I quoted CAP'N WOW on that. I expect that he inquired at the meeting and got at least that bit of solid info. (WOW!!)
Most likely, if typical, they get one years maintenance and possibly calibration for that 40K. After that, the customer would pay. (I assume that the "signatures" are hard wired, something like CMOS on a computer, and not much in the way of calibration is needed).
Most Hospitals that I know about ain't loaded with money.
I can recall when the hospital fee per day was about 10 bucks, and doctors office visits were generally 3 bucks.
But that was long ago and far away.. the typical prescription was one to five bucks.
Now with much higher fees and costs, they still stay about broke.
