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In their quest for growth and profits, large nonprofit hospitals in North Carolina have pushed up healthcare costs, paid executives millions and left thousands with bills they struggle to pay. In a joint investigation, the Charlotte Observer and the News & Observer of Raleigh found that urban hospitals in North Carolina have generated some of the nation's largest profit margins and have amassed billions of dollars in reserves. Hospitals in the Charlotte area have sued thousands of needy patients they could afford to help, frequently putting liens on their homes and damaging their credit. Raleigh-Durham hospitals, meanwhile, have sent collection agencies after thousands of patients, ruining the credit ratings of many in the process.