CommonSpirit Health to Sell Three More North Dakota Hospitals to Altru Health System

The transaction, expected to close in early 2027, is subject to regulatory approvals and other customary closing conditions.

CommonSpirit Health has signed a definitive agreement to transfer three North Dakota hospitals to Altru Health System, expanding the latter’s presence in the state’s healthcare market. The transaction, expected to close in early 2027, is subject to regulatory approvals and other customary closing conditions.

The agreement covers CHI St. Alexius Health Bismarck, a multispecialty acute care medical center in North Dakota’s capital, along with two critical access hospitals: CHI St. Alexius Health Turtle Lake and CHI St. Alexius Health Garrison. Financial terms of the transaction have not been disclosed.

The announcement follows a 10-month due diligence process after the organizations signed a letter of intent in January 2026 to explore the proposed transfer.

Once completed, the transaction will bring the three hospitals under Altru’s network, which already includes its flagship acute care hospital, a critical access hospital acquired from CommonSpirit in March 2026, a trauma center, a specialty hospital and 20 practice locations across northern North Dakota.

Both organizations said the proposed ownership transition will not affect patient care or day-to-day hospital operations. The facilities will also retain their Catholic identity and mission following the transfer.

“Through our work together over the years, we’ve developed tremendous confidence in Altru’s commitment to high-quality, compassionate care,” said Tim Bricker, president of CommonSpirit Health’s Central Region. He added that Altru would build on the hospitals’ existing legacy while continuing their Catholic mission.

The transaction is part of a broader portfolio restructuring at CommonSpirit Health as the nonprofit health system works to improve its financial performance amid anticipated Medicaid funding cuts.

The $42.4 billion health system has pursued several hospital divestitures as part of its operational turnaround efforts. Alongside the planned transfer of the North Dakota facilities, CommonSpirit completed an earlier hospital handoff to Altru and agreed to sell a four-hospital system in Ohio to UPMC in September 2026.

For Altru, the acquisition would expand its hospital footprint and strengthen its healthcare network across North Dakota. The Grand Forks-based nonprofit reported more than $700 million in revenue in 2024 and operates healthcare facilities across northeastern North Dakota and northwestern Minnesota.

The proposed transfer of the three hospitals is the latest development in a series of transactions between the two nonprofit health systems.

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