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North Memorial Health plans to merge with Sanford Health to create a single nonprofit health system. This merger marks Sanford Health's expansion from its Sioux Falls base into the Twin Cities market, following a previous deal with Fairview Health Services that fell apart three years ago.

The two health systems announced their merger in a joint statement Friday, pledging to invest $600 million to uphold trauma care and emergency services at North Memorial’s Robbinsdale hospital, while also doubling the size of its hospital in Maple Grove. 

The deal is expected to be finalized later this year, pending regulatory approval from state and federal agencies.

The proposed move could help stabilize North Memorial’s Robbinsdale hospital, a level one trauma center that is struggling financially. The hospital anticipated receiving about $24 million annually from a legislative proposal aimed at securing funding for HCMC in Minneapolis, but an amendment removed North Memorial from that bill entirely.

“We’ve been open about the financial and regulatory pressures and the rising costs that make it harder to protect access to care on our own. Through a deliberate national search, Sanford stood out as a partner who understands our true value and shares our belief that better — not just bigger — is what matters,” said North Memorial Health CEO Trevor Sawallish in the joint statement.

In addition to its two hospitals in Robbinsdale and Maple Grove, North Memorial has clinics, urgent and emergency care, as well as transportation services throughout the Twin Cities. 

Sanford Health is the largest rural health system in the U.S, operating 58 hospitals and 289 clinics across the upper Midwest, including Minnesota.

“By coming together as one nonprofit healthcare organization, with shared Midwest values and a deep commitment to the communities we serve, we will deliver more coordinated, regionally connected care — ensuring patients can access the right services, in the right place, at the right time,” Sanford President and CEO Bill Gassen said in a statement.

The Minnesota Nurses Association said in a press release that the merger announcement is concerning. “Nurses are closely watching how this may impact contracts and benefits, healthcare costs, local-decision making, and the continued corporatization of healthcare services into increasingly large systems,” the MNA said.

Nearly 600 Maple Grove nurses are preparing to vote on whether to authorize a strike due to unresolved issues in negotiations over their first contract. Meanwhile, nurses at Sanford Health in Bemidji are holding an informational picket Friday as they advocate for a fair contract. 

SEIU Healthcare Minnesota & Iowa, which represents more than 1,000 healthcare workers at North Memorial, called the merger in Minnesota “worrisome” for both staff and patients. “It is especially concerning because previous merger attempts by Sanford Health to come into Minnesota have failed due to their values and corporate behavior,” the union said.

Members of SEIU are asking Minnesota’s Attorney General Keith Ellison to provide oversight into the proposed merger.

In a statement, Ellison said that under the proposal, North Memorial Health would retain its corporate structure but become a subsidiary of Sanford Health. His office will review the proposed transaction with the Minnesota Department of Health to assess its impact on patients and healthcare workers.

The Attorney General’s Office is also considering public comments as part of its review to assist in evaluating the proposed merger.

“As we have done and are currently doing with other healthcare transactions, we are conducting a thorough review of this potential acquisition to ensure it complies with the law and is in the public interest,” said Ellison in a statement. “Proposed healthcare consolidation requires careful examination.”

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The health systems plan a $600 million investment in Robbinsdale and Maple Grove hospitals.

North Memorial plans merger with South Dakota-based Sanford Health

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