Ascension reported Monday a $466 million loss from operations (-2.3% operating margin) and $195 million of net income for the nine months ended March 31. The large nonprofit painted these results as progress as it adjusts its hospital portfolio and recovers from last year’s major cybersecurity attack.
The performance is a step back from the $238 million operating loss (-1.1% operating margin) and $343 million net income Ascension had logged across the first nine months of its prior fiscal year, even when including that period’s more substantial net impairment and nonrecurring losses ($85 million in nine months of FY 2025 versus $253 million in nine months of FY 2024).
Still, the organization framed the performance in each of FY 2025’s successive quarters as a “significant improvement” over the final frame of FY 2024, when it suffered the worst of a cybersecurity attack’s operating impact.
Specifically, the fourth quarter of FY 2024’s recurring operating loss (which excludes net impairment losses) was over $1.4 billion, with the subsequent quarters landing at a $197 million loss, a $116 million loss and a $68 million loss.
“Since Q4 FY24, we have improved recurring operating performance by $1.4 billion, while increasing patient volumes and same-facility revenue,” Ascension President Eduardo Conrado said in a release. “This momentum reflects the discipline of our teams, the dedication of our caregivers and a strategy grounded in compassion, performance and data-driven decision-making. We are removing barriers to care, improving patient experiences and building a more connected system that is better equipped to serve every community today and into the future.”
Ascension’s major financial metrics have generally declined since the prior fiscal year due to divestitures, including the handoff of eight Illinois hospitals to Prime Healthcare, the transfer of a majority interest in eight hospitals to Henry Ford Health and the sale of three others to MyMichigan Health.
As such, Ascension’s operating revenues were $6 billion for the quarter and $19.5 billion year to date, down from $7.4 billion and $22.4 billion in the prior year. Here, the system noted a 1.1% year-over-year increase in same facility net patient service revenue (NPSR) and a 1.4% rise in same facility NPSR per equivalent discharge across the nine-month periods. The update was primarily attributed to managed care rate negotiations with commercial payers.
Total operating expenses were $6.1 billion for the quarter and just under $20 billion across nine months, also down from $7.4 billion and $22.5 billion. Ascension saw a 1.1% increase in year-to-date same facility total operating expenses and a 1.6% rise in same facility year-to-date cost per equivalent discharge; for both, it said cost containment and economic improvement plans had somewhat checked inflationary pressures. Nine-month total salaries, wages and benefits dropped 12.6% year to year and 0.7% on a same facility basis. This was attributed to initiatives limiting agency staffing and reducing turnover, with Ascension highlighting its five-year high nurse retention rate of 88.3%.
“This achievement reflects the success of ongoing initiatives to foster a more supportive and engaging workplace,” the system wrote in a release. “By investing in career growth opportunities and reinforcing a culture that prioritizes associate well-being, Ascension is strengthening its workforce, reducing turnover, and decreasing reliance on agency staffing—ensuring a more stable, consistent care environment for patients.”
On a same facility basis, Ascension’s nine-month volumes were down slightly from FY 2024. Equivalent discharges were down 0.5%, emergency room visits by 1.4%, inpatient surgery visits by 2.9% and outpatient surgery visits by 2.7%.
However, the system said those numbers were “consistent with expectations” as it has been working to gradually ramp its volumes back up since the cybersecurity attack in May 2024, such as by rescheduling delayed procedural volumes. Compared to that fourth quarter a year prior, year-to-date volume change per day have been almost entirely higher: a 5.9% increase in equivalent discharges, a 6.4% increase in emergency room visits and a 6.3% increase in inpatient surgery visits. Outpatient surgery visits were the only exception, falling 1.6%.
Investment returns across nine months were $910 million, a $114 million improvement over the prior year’s period.
It has 218 days of cash on hand as of March 31, well above the 194 days it had at the top of the fiscal year, though net days in accounts receivable has dropped from 78.4 to 57.5.
Ascension also called out $1.2 billion of charity care and other community benefit across nine months, down from almost $1.4 billion a year prior.
“We have seen measurable growth in same-facility revenue, patient throughput, and nurse retention—all reinforcing our operational foundation,” Saurabh Tripathi, executive vice president and chief financial officer, said in a release. “These results allow us to reinvest in critical areas, including clinical infrastructure, digital innovation, and expanded access in the communities we serve. Our financial strategy remains focused on long-term stability and mission-aligned growth.”
As of quarter close, Ascension had 94 wholly owned or consolidated hospitals as well as ownership interests in an additional 27. It employed about 99,000 people across 16 states and the District of Columbia. Across the entirety of FY 2024, it reported $28.6 billion total operating revenue, $30.1 billion in total operating expenses, a $1.8 billion operating loss and a $1.1 billion net loss.
Ascension’s portfolio realignment has continued since the quarter’s close. In April, it announced it would be selling off four southwest Michigan hospitals to Beacon Health System, virtually completing its exit from the state, while also purchasing the majority stake in a Texas hospital and its ancillary businesses from Community Health Systems.