CommonSpirit Health has locked in a deal to sell three hospitals to Altru Health System, rural North Dakota nonprofit.
The deal is contingent on regulatory review and other customary closing conditions, but expected to close in early 2027. The pair's new definitive agreement, announced Wednesday, follows 10 months of due diligence following a letter of intent unveiled near the top of the year (see that story below). Financial details were not disclosed.
The to-be-sold facilities are CHI St. Alexius Health Bismarck, a multispecialty acute care medical center in the state’s capital, and two smaller critical access hospitals, CHI St. Alexius Health Turtle Lake and CHI St. Alexius Health Garrison.
They would join Altru's flagship acute care hospital, a critical access hospital it also purchased from CommonSpirit in March, a trauma center, a specialty hospital and 20 practices spread across the northern part of the state.
The organizations said there are no changes to patient care or day-to-day operations related to the deal. The hospitals will maintain their Catholic identity and mission.
"Through our work together over the years, we’ve developed tremendous confidence in Altru’s commitment to high-quality, compassionate care," Tim Bricker, president of CommonSpirit Health's Central Region, said in reference to prior partnerships with the We believe Altru is the right partner to build on St. Alexius’ proud legacy, honor its Catholic mission and continue serving patients and families for generations to come.”
CommonSpirit is in the midst of a sweeping operational overhaul as it looks to bolster its financial performance ahead of imminent Medicaid cuts. Those efforts have opened the $42.4 billion system to a string of hospital divestitures, including its four handoffs to Altru as well as the sale of a four-hospital Ohio system to UPMC in September.
Jan. 22, 2026
CommonSpirit Health in talks to hand off 3 more N.D. hospitals to Altru Health System
CommonSpirit Health and Altru Health System are considering a deal to transfer three North Dakota hospitals to the latter, the organizations announced Thursday.
The pair’s signed letter of intent outlines plans to evaluate a potential deal for the facilities, a process they said would run “the next several months” before a potential definitive agreement might be struck.
In the balance are CHI St. Alexius Health Bismarck, a multispecialty acute care medical center in the state’s capital, and two smaller critical access hospitals, CHI St. Alexius Health Turtle Lake and CHI St. Alexius Health Garrison. All three are Catholic facilities within CommonSpirit’s regional healthcare system CHI St. Alexius Health.
Potential financial terms of any deal for the hospitals were not disclosed, nor were any details on whether other assets tied to the hospitals, such as clinics, would be included.
“This is a natural next step in exploring how we can continue to support strong, sustainable healthcare for the region,” Tim Bricker, president of CommonSpirit Health’s central region, which includes CHI St. Alexius Health, said in the announcement.
CommonSpirit is a $40 billion nonprofit that counted 137 hospitals in two dozen states. It’s in the midst of an operating performance turnaround initiative and, at this month’s J.P. Morgan Healthcare Conference, teased “a couple” of portfolio divestitures to be announced in the next quarter as part of the effort.
Grand Forks, North Dakota-based Altru Health System is a smaller nonprofit, with just over $700 million of revenue in 2024 from its sole acute care hospital, a specialty hospital and 20 practice locations in northeast North Dakota and northwest Minnesota. It opened a new $500 million hospital in January 2025.
The news comes hot on the heels of another deal between the systems for ownership of CHI St. Alexius Health Devils Lake, another critical access hospital. That handoff was unveiled in December and is set to close March 1.
Both deals have been described as a boon for rural communities and an opportunity for Altru to better coordinate its local care.
“Altru has a long history of serving communities across North Dakota and northwest Minnesota, and our organizations share a deep respect for the people we serve and the responsibility that comes with delivering local healthcare,” Todd Forkel, CEO of Altru, said in the announcement. “We look forward to working more closely with CommonSpirit to strengthen access to care for patients and families well into the future.”