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T wo degrees make a difference. As an obstetrics nurse who helps deliver babies and cares for mothers and newborns, Brenda Meadwell knows that taking an accurate tempera- ture is critical for properly assessing her patients. "On a newborn, the temperature might be the first clue that something is wrong," said Meadwell, who has worked 29 years at Bluefield Regional Medical Center, a hospital in the northernmost part of West Virginia. So when Meadwell and her RN colleagues were regis- tering more than two degrees difference in readings between what she called the hospital's "old-old" thermometers and "new-old" thermometers, they decided to lobby management for the thermometers and other basic equipment they needed, such as vital sign monitors and blood pres- sure cuffs. Meadwell said that when she first tried to hand her super- visor the nurses' signed petition, "my boss wouldn't even look at me." Days later, all the "old-old" thermometers disappeared from the units, and management told the nurses that it would "be a while" before they received new thermometers. Angered that hospital administration would punish them for their reasonable request to have basic, functional equip- ment, the Bluefield nurses decided to host a bake sale to raise funds to "donate" to the hospital. "We decided we'd shame them," said Meadwell. "Maybe if the public knew we didn't have the equipment we needed to take care of our patients, then the hospi- tal might finally do something about it." So this April, Meadwell and her coworkers set up a table loaded with cup- cakes, cookies, and Rice Krispie treats at a local shopping center. They handed out flyers, chatted with many local residents about their hospital experi- ences, and ultimately raised $150, which they plan to present to the hospital CEO. The irony of the whole sit- uation is that Bluefield Regional can well afford new thermometers, blood pres- sure cuffs, and vital sign monitors. Bluefield Regional is not some struggling, inde- pendent community hospi- tal. It is not a public, county hospital depending on a dwindling tax base. Rather, it is just one of a vast for-profit hospital chain owned by Community Health Systems, a publicly traded healthcare corporation based in Tennessee that reported annual revenues of more than $13 billion last year, and profits of more than $140 mil- lion. Community Health Systems is currently the country's largest hospital system, with 206 hospitals and about 31,000 licensed beds sprawled across 29 states. Six of the 10 most expensive hospitals in the United States, meaning those hospitals that set the highest prices for their services (on average at least 10 times the actual cost), are CHS facilities. Its chief executive officer, Wayne Smith, is one of healthcare's highest-paid executives and enjoyed a compensation package worth almost $9 million in 2013 and, in his best year of 2011, a package valued at $21 million. In addition to the actual hospitals it owns and runs, CHS is also a holding company that owns some 750 subsidiary businesses. These range from doctors' groups to home health agencies to group purchasing organizations, from healthcare consultancies to hospital construction MONOPOLY MEDICINE This past year, Community Health Systems has swiftly and quietly become the largest hospital chain in the United States. Learn why nurses are saying this corporation's vast influence and control over healthcare is very, very bad for patients and RNs, and why the company should be renamed "Corporate Wealth Systems." B Y L U C I A H W A N G 12 N A T I O N A L N U R S E W W W . N A T I O N A L N U R S E S U N I T E D . O R G J U N E 2 0 1 4 RNs in Bluefield, W.V. held a bake sale to raise money for basic equipment