Children’s Hospital of Philadelphia delivered a record $7.7 million pay package to CEO Madeline Bell in 2021, as the coronavirus pandemic wreaked havoc in the health care industry, with deaths mounting and labor shortages putting nurses and other hospital staff under duress.

Bell’s pay was not just the highest in the region for CEOs of 13 Philadelphia-area not-for-profit health systems that year. Both the bonus and total pay are likely the largest ever received by a local health system CEO, an Inquirer analysis of tax returns has found. The bulk of Bell’s total compensation was a $5.6 million bonus.

Her total pay amounted to more than the nonprofit hospital spent on free and discounted services to financially needy patients, or charity care, over the three previous years combined.

Bell’s pay was 43% higher than the region’s next highest-paid hospital executive in 2021. Ranking second behind Bell was Stephen K. Klasko, former CEO of Thomas Jefferson University and Jefferson Health. His pay in 2021 was $5.4 million. (Klasko’s top annual pay at Jefferson came in 2019, when he made $7.4 million, not including amounts reported in previous years.)