What are St. Jude’s administrative and fundraising overhead ratios compared to peer hospitals?
This fact-check may be outdated. Consider refreshing it to get the most current information.
Executive summary
St. Jude’s fundraising arm ALSAC reported roughly $2.7 billion in revenue with about $836 million (≈31%) spent on fundraising and $1.4 billion (≈51%) transferred to the hospital in one recent filing, while the hospital’s consolidated statements show fundraising costs of $75.5M and administrative costs of $36.5M in one fiscal presentation (ALSAC/St. Jude filings) [1] [2]. Independent reporting and watchdog analyses place St. Jude’s long‑running averages at about 82% of each donated dollar to program (treatment/research/operations) and roughly 18–30% to fundraising and reserves, producing sharp disagreement across sources about how to classify “overhead” [3] [4] [5] [6].
1. Two organizations, two accounting pictures — fundraising vs. hospital
St. Jude’s financials are split between the hospital (St. Jude Children’s Research Hospital) and ALSAC, its fundraising arm; ALSAC’s IRS‑style reporting shows large fundraising expenses and transfers, while the hospital’s consolidated statements show program, fundraising and administrative line items separately — for example, one combined statement lists $110.3M program costs, $75.5M fundraising and $36.5M administrative costs for the years ended June 30 [2]. That structural split creates differing denominators and makes single “overhead” ratios misleading unless you state which entity and which accounting rules you use [2].
2. Fundraising expenses: large in dollars, debated in percentage terms
ALSAC reported total revenue of $2.7 billion and spending of $836 million on fundraising — about 31% of revenue — in the reporting cited by Paddock Post summarizing ALSAC’s Form 990 [1]. Other summaries and watchdogs say roughly 30% of contributions have been used for fundraising over multi‑year windows, while St. Jude itself cites that 82 cents of every donated dollar went to program (research/treatment/operations) over seven years, leaving about 18% for fundraising and general support [6] [4] [3]. The difference between ~18% and ~30% reflects alternative ways to allocate shared costs, timing of transfers, and whether reserves or transfers to the hospital are counted as “program” immediately [1] [4] [6].
3. Administrative (general) costs are small as a share of reported expenses but depend on scope
St. Jude’s combined financial statement lists administrative and general costs at $36.5M in one period mentioned, a fraction of its multi‑billion budget [2]. The hospital’s public FAQs note “five cents of every dollar” supports administration costs in their presentation of long‑term averages — a claim that aligns with St. Jude’s framing that program spending is the dominant share [3]. Critics point out that when ALSAC fundraising overhead and reserves are included, the share of dollars not directly used for patient care or research rises substantially [6] [1].
4. Peer comparison is messy — different accounting, different missions
Available sources do not provide a side‑by‑side, apples‑to‑apples table comparing St. Jude’s overhead ratios with specific peer hospitals using identical methods. Charity Navigator and other evaluators calculate program expense ratios and fundraising efficiency using 990s, yet St. Jude’s split structure and large transfers complicate those comparisons; Charity Navigator explains methodology but the exact peer benchmarks for comparable pediatric research hospitals are not provided in the materials here [7]. Independent analyses in the literature warn that large hospitals and charities often report fundraising differently, making direct comparisons fraught unless you harmonize definitions [8].
5. Investigations and watchdogs highlight reserves and classification choices
ProPublica and academic summaries report that about half of funds raised went to patient care and research in some multi‑year looks, with ~30% for fundraising and ~20% into reserves — a portrayal that has driven debate over whether St. Jude is “hoarding” funds or prudently preparing for long‑term research commitments [6] [9] [10]. Those stories rely on combining ALSAC and hospital figures and scrutinizing transfers and unspent revenue; St. Jude’s own materials emphasize multi‑year program ratios and external charity ratings [4] [3].
6. What the numbers mean for donors and peers — two perspectives
From the institution’s perspective, St. Jude stresses that most donated dollars support care, research and operations (82% over seven years) and that fundraising enables the hospital’s no‑bill model and global initiatives [3] [11]. From critics’ and watchdogs’ perspective, when ALSAC fundraising costs, vendor fees and the build‑up of reserves are counted together, a much larger slice of revenue is not immediately spent on patient care, prompting questions about fundraising efficiency and the timing of spending [1] [6].
7. Bottom line and reporting caveats
You will get different “overhead” percentages depending on whether you (a) look at ALSAC alone, (b) look at the hospital alone, (c) combine both and treat transfers or reserves as program or not. Sources here show ALSAC fundraising at roughly 30% of revenue in at least one recent filing [1], St. Jude’s long‑term program claim of 82% [4] [3], and academic/watchdog summaries finding about 50% to program with 30% fundraising and 20% reserves across certain years [6] [9]. Direct peer comparisons using a single standardized methodology are not present in available reporting (not found in current reporting).