Tenet Healthcare Corp. THC is set to join the S&P MidCap 400 replacing Jarden Corp. JAH after trading closes on Apr 15, 2016. This means that Tenet will be removed from the elite S&P 500 as trading closes on the same date. With market capitalization of $2.3 billion, Tenet is likely to be fit for the “mid-cap market space”, rather than the S&P 500 group. Tenet will be added to the S&P MidCap 400 GICS Health Care Facilities Sub-Industry index.Revisions in the S&P 500 remain an ongoing process with acquisitions or not-so strong performance by the companies in the elite group. Last week, Cameron International was removed (as Schlumberger Limited acquired Cameron) with Foot Locker Inc. FL replacing it. Last month, Consol Energy CNX was removed from the list due to sustained weak performance while the better-performing American Water Works Company Inc. AWK replaced it.Coming back to Tenet, shares lost about 1.11% in yesterday’s trading session and about another 2.7% in after-market trading to finally close at $27.75. While trading volumes fluctuated by a considerable margin each day over the past several weeks, the stock returned -41.96% in the last one-year period comparing unfavorably with -1.2% by the S&P group. Also, the stock has been witnessing negative estimate revisions over the last eight weeks. The Zacks Consensus Estimate moved down 22% for both 2016 and 2017 and most of the estimates were revised lower. Notably, the bottom line in 2016 is expected to decline nearly 12% from 2015.Headquartered in Dallas, TX, Tenet Healthcare owns and operates general hospitals and related healthcare facilities. Tenet Healthcare serves a large number of uninsured and underinsured patients with a high burden of co-payments and deductibles. Consequently, the company has a high level of uncollectible accounts and rising bad debts. Tenet Healthcare expects a high level of uncollectible accounts in the coming years as well.The company has also been experiencing high levels of operating expenses that are coming in the way of margin expansion. Tenet Healthcare is a highly leveraged company with long-term debt-to-equity ratio of 20.8x. It deploys a substantial part of its cash flow to pay the interests on its debts and is left with limited funds for its operations, growth initiatives or capital expenditures. This stock currently holds a Zacks Rank #4 (Sell).Nonetheless, the company’s synergies from acquisitions, higher revenues and growth in the outpatient business are its long-term drivers. Also, Tenet Healthcare has been evaluating strategies to evaluate areas best suited for its integrated delivery networks and those where it has a low market share. The expected long-term earnings growth rate is currently pegged at 12.3%.Tenet Healthcare is slated to report its first-quarter earnings results on May 2 after the market closes. The Zacks Consensus Estimate is pegged at 30 cents per share, translating into a year-over-year decline of 41.9%. Also, our proven model cannot conclusively say if it will beat or miss expectations because not only does the company have an Earnings ESP -23.08%, it also carries a Zacks Rank #4 (Sell). We caution against stocks with a Zacks Rank #4 or 5 (Sell rated) going into the earnings announcement.Yet, the company posted positive surprises in three of the last four quarters, with an average beat of 42.98%.Want the latest recommendations from Zacks Investment Research? Today, you can download 7 Best Stocks for the Next 30 Days. Click to get this free report >>Want the latest recommendations from Zacks Investment Research? Today, you can download 7 Best Stocks for the Next 30 Days. Click to get this free report AMER WATER WORK (AWK): Free Stock Analysis Report CONSOL ENERGY (CNX): Free Stock Analysis Report TENET HEALTH (THC): Free Stock Analysis Report JARDEN CORP (JAH): Free Stock Analysis Report FOOT LOCKER INC (FL): Free Stock Analysis Report To read this article on Zacks.com click here. Zacks Investment Research