What did ProPublica base its analysis of St. Jude’s fundraising and reserves on, and how do ALSAC and St. Jude respond line-by-line?
Executive summary
ProPublica’s reporting rested on nonprofit tax filings, internal financial disclosures and interviews to calculate how much St. Jude and its fundraising arm ALSAC raised, spent on fundraising, and set aside in reserves — including headline figures about an $886 million increase in unspent revenue and a multibillion-dollar reserve built from years of surpluses [1] [2]. ALSAC and St. Jude countered that the reporting was selective or flawed, pointed to the hospital’s mission and long history of helping families, defended bequest practices and cited recent expansions in family benefits as a response to the scrutiny [3] [4] [5] [6].
1. What ProPublica based its analysis on: tax returns, internal budgets and Alliance rules
ProPublica’s investigations drew primarily from IRS tax filings and the charities’ own financial disclosures and budgets — combining ALSAC’s fundraising expenses with St. Jude hospital expenses to measure total spending and reserves — and applied an industry “reserve” comparison used by the Children’s Hospital Association (the alliance) that deducts fixed assets and compares cash-like reserves to a budget figure to produce ratios such as the alliance’s 3.05-times figure [1] [2].
2. The principal numbers ProPublica highlighted and how they were derived
Reporters emphasized that ALSAC spent roughly $626 million in fiscal 2021 on operations including fundraising, that roughly 30% of donations covered fundraising costs while another ~20% increased reserves, and that the charity steered an average of about $400 million a year into reserves between 2016–2020, leaving a multibillion-dollar reserve total reported as $5.2 billion as of June 30, 2020; those figures come from the organizations’ filings and the alliance’s calculation method cited by ProPublica [1] [5] [4].
3. ALSAC and St. Jude’s line-by-line rebuttals and public defenses
ALSAC and St. Jude pushed back on specific lines of criticism: they told ProPublica that its bequest reporting was “highly selective and flawed,” arguing ProPublica focused on a small number of contested cases rather than the breadth of donations ALSAC receives [3]; lawyers for the organizations emphasized the institution’s positive impact since 1962 and said bequest programs “operate with the highest ethical standards,” defending solicitation and legacy-gift practices as standard among large charities [4] [6]; and after being provided with ProPublica’s findings, the hospital publicly announced expanded family supports — broader travel and housing assistance — casting that as a concrete institutional response to concerns raised in the reporting [5].
4. Alternative interpretations, motivations and the story’s implicit tensions
ProPublica framed the central tension as a question of allocation: aggressive, national-scale fundraising that builds large reserves can undercut local hospitals’ appeals and leaves families still burdened by costs, a narrative supported by interviews with some doctors and families and by showing many families using crowdfunding [7] [6]. ALSAC’s rebuttals emphasize mission, ethics and outcomes, which serves both reputational defense and fundraising interests; critics argue the charity’s size and national reach create market effects that merit scrutiny, while supporters insist reserves are prudent for a research hospital with multiyear projects and unpredictable funding needs [2] [1].
5. What the reporting shows and what remains open or disputed
The documentary basis — tax filings, disclosed budgets and alliance comparison rules — is clear in ProPublica’s work and anchors its arithmetic [1] [2], but ALSAC disputes selection and context, saying isolated legal disputes over bequests do not reflect routine practice [3]. ProPublica’s figures about fundraising share and reserves rely on aggregation choices (combining ALSAC and hospital budgets, excluding fixed assets per the alliance metric) that materially affect the headline ratios, and ALSAC’s responses foreground mission and recent policy changes; beyond those published responses, the sources provided do not contain independent audit rebuttals or a neutral third-party forensic accounting that settles methodological disagreements [1] [3] [5].
Conclusion
ProPublica anchored its critique in publicly available financial filings and an industry reserve-comparison method to show a pattern of large fundraising, substantial fundraising costs and fast-growing reserves [1] [5]; ALSAC and St. Jude responded by disputing selectivity, defending ethical practices around bequests, pointing to decades of patient care and publicizing expanded family benefits as corrective measures [3] [4] [5]. Where interpretation depends on aggregation choices and framing — what counts as “reserve,” how fundraising expenses are judged — reasonable observers can disagree, and the public record assembled by ProPublica and the organizations’ statements both remain central to that debate [1] [4].