New report finds cost-cutting at MedStar Franklin Square puts patient care in jeopardy

Researchers find chronic understaffing leads to poorer patient outcomes on keys measures

In a new report, "The Cost of Cutting Care: How MedStar Is Failing Franklin Square Nurses and Patients", released by National Nurses United (NNU), the country's largest nurses union, finds chronic registered nurse (RN) understaffing by MedStar Franklin Square Medical Center in Baltimore, Md., puts patient care at risk and leads to numerous poor outcomes as measured by U.S. Centers for Medicare and Medicaid Services (CMS).

"This research paper puts in black and white what many nurses know to be true: We are doing all we can to care for our patients, but MedStar Health is failing all of us by refusing to properly invest the resources we need to do our jobs," said Dana Dawkins, RN. "It is time that MedStar step up and provide nurses the staffing we need to provide the highest quality of care to our patients. That is why we are forming a union, so that we will have a seat at the table when decisions are made about patient care."

The report outlines some of the persistent problems with MedStar Franklin Square including:

• Only 29 percent of patients receive appropriate care for sepsis and septic shock. This is far below the national average of 65 percent.
• Patients are experiencing serious complications during hospital stays or after surgical procedures that is 41 percent higher than the national average.
• The rate of bedsores per discharge is more than three times the national average.

Beyond the CMS data, researchers found that lack of staffing led to high levels of workplace injuries for nurses. In 2025, the rate of RN work-related injuries at MedStar Franklin Square was 30 percent higher than the national average.

In the study, nurses reported health care workers experience "regular incidents of violence and pervasive sexual harassment." Nurses hold management accountable for failing to institute proper safety protocols or prevention measures. The report notes that "workplace violence is significantly more likely to happen when units are short-staffed and when nurses have heavy workloads."

"Understaffing creates serious risks for nurses and patients. We see nurses injured when they must physically move patients on their own," said Marcy Aulenbacher, RN. "This also increases the likelihood of patient falls. Lack of staffing also leads to an increase in workplace violence as patients who are suffering with physical, emotional, and behavioral crises must wait longer for care. This is not fair to our patients and we demand that MedStar do better."

In an effort to address these longstanding issues, nurses at MedStar Franklin Square are advocating for their patients by organizing to form a union. The nurses say their aim is to see safe staffing in all units across the hospital, to put in place unit-specific workplace violence prevention plans, to ensure that equipment on the floors is in good working order, and to hold management accountable for addressing the many deficiencies in the hospital.

Unfortunately, nurses say they have faced an aggressive anti-union campaign by management. This includes management interrogating nurses about union support, surveilling nurses, and using security to interfere with nurses speaking with coworkers.

Based on previous contracts reported to the Dept. of Labor, NNU estimates MedStar Health is spending an estimated $28,000 to $40,000 per week on union-busting efforts. This is money nurses say should be put towards patient safety and necessary resources.

Nurses note the not-for-profit hospital receives millions of dollars in tax breaks, as well as federal and state grants. According to the Federal Audit Clearinghouse, in 2025 alone, MedStar Health spent $78.9 million of federal funding awards. Notably, according to their own financial records, MedStar Health made more than $1 billion in 2024 and 2025. Furthermore, MedStar Health CEO Ken Samet took home just under $45 million in compensation from 2021 through 2025.

The union election is scheduled to be held on Oct. 14 and 15. Some 900 nurses work at MedStar Franklin Square. NNOC/NNU represents more than 2,200 registered nurses at MedStar Washington Hospital Center in Washington, D.C.

National Nurses United is the largest and fastest-growing union and professional association of registered nurses in the United States with more than 225,000 members nationwide. NNU affiliates include California Nurses Association/National Nurses Organizing Committee, DC Nurses Association, Michigan Nurses Association, Minnesota Nurses Association, and New York State Nurses Association.