Official Seal, Everything Is Broken (2026)

Everything Is Broken

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

California · Ranked 519 of 1033 by CEO pay.

Mark Twain Medical Center

Douglas P Archer, President & CEO. Fiscal year ending 2025-06.

$774,445
CEO total compensation
Form 990 Part VII, columns D+E+F
1.28%
of expenses spent on charity care
Schedule H Part I line 7a
67.4%
CEO pay as a share of all charity care
Douglas P Archer’s pay of $774,445 equals 67.4 percent of the $1,148,254 the system spent on charity care in the same year.

Most of the reported compensation ($650,563 of $774,445) came from a related organization (Part VII column E) and was reported on this filing.

§1The filing

Total revenue
$91,192,347
Total expenses
$89,857,813
Net assets
$47,887,045
Employees
519
Hospitals covered
1 facilities across 1 filing
Charity care, net
$1,148,254
Bad debt
$1,564,277
Medicare surplus (shortfall), as filed
($9,884,478)
CEO pay from the organization (Part VII col. D)
$0
From related organizations (col. E)
$650,563
Other compensation, including deferred pay and nontaxable benefits (col. F)
$123,882
CEO total compensation (D+E+F)
$774,445 to Douglas P Archer

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, Mark Twain Medical Center, EIN 68-0127677, fiscal year ending 2025-06, as published by the IRS. CEO identification: ceo title.

§2Community benefit versus charity care

What the system reported as total community benefit (Schedule H line 7k)$9.0M Of which charity care to patients who could not pay (line 7a)$1.1M (13%)

The rest of line 7k is Medicaid shortfall, medical education, research, subsidized services and contributions. Bad debt ($1.6M) 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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Mark Twain Medical Center: CEO pay $774,445, charity care 1.28% of expenses