In 2010, Lancaster General Health notched record revenues of nearly $1 billion. But its annual surplus fell for the fourth straight year. Though destitute by no means, galloping expenses and uncertainty in the marketplace were hammering LGH's business model, prompting changes. Two units were closed, some positions were eliminated, and 170 employees were reassigned. Yet even as the bottom line eroded, there was little austerity in the executive suites. In 2010, each of 21 executives systemwide would earn total compensation—salary, bonuses and incentives, benefits and expenses—of at least $250,000, according to LGH's Internal Revenue Service Form 990, the annual financial report that nonprofit health systems such as LGH must file with the federal government.