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Patient care is in crisis in Pennsylvania.

Over the last 20 years, hospital profits and CEO pay have grown to record-levels while health care systems across the state are consolidating and investing more capital in for-profit subsidiaries and insurance operations. The 1990s especially saw unprecedented restructuring of the health care industry, featuring a staggering rate of mergers, acquisitions and closures of hospitals—between 1987 and 1997, 675 acute care hospitals across the county closed —as well as major shifts in where and how care is delivered. With competition and pressure to keep the doors open on the rise, major corporations and executives began, and continue to this day, to enact policies and practices that put profits over patients, and reduce labor costs. Our health care systems are feeling the effects of these decisions now more than ever.

Nurses and other health care professionals across the state and in every work setting are increasingly forced to do more with less. This broken system views nursing and frontline care as a line item on a spreadsheet, disregarding nurses’ critical role in providing quality care. Our broken system sees nurses as a cost, not a value.

This report compiles results of a survey of 1,000 nurses – who work in hospitals, schools, rehabilitation centers, long-term care and other facilities across the state — who report that they have less input into how their work is done, are spending less time at the bedside, and face chronic staffing shortages.