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February 2, 2010; | There have been a number of articles recently that suggest that 2010 will not be an easy year for nonprofit hospitals but this one is particularly vivid. States this article at, “The nation’s largest publicly traded hospital chains are stalking medical centers that have been hurt by the cost of charity care and unpaid bills in a recession…” Apparently the intended prey of certain big, publicly funded hospital chains is relatively small community hospitals in areas with larger numbers of uninsured patients. The object, of course is merger (or acquisition). The article says that the bigger chains may find more willing partners among small locally based hospitals as the probability of health care reform and funding for the uninsured fades and as capital continues to be tight. Meanwhile Fitch Ratings reports it “is maintaining a Negative Outlook for U.S. nonprofit hospitals and health systems in its special outlook report issued today. Over the near term, the evolving elements of health reform, lingering recessionary effects, continued instability in the financial sector and government cost containment efforts will pressure providers’ revenues, operations, profitability and capital access.”—Ruth McCambridge