In the days after Hamas’s October 7th attack, American donors were told their contributions would make the difference between life and death. Appeals framed the moment in the starkest possible terms: helmets were needed now, medics were rushing into fire now, and ambulances needed fuel now. Few imagined that the “emergency donations” they wired in October would be booked in Israel as restricted investments, sitting in bank accounts as the war ground on. Yet that is what the audited financials of United Hatzalah of Israel, one of the country’s best-known volunteer rescue organizations, reveal.
According to the organization’s 2023 audit, restricted net assets jumped from 29.9 million shekels in 2022 to 274.7 million by the end of 2023. The auditors describe these sums as designated for “emergency operations in Israel and support for the fighting.” In other words, roughly $66 million in wartime contributions were parked in restricted accounts rather than spent in 2023. Meanwhile, Friends of United Hatzalah in the United States reported to the IRS that it had disbursed $132.2 million
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More: United Hatzalah: The Full Investigationoverseas that year, nearly double the amount the Israeli entity shows as received.
The mismatch might be explained as a timing difference between U.S. and Israeli reporting systems, or as funds held temporarily by related organizations. But for donors who believed their dollars were destined for immediate lifesaving deployment, the optics are unsettling. A hospital that raised money for “emergency trauma response” but then left the majority of it in savings accounts would be accused of misleading its supporters. Accounting rules may allow the practice, but fundraising ethics demand a higher standard of candor.
The concern deepens when one examines how United Hatzalah presents its everyday operations. The 2023 Israeli audit shows annual turnover of 288 million shekels. Yet that headline number does not reflect only cash donations. It also includes “cash equivalent” entries such as volunteer hours, gasoline donated in kind, and estimated rental values. These are permissible under Israeli GAAP but they inflate both revenues and expenses by tens of millions of shekels. In 2023, United Hatzalah booked 54.8 million shekels—roughly $15 million—in money-equivalent donations, including 40.5 million attributed to the value of volunteer time.
The same accounting treatment appears in the expense column. The organization’s “cost of operations” includes not just actual cash outlays like payroll and vehicle maintenance, but also depreciation of fixed assets and the imputed value of volunteer hours. Depreciation alone accounted for more than 20 million shekels, while volunteer wages added another 40 million. Together these non-cash items made up nearly a third of reported operating expenses. Add in communications, advertising, and gala events, and the portrait of daily costs grows murkier.
For a donor trying to understand how much it truly costs to keep the organization running day to day, the numbers are confusing. The audit suggests nearly 200 million shekels in operating costs. Strip away depreciation and non-cash volunteer entries, and the actual out-the-door cash expenditures are significantly lower. The result is an inflated picture of urgency: a charity that seems to be burning through vast sums each year when in reality it is booking accounting entries that never leave the balance sheet.
This practice matters because it colors the narrative of need. United Hatzalah can tell prospective supporters that it spends hundreds of millions of shekels annually to keep its volunteers in the field. Yet much of that figure consists of depreciation on vehicles purchased years ago and valuations of volunteer hours that were never paid for. The public hears about “daily operational costs” that sound daunting, and fundraisers can say without lying that the numbers come straight from audited financials. But the impression left with donors—that constant, massive infusions of cash are the only way to sustain operations—is more dramatic than reality.
Combine this with the revelation that emergency donations were largely parked in bank accounts, and a troubling pattern emerges. On the one hand, the organization inflates its operating costs through accounting conventions that overstate daily needs. On the other, it delays deploying actual wartime contributions, preferring to hold them as restricted assets. The net effect is a balance sheet that looks larger and an operation that appears more expensive than it really is, while the immediacy promised to donors is undercut by funds sitting idle.
None of this suggests that the organization fails to provide real services. Thousands of volunteers respond to medical emergencies, sometimes heroically. Nor does it imply that accounting standards were violated; the entries conform to accepted rules. The issue is trust. Emergency appeals carry an implicit promise that donations will be put to work immediately. Operating cost figures carry an implicit promise that they represent cash out the door. When both turn out to be more complicated, donors have reason to question the story they are being told.
United Hatzalah’s leaders could resolve the doubts easily. They could publish a reconciliation of how much the American affiliate transferred in 2023, how much was received in Israel, and how much has actually been spent on emergency equipment, protective gear, and medical supplies. They could disclose separately the true cash operating costs, excluding depreciation and non-cash valuations, so donors can understand the baseline expense of keeping the network alive. And they could commit to using the language of “emergency” only when donations will in fact be spent with urgency.
Until then, the filings speak for themselves. The organization ended 2023 with nearly 275 million shekels of restricted assets earmarked for the war, while at the same time presenting an inflated picture of daily expenses by counting volunteer time and depreciation as if they were cash burn. It is a troubling juxtaposition: money collected under the banner of urgency sitting idle in accounts, and money never spent being portrayed as if it had been. For a nonprofit that relies entirely on donor trust, that is an emergency of a different kind.