Official Seal, Everything Is Broken (2026)

Everything Is Broken

Report No. 1 · Nonprofit Hospital Executive Pay vs Charity Care · Annual Report, 2026 edition

Montana · Not ranked: see note below.

Holy Rosary Healthcare

Karen Costello, President Hrh/President Sjb(Partial). Fiscal year ending 2024-12.

$726,032
CEO total compensation
Form 990 Part VII, columns D+E+F
2.76%
of expenses spent on charity care
Schedule H Part I line 7a
33.3%
CEO pay as a share of all charity care
Karen Costello’s pay of $726,032 equals 33.3 percent of the $2,177,434 the system spent on charity care in the same year.

Not in the ranking because the chief executive could not be identified from the filing with confidence. The figures below are shown as filed.

Most of the reported compensation ($548,419 of $726,032) came from a related organization (Part VII column E) and was reported on this filing.

§1The filing

Total revenue
$87,791,278
Total expenses
$78,828,803
Net assets
$104,400,074
Employees
405
Hospitals covered
1 facilities across 1 filing
Charity care, net
$2,177,434
Bad debt
$1,320,885
Medicare surplus (shortfall), as filed
$2,606,191
CEO pay from the organization (Part VII col. D)
$0
From related organizations (col. E)
$548,419
Other compensation, including deferred pay and nontaxable benefits (col. F)
$177,613
CEO total compensation (D+E+F)
$726,032 to Karen Costello

Medicare surplus (shortfall) is Schedule H Part III line 7: Medicare revenue minus the cost of Medicare care. A figure in parentheses is a shortfall. Like bad debt, it is not community benefit on the IRS form.

Source: Form 990, Holy Rosary Healthcare, EIN 81-0231792, fiscal year ending 2024-12, as published by the IRS. CEO identification: president title multiple.

§2Community benefit versus charity care

What the system reported as total community benefit (Schedule H line 7k)$6.9M Of which charity care to patients who could not pay (line 7a)$2.2M (32%)

The rest of line 7k is Medicaid shortfall, medical education, research, subsidized services and contributions. Bad debt ($1.3M) and Medicare shortfall are reported separately by the IRS and are not community benefit on the form.

Every number on this page was copied from the filing linked above. If a figure is wrong, send the filing that contradicts it and the correction runs at the top of this page.

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Holy Rosary Healthcare: CEO pay $726,032, charity care 2.76% of expenses