Be careful with these numbers. As far as I know they operate more like a lot of non-profits around DC. Big money for insiders and leadership, but no profit at the end of the year.
The keyword is “should”. But they don’t. I know somebody who did research into the ownership structure of hospitals in an area and where the money goes and you can’t compare this to normal companies. It’s a highly corrupt insider system that makes a lot of money from local governments and patients.
In situations where large sums of money are vanishing on a continuing basis, Hanlon's razor ("don't attribute to malice what can be explained by incompetence") must reversed.