Pay for nonprofit hospital executives in New Hampshire ranges widely, from a salary less than that of a pediatrician to one higher than the best-paid surgeons, according to a review of tax records for the state's 25 acute care hospitals.

Those records reveal that Concord Hospital's Mike Green is among the best-paid hospital executives in the state. According to a filing made in 2007, he earned more than $730,000 in combined salary and benefits.

On the low end of the scale is Louise McCleery, the CEO of the state's smallest hospital in Colebrook. McCleery makes just more than $125,000, and said she's grateful for what she gets.

Hospital board members and industry watchers said that hospital CEOs are charged with managing complex organizations with multimillion dollar revenue streams and hundreds of employees. In many cities, including Concord, hospitals are among the largest employers. Without competitive pay packages, they said, it would be difficult to attract and retain qualified executives.

But critics charge that in an environment of skyrocketing health care costs and insurance premiums, the managers of nonprofit organizations should limit their earnings.

"More and more, nonprofit hospital earnings are growing, yet individuals continue to feel the pinch of the skyrocketing cost of health care," said Zandra Rice Hawkins, a spokeswoman for New Hampshire for Health Care, a group that advocates for universal health care policy.

"At a time when more and more people are losing their health care coverage, including health care workers, excessive CEO pay at any hospital is hypocritical," she added.

Hospital board chairmen say they engage in a rigorous process in determining executive compensation. They review the pay of CEOs at similarly sized hospitals, and they enlist consultants to tell them what it would take to replace their top executive. At Concord Hospital, board members also put Green through an annual performance review. His final salary number is drawn after reviewing all these variables.

"The expectations for these CEOs are just extraordinary," said Rachel Rowe, the chairwoman of the Concord Hospital board of directors. "We expect them not only to respond to community needs. We expect them to be highly astute businesspeople to maintain the viability of a complex organization."

At the state's larger southern hospitals, that responsibility includes managing the hospital's employees, maintaining an extensive physical plant, ensuring improvements in care and quality, and guiding an array of hospital-owned practices and medical clinics. Most, but not all of those hospitals bring in operating margins north of 5 percent.

Dartmouth-Hitchcock Medical Center, the state's largest hospital and its only academic medical center, opted last year for a two-president management model. Nancy Formella and Dr. Thomas Colacchio share responsibility for the system's medical practices, hospitals and clinics. They also have equal salaries of $600,000 a year.

Though that approach is unusual, Dartmouth engaged in a salary review process similar to Concord Hospital's before arriving at the numbers. They looked at a group of similar institutions in New England and picked a number that was lower than some of their peers, said Wayne Granquist, who led the system boards' compensation committee.

Steve Norton, the executive of the New Hampshire Center for Public Policy Studies, who frequently reviews hospital financial figures, said that executive pay can seem high, but may be appropriate given the significance of the hospitals on local economic conditions. He said that recent labor data suggests that close to 40 percent of all job growth in the near future will come in health care.

"These organizations account for a significant amount of economic activity in the communities," he said.

Even the best-paid New Hampshire executives earn less that CEOs at major urban hospitals in the northeast. Dr. Peter L. Slavin, the president at Massachusetts General Hospital, earns close to $1.2 million in salary and benefits. Dr. Herbert Pardes, the CEO at New York Presbyterian Hospital in New York earned a pay package just under $2.5 million, according to a tax filing from 2006.

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