BISMARCK — The Altru Health System Board of Directors has voted to continue to pursue the acquisition of three hospitals in central North Dakota, including St. Alexius Health Medical Center in Bismarck.
If a deal does go through, it’s likely the hospitals will still have an affiliation with the Catholic Church, creating an association unique under the Altru umbrella.
And while no definite agreements have been made between Altru and CommonSpirit Health, some in Bismarck are anxious for news and are touting the possibilities that could come if the Grand Forks-based system acquires CommonSpirit’s hospitals in Bismarck, Turtle Lake and Garrison.
“I think it’s being felt throughout the community,” said Brenda Nagel, president and CEO of the Bismarck-Mandan Chamber/Economic Development Corp. “People are literally saying ‘let’s go. When is it going to happen?’”
In January, Altru leaders announced a letter of intent to “explore a potential agreement” to acquire the hospitals. It came days after an event marked Altru’s acquisition of CommonSpirit’s Devils Lake hospital, CHI St. Alexius Health Devils Lake.
Shortly after that announcement, Altru CEO Todd Forkel said he and others would enter a period of due diligence “to evaluate clinical quality, financial stability and cultural alignment.” The goal is “to ensure this move truly strengthens care for Bismarck, Garrison and Turtle Lake in addition to the communities we already serve.”
Financial particulars aren’t being made public, and no distinct timeline has been announced. Altru President Dr. Joshua Deere told the Grand Forks Herald it’s unlikely there will be any public movement in the coming weeks. Hesitant to provide a timeline, he did say the process likely will take “months up to a year.”
There have been developments, however. On July 20, the Altru board approved moving forward with the process. Although it won’t mean much until both entities set and agree to final terms, Deere said it’s “a key point” in the process.
“Our goal has long been to get to this point of board approval and vision based off of the information and good relations and teamwork we have with the CommonSpirit team,” he said. “Now, it’s just wrapping up the agreements and terms of the deal so that we can get moving forward. …”
Forkel said Altru leaders are “happy to share our board approved to move forward with the opportunity to acquire St. Alexius in Bismarck, Garrison and Turtle Lake.”
He added that “while this shows positive momentum, we continue to work toward definitive agreements and determining a transition date, which will align the work required to bring St. Alexius into the Altru organization. We continue to firm up final details of the agreement, and feel that we will arrive at a positive position for Altru, St. Alexius and CommonSpirit.”
Most notable in the process so far is Altru’s plan to keep in place the three hospitals’ association with the Catholic Church. That means if it ever does become official, the Bismarck hospital likely would be called Altru St. Alexius, or wording to that effect.
It would mean at least some sort of board representation by members of Benedictine Sisters of the Annunciation Monastery, Deere said.
“They would be part of the organization and would actually be sponsoring the Catholicity of (the three hospitals) and care delivery,” Deere said. “They certainly would have influence and input into the mission of the organization and how we would move forward with caring for our patients.”
That didn’t happen in Devils Lake, which now is known as Altru Devils Lake.
“The Devils Lake acquisition was different. The decision was made to take it off the Catholic registry,” Deere said. “The majority of their (facilities) are not sponsored by the sisters specifically, and (the three central North Dakota hospitals) are sponsored by the sisters.”
No other Altru facilities would have a connection to the church, either.
Raumi Kudrna, market chief nursing officer for CHI St. Alexius Bismarck, said Altru’s interest in maintaining a connection to the church is helping to create a “true partnership” between the entities. That, she said, is prompting optimism.
“There is uncertainty that comes with any conversation like this, of course,” she said during a roundtable discussion in Bismarck, organized and hosted by Prairie Business Magazine. “We’re not to the point where we can answer all of the questions yet, but I think overall, (people) are optimistic.”
Joel Kostelecky, of First National Bank & Trust in Bismarck, also was at the Prairie Business meeting. He believes Altru can help solve healthcare challenges in the community.
“I think we’re pretty excited to have Altru come in,” he said.
Bismarck Mayor Mike Schmitz wasn’t at the meeting, but in a subsequent interview said he can’t make any direct comments about residents’ feelings, “other than it’s coming across as positive.”
He said that to his knowledge, care has been good in Bismarck, but that CommonSpirit’s financial issues nationwide are known. In May, a report by Becker’s Hospital Review noted that CommonSpirit posted a $3.4 billion loss in the third quarter of fiscal 2026.
CommonSpirit’s finances notwithstanding, Kudrna said she sees the possible deal as “North Dakotans taking care of North Dakotans,” adding that “Altru is really putting their best foot forward to deliver healthcare.”
A message left with Reed Reyman, president of CHI St. Alexius Bismarck, was not returned.
It’s been a period of growth for Altru, which in January 2025 opened its new $500 million hospital in Grand Forks, followed by the acquisition this year of the Devils Lake hospital. The system also is expanding its behavioral health center in Grand Forks, with completion expected in spring 2027.
Deere said the board is confident the projects are not stretching Altru’s resources.
“I’d like to instill confidence that our board and executive team have done proper due diligence to ensure (the expansion projects are) are a positive,” he said. “We want the community that we currently serve and that we will serve in the future to grow and get the best care they can receive. We feel we’re well positioned for that.”
Korrie Wenzel has been publisher of the Grand Forks Herald and Prairie Business Magazine since 2014.
Over time, he has been a board member of the Grand Forks Region Economic Development Corp., Junior Achievement, the South Dakota Historical Society Foundation, United Way, Empire Arts Center, Cornerstones Career Learning Center and Crimestoppers.
As publisher, Wenzel oversees news, advertising and business operations at the Herald, as well as the newspaper’s opinion content.
In the past, Wenzel was sports editor for 14 years at The Daily Republic of Mitchell, S.D., before becoming editor and, eventually, publisher.
Wenzel can be reached at 701-780-1103.