From vulnerability to closure: a ten-year longitudinal case study of St. Martin de Porres Charity Hospital (2014–2024)

Non-government organizations and nonprofit healthcare institutions in emerging economies operate under persistent financial and operational constraints while fulfilling social service mandates. This study examined the organizational decline of St. Martin de Porres Charity Hospital (SMPCH), a 121-bed nonprofit hospital in San Juan City, Philippines, which had served indigent populations from 1959 until its closure in January 2024. A qualitative single-case study design with a longitudinal approach was used, combining primary data from key informant interviews conducted in 2014 and observation with secondary analysis of institutional documents and publicly available sources. Findings revealed four key drivers of decline: compensation misalignment leading to staff turnover, limited marketing and outdated technology reducing donor engagement, financial vulnerability due to reliance on irregular donations, and operational service gaps. Financial ratio analysis and SWOT assessment further illustrated persistent resource constraints over time, demonstrating how the hospital's resources failed to meet the VRIN criteria — Valuable, Rare, Inimitable, and Non-substitutable — thereby accelerating institutional vulnerability. The study provided implications for nonprofit hospital management, donor governance, and health policy in strengthening institutional sustainability in resource-limited settings.