PHILADELPHIA (October 7, 2026) – Patients treated at for-profit hospitals experienced higher mortality and readmission rates, while nurses working in those hospitals reported less safe staffing and substantially worse working conditions, according to a new study led by researchers at Penn Nursing’s Center for Health Outcomes and Policy Research (CHOPR) and the Leonard Davis Institute of Health Economics.
The findings , published open access in Medical Care , arrive amid increasing hospital corporatization and profit-driven health care. The study found that differences in nurse staffing accounted for part of the observed lower quality in for-profit hospitals. The findings suggest that investments in nursing and state policies establishing safe staffing requirements are important and actionable mechanisms to ensure patient safety, nurse retention, and quality of care for patients regardless of the ownership type of their hospital.
Researchers studied the outcomes of more than 1.17 million patients across 143 for-profit and 798 nonprofit adult acute care hospitals in 10 states. Nurses in for-profit hospitals reported markedly worse staffing: 71% said their assigned patient workloads were not safe. Patient outcomes followed the same pattern. Compared with nonprofit hospitals, in for-profit hospitals:
The consequences for nurses working in for-profit hospitals were concerning. Nurse burnout was significantly higher in for-profit hospitals. Nurses in for-profit hospitals were far less likely to recommend their hospital to family and friends as a place of care or a place to work because of their concerns about poorer staffing.
“Treating safe nurse staffing as a core component of quality rather than a discretionary operating expense is especially important where incentives to cut labor costs are strongest,” said lead author Matthew D. McHugh, PhD, JD, MPH, RN, FAAN , Independence Chair for Nursing Education, Professor of Nursing, CHOPR Director at Penn Nursing, and Senior Fellow at the Leonard Davis Institute of Health Economics. “Minimum safe staffing requirements and ownership transparency are practical safeguards for patients and nurses.”
The authors conclude that policies establishing minimum safe nurse staffing requirements and enhancing hospital ownership transparency could meaningfully improve patient, nurse, and hospital outcomes.
The study was conducted with CHOPR co-authors Karen B. Lasater, PhD, K. Jane Muir, PhD, Trissa Lyman, MPH, Angelo Petto, BSN, and Linda H. Aiken, PhD. Lasater, Muir, Lyman, and Aiken are also fellows of CHOPR and the Leonard Davis Institute of Health Economics. This research was supported by the National Institute of Nursing Research (NINR) of the National Institutes of Health (NIH) under grant award numbers R01NR014855, T32NR007104, and R01NR021707.
The article, “ Patient Outcomes and Nurse Understaffing in For-Profit Hospitals ” (DOI: 10.1097/MLR.0000000000002376), is available open access in Medical Care .
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Related Research:
Muir, K. J., Sliwinski, K. S., Golinelli, D., McHugh, M. D., & Lasater, K. B. (2025). Hospital ownership type correlated with investments in nursing services: evidence from Illinois. Medical Care, 63(8), 594.
About the University of Pennsylvania School of Nursing
The University of Pennsylvania School of Nursing (Penn Nursing) is a global leader in nursing education, research, and practice. Ranked the #1 nursing school in the world by QS World University (2026)—a distinction it’s held nine prior times—Penn Nursing is also home to the nation’s #1-ranked BSN program according to the U.S. News & World Report Best Colleges Rankings, with graduate programs also consistently ranked among the nation's best. As the top National Institutes of Health (NIH)–funded nursing research institution in the U.S., Penn Nursing integrates innovation, interdisciplinary collaboration, and evidence-based practice to prepare nurse scientists, clinicians, and leaders to meet the complex health needs of a global society. Follow Penn Nursing: Facebook | LinkedIn | YouTube | Instagram .
About the Center for Health Outcomes and Policy Research
The Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing is dedicated to building the actionable evidence base needed to advance effective policy, practice, and health system reforms that improve health outcomes for patients while cultivating clinician well-being.
Medical Care
Patient Outcomes and Nurse Understaffing in For-Profit Hospitals
3-Sep-2026