In a pitch to leery investors, Cool Springs-based Community Health Systems says the company has urbanized. The company has been selling off or closing poorly performing rural hospitals for the last several years.

The selling spree is primarily meant to pay down the company’s outsized debt load left over from when Community Health was growing as fast as it could. But the hospital chain was also strategically pulling out of small towns, including several in Tennessee.

CEO Wayne Smith told investors gathered at this week’s annual
J.P. Morgan Healthcare Conference in San Francisco that it’s almost entirely left communities with fewer than 50,000 people — once its calling card compared to competing hospital chains.

“So our markets look a lot more like HCA and Universal and Tenet than they did in the past,” Smith said late Wednesday
during a company presentation. “We’re no longer a non-urban, or for some of you all a rural, hospital company.”

As it’s repositioned, Community Health’s stock price tumbled to
nearly two dollars a share, stoking concern of whether the company could even recover.

The hospital chain has continued to see shrinking admissions and ER visits, but executives assured investors this week they’ve regained their footing.

“Those divestitures have helped us in terms of paying down our debt, improving our margins, improving our cash flow, which you will see more of in 2019,” Smith said.