Sanford posts $93.3M operating income, 1.1% margin through Q3: 5 things to know

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Sioux Falls, S.D.-based Sanford Health reported an operating income of $93.3 million (1.1% margin)  for the nine months ended Sept. 30, down from a $195 million operating gain (3.5% margin) in the same period last year, according to financial documents published Nov. 14.

Five things to know:

1. Total operating revenue for the first nine months of 2025 was $8.5 billion, up from $5.6 billion during the same period in 2024. This includes $4.7 billion in patient revenue, $1.9 billion in premium revenue, and $1.3 billion in other operating revenue.

2. Operating expenses increased to $8.4 billion, up from $5.4 billion in the prior-year period. The largest line items were salaries and benefits ($3.9 billion), supplies ($1.8 billion), and medical claims ($1.2 billion).

3. After accounting for nonoperating items, Sanford reported a net income of $941 million (11% margin) for the nine months ending Sept. 30, 2025, compared to a $231 million net gain (5.1% margin). 

4. Cash and investments totaled $4.5 billion as of Sept. 30, while total long-term debt stood at $3.3 billion. Sanford had 147.8 days cash on hand and a debt-to-capitalization ratio of 36.7%.

5. Recent growth includes the acquisition of Prairie Lakes Healthcare System and Lewis Drug, which will be reflected in future financials beginning Q4 2025. Sanford also merged with Marshfield (Wis.) Clinic Health System, effective Jan. 1, 2025, creating a 56-hospital system with more than 4,500 providers and 56,000 employees.

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