Ascension
Legal name: Ascension Health Alliance
Nonprofit profile at a glance
- EIN
- 453358926
- IRS 990 coverage
- 2013–2024
- Official website data refreshed
- Jun 2026
- Forms available
- Form 990 2024, Form 990-T 2024
- Location
- St Louis, MO, USA
- Phone
- 3147338000
- Rating
- 77
- Verdict
- SUPPORTED
- Rating confidence
- Moderate
Reported finances
- Revenue
- $3,284,806,032
- Expenses
- $2,096,639,578
- Assets
- $22,161,926,422
- Liabilities
- $9,728,766,153
Source: IRS Form 990. Selected filing: tax year 2024. Amounts in USD.
Leadership & pay
18 people listed
Executive titles in this filing
- JOSEPH R IMPICCICHE JD MHA (CEO)
- EDUARDO F CONRADO (PRESIDENT)
Highest reported compensation
- JOSEPH R IMPICCICHE JD MHA (CEO): $14,086,474 total reported compensation
- EDUARDO F CONRADO (PRESIDENT): $10,919,629 total reported compensation
- CHRISTINE K MCCOY JD (EVP & GENERAL COUNSEL): $5,287,112 total reported compensation
Source: IRS Form 990. Selected filing: tax year 2024. Names and roles reflect this filing, not necessarily current officeholders.
Overview
Mission
Ascension is dedicated to supporting our communities. Most people know about the BRCA gene mutations, so we can use this as an example to evaluate a person’s risk of developing breast cancer. If you have a BRCA1 or BRCA2 gene mutation, it can mean you’ll have up to a 7 in 10 chance of getting breast cancer by age 80. This increases if you have multiple family members who have had breast cancer. You’re more likely to be diagnosed younger, and have cancer in both breasts. You also have a higher risk of ovarian, pancreatic or other cancers. For your family and future generations, genetic testing can help save their lives and better understand how sooner evaluation and intervention could be lifesaving. Gene mutations that are linked to breast cance.
What it reported doing in 2024
Ascension Health Alliance is a mission-focused organization guided by its religious sponsors in transforming health care by providing the highest quality care to all, with special attention to those who are poor and vulnerable, and through innovation. As the parent of the Ascension Catholic health ministry, Ascension Health Alliance supports Ascension Health Ministries ("Ascension Sponsor"), a Public Juridic Person approved by the Vatican, and the efforts of Ascension hospitals and health facilities, providing care to individuals and communities. In fiscal year 2025, the Ascension health system employed 99,000 associates serving in 1,924 locations in more than 16 states and the District of Columbia. However, in comparison to many other organizations of similar scope and complexity, as a nonprofit, spiritually centered healthcare system, Ascension differentiates itself in terms of mission, priority and challenges. In fiscal year 2025 alone, Ascension Health provided $1.7 billion in care of persons living in poverty and other community benefit programs, 21,083,414 physician office and clinic visits, 2,484,054 emergency room visits, 564,953 discharges, 467,315 surgery visits, 62,632 births, 17,629 available beds, 22,300 affiliated providers, and 95 hospitals. Financial assistance and community benefit totaled more than $3.5 billion with the inclusion of $1.8 billion of unpaid costs of Medicare.
Operating model
- Revenue model
- Other-operating. 75% of the money available for current operations came from other operating revenue.
- Distribution model
- Direct operator. The filing allocates 99% of reported program-service expenses outside its grant, affiliate-payment, and member-benefit lines. This expense classification does not rule out separately announced grant awards.
The verdict
SUPPORTED - A large share of available resources goes toward mission work and the filed numbers largely add up. The filing reports few safeguards for money sent abroad and liabilities are high compared with assets.
Rating breakdown
- Financial Efficiency: 67
- Transparency & Controls: 74
- Accountability: 93
- Sustainability: 81
- Growth: 100
Detailed rating inputs
Financial Efficiency
- Mission deployment rate: 71.7%; rating input score 72
- Program expense ratio: 81.9%; rating input score 82
- Fundraising efficiency: Limited
Transparency & Controls
- Consistency checks: 92.3%; rating input score 92; 12th percentile among comparable filings
- Pay-setting controls: 4 of 6 controls in place; rating input score 67
- Compensation committee: Pass
- Independent consultant: Pass
- Other Form 990s reviewed: Missing
- Written employment contract: Missing
- Compensation survey or study: Pass
- Board or committee approval: Pass
- Foreign activity oversight: Scored; rating input score 0
- Grant itemization coverage: 99.4%; rating input score 99; 40th percentile among comparable filings
- Major donor itemization: Yes; rating input score 100
- Related-party transparency: Yes; rating input score 100
Accountability
- Independent voting board: 87.5%; rating input score 88; 34th percentile among comparable filings
- Governance controls: 9 of 9 controls in place; rating input score 100
- Conflict-of-interest policy: Pass
- Whistleblower policy: Pass
- Document-retention policy: Pass
- CEO compensation review process: Pass
- Other executive compensation review process: Pass
- Form 990 shared with the board: Pass
- Board meeting minutes documented: Pass
- Audit committee oversight: Pass
- Independent financial-statement audit: Pass
Sustainability
- Operating margin: 36.2%; rating input score 94; 94th percentile among comparable filings
- Total-asset coverage ratio: 10.57; rating input score 92; 92nd percentile among comparable filings
- Liabilities to assets ratio: 0.44; rating input score 41; 41st percentile among comparable filings
- Officer compensation ratio: 2.8%; rating input score 42; 42nd percentile among comparable filings
Growth
- Program expense growth: 7.3% per year; rating input score 100; 59th percentile among comparable filings
- Revenue growth: 9.1% per year; rating input score 100; 73rd percentile among comparable filings
- Asset growth: 8.2% per year; rating input score 100; 60th percentile among comparable filings
Details
- What they do: 4 programs and campaigns described on the official site · 1 operating location identified
- Where the money goes: 71.7% of revenue deployed · 81.9% of spending went to programs
- Governance: 7 of 8 board members independent · 9 of 9 filing controls reported
- Programs: 1 filed program accomplishment · $1.7B in reported program spending
- Leadership: top reported pay $14.1M · 18 people listed · 4 of 6 pay-setting controls reported
- Highest-paid contractors: 5 contractors listed · $34.2M reported
- Consistency: 36 of 37 current checks pass · 1 finding to review
- Schedules: 11 filed schedules · includes major donors, foreign activity, grants, executive pay, and related organizations
- Filing history: 12 filing years from 2013 to 2024
- Contacts: How to reach this organization
- Money network: 28 filed money-flow records
- Related organizations: 408 filed related-organization links
- Grant readiness: Federal tax and exclusion status, award history, and grant-maker relationships.
- People: Everyone the filings name, and which of them the filings identify by more than a name.
- Staff and benefit plans: Retirement and health plans the organization files with the Department of Labor, and the people in them.
Key Signals
Signals prioritize questions for review. They are not findings of misconduct.
- High — Transparency & Controls: Foreign activity oversight scored 0/100.
- Moderate — Sustainability: Liabilities to assets ratio scored 41/100.
- Moderate — Sustainability: Officer compensation ratio scored 42/100.
- Review — Transparency & Controls: Domestic grant itemization did not reconcile in the filed values.