Lown Institute, a nonpartisan healthcare think tank, released a new report April 11 examining the finances of 1,773 nonprofit hospitals in the U.S. The report — which does not include large health systems like Renton, Wash.-based Providence; Oakland, Calif.-based Kaiser Permanente; Somerville, Mass.-based Mass General Brigham; Cleveland Clinic; and Detroit-based Henry Ford — found that some hospitals fell short on and others exceeded expected investments in their communities.
For the report, Lown calculated private nonprofit hospitals' "fair share spending" based on 2020 IRS Form 990 by comparing the estimated value of hospitals' tax exemptions to spending on financial assistance and meaningful community investment — including community health improvement activities, contributions to community groups, community-building activities, and subsidized healthcare services. IRS categories of Medicaid shortfall, health professions education and research were not included.
Lown said expenses, income and community investment data were prorated across hospitals for hospitals that file as a group, based on their share of system revenue. Financial audit or CMS cost report information was used to calculate expenses and net income for hospitals filing with universities where Schedule E was submitted. Providence, Kaiser Permanente, Mass General Brigham, Cleveland Clinic and Henry Ford were not included in the report because 2020 IRS filings were unavailable.
Lown considered hospitals that dedicated at least 5.9 percent of overall expenditures to charity care and meaningful community investment as spending their fair share. More information on the methodology is available here.
Here are 25 hospitals that had the largest "fair share" surpluses, meaning their spending on charity care and community investment exceeded the value of their tax exemption in 2020, according to Lown. They are listed in descending order based on surplus amount. Note: The list includes ties.
1. NewYork-Presbyterian Hospital (New York City): $117 million
2. Nebraska Medical Center (Omaha): $116 million
3. Stanford Health Care (Palo Alto, Calif.): $92 million
4. Mount Sinai Hospital (Chicago): $54 million
5. Christus Spohn Hospital Corpus Christi (Texas): $47 million
6. UPMC Western Maryland (Cumberland): $44 million
7. Gerald Champion Regional Medical Center (Alamogordo, N.M.): $42 million
8. Saint Francis Hospital (Tulsa, Okla.): $41 million
8. Wellstar Kennestone Hospital (Marietta, Ga.): $41 million
10. Summit Healthcare Regional Medical Center (Show Low, Ariz.): $40 million
10. United Regional Health Care System (Wichita Falls, Texas): $40 million
12. Martin Luther King Jr. Community Hospital (Los Angeles): $39 million
13. UCHealth Medical Center of the Rockies (Loveland, Colo.): $38 million
14. Tidal Health Peninsula Regional Medical Center (Salisbury, Md.): $35 million
15. Baptist Memorial Hospital (Memphis, Tenn.): $31 million
16. St. Joseph Regional Medical Center (Bryan, Texas): $30 million
17. Meritus Medical Center (Hagerstown, Md.): $29 million
18. University of Maryland Shore Medical Center at Easton: $25 million
18. Regional West Medical Center (Scottsbluff, Neb.): $25 million
18. Wellstar Cobb Hospital (Austell, Ga.): $25 million
18. Kuakini Medical Center (Honolulu): $25 million
22. Boston Medical Center: $24 million
22. Rochester (N.Y.) General Hospital: $24 million
24. St. John's Episcopal Hospital at South Shore (Far Rockaway, N.Y.): $23 million
24. Houston Methodist Sugar Land (Texas) Hospital: $23 million