ACHE annual survey asked hospital CEOs to identify their top three issues of concern in 2022. The overwhelming number one choice was “Workforce Challenges”. This new category includes “Personnel shortages” that had been asked about in prior surveys. Within Workforce Challenges, 90% cited shortages of RNs and 83% cited technician shortages. Concern over burnout of non-physician staff was also high on the list. Again in 2022, Financial Challenges came in second. The biggest financial challenge was increasing costs for staff, supplies, etc. The third-ranked concern was Behavioral health and addiction issues, where concerns included lack of appropriate facilities in the community and lack of funding. Concern over Patient safety and quality slipped to fourth, tied with Governmental mandates. Response rate 21%, by the American College of Healthcare Executives. Updated February 2023.