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4. Tenet Healthcare
4. Tenet Healthcare
Fortune 500 rank: 253
2009 revenue: $9.2 billion
2009 total shareholder return: 368.7%

Tenet has come back from its near-death experience after regulators discovered fraudulent activities in 2002. After selling off underperforming properties, this conglomerate of 50 general hospitals now boasts the No. 2 position in half its local markets.

But Tenet is still highly leveraged, and shareholders are relying on the capital market to refinance the company's next round of major debt repayments starting in 2012.

NEXT: 5. Unisys

Last updated April 15 2010: 7:07 AM ET
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