and weak patient volume to offset increasing
