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America's hospitals and health systems have been severely impacted by the COVID-19 pandemic, with over 80 million cases, nearly 1 million deaths, and over 4.6 million hospitalizations. Hospitals have experienced historic volume and revenue losses, as well as skyrocketing expenses, with over 33% operating on negative margins. The pandemic has led to billions of dollars in losses, and hospitals have not received government assistance to mitigate rising expenses and lost revenues during the delta and omicron surges. Patient acuity has increased, with the average length of stay rising 9.9% by the end of 2021, and hospital expenses have grown 11% compared to pre-pandemic levels. Key pressures facing hospitals include workforce and contract labor expenses, drug expenses, medical supply and PPE expenses, and rising economy-wide inflation. The hospital workforce is central to the care process, and labor costs account for over 50% of hospitals' total expenses, with a significant decline in hospital employment and an increased reliance on contract staffing firms.