Johns Hopkins will mandated that the hospital named after him must care for those patients who could not afford medical services. Staying true to its original mission, the Hospital operated at a deficit for every year from its inception in 1889 through 1977, the first year it ran in the black. Deficits were paid by trustees, donors, and payments from the endowment.
The financial turnaround is credited to Hospital chief Robert Heyssel, who in 1972 convinced state authorities to allow it to raise rates on those who could afford to pay. He also cut operating costs and improved efficiency.