It depends to your level of management, but really, it's usually not directly applicable to the host.
For instance, if you are paying for a colocated server - most sites will install the basic OS, give you your IP list, and your root password. From there, it's all yours.
However, if you are paying for a managed host, you really need to see what their level of support is. Most 'managed' will monitor HTTP and do basic support, but not that many offer upgrades or updates beyond your initial install - some of them aren't even aware that they should update the OS, being that DirectAdmin/CPanel have the ability to update their specific Apache 1.3/PHP/etc support tools.
The closest experience to a fully managed system I've actually had was through a non-adult service,
ICDSoft. They actually scanned all clients, and alerted those with phpBB2 to ensure they ran updates. It was surprising, being how cheap their services were. However, they DO NOT do adult, and I don't believe that they offer anything other than shared accounts at this time.
Sorry to hear you got hacked. It'd be interesting to know how they got in.