Altru Health System to Acquire CHI St. Alexius Hospitals in Bismarck, Turtle Lake, and Garrison

On Wednesday, Nov. 4, in Grand Forks, North Dakota, Altru Health System announced it has signed a “definitive agreement” with CommonSpirit Health that pushes forward the Grand Forks-based system’s plan to acquire three west-central North Dakota hospitals, Yahoo News reported. Pending regulatory review and customary closing conditions, the transaction is expected to close in early 2027, bringing CHI St. Alexius hospitals in Bismarck, Turtle Lake and Garrison into the Altru network.

This deal marks the latest step in Altru’s expansion across the region and will extend a system that already serves northwest Minnesota and northeast North Dakota. The deal changes which group controls and runs hospitals in Bismarck, Garrison and Turtle Lake but keeps the Catholic healthcare model that has shaped St. Alexius for more than 140 years and distinguishes these facilities from Altru’s other properties.

A $500 Million Bet on Regional Growth

Altru has been on an acquisition tear. The system moved into its new $500 million hospital in Grand Forks in early 2025, and in March 2026 it officially completed the acquisition of the CHI St. Alexius hospital in Devils Lake. Now, with the definitive agreement signed, Altru is preparing to absorb three more facilities simultaneously.

The process publicly began in January, when Altru leaders announced their intent to “explore a potential agreement,” followed by months of due diligence focused on clinical quality, financial stability and cultural alignment. In July, the Grand Forks Herald reported that Altru’s Board of Directors had voted to continue pursuing the acquisition.

“Altru has a deep commitment to the communities we serve, and this agreement reflects our shared vision with CommonSpirit for the future of healthcare in North Dakota,” Altru CEO Todd Forkel said in the release. “We are thrilled to have reached this important milestone and look forward to welcoming the St. Alexius team to Altru, and working together to strengthen access to high-quality care while honoring the mission and values that have guided St. Alexius for more than 140 years.”

Preserving a 140-Year Catholic Legacy

What makes this acquisition different from Altru’s Devils Lake deal is the preservation of Catholic identity. The three hospitals in Bismarck, Turtle Lake and Garrison will retain their affiliation with the Benedictine Sisters of Annunciation Monastery, creating a unique arrangement under the Altru umbrella.

Altru President Joshua Deere explained in July that the three hospitals would be “sponsoring the Catholicity” of care delivery and would have “influence and input into the mission of the organization.” Sister Nicole Kunze, prioress of the Benedictine Sisters, confirmed this commitment in the Wednesday announcement.

“St. Alexius has a rich history rooted in the Benedictine tradition of compassionate care of the sick, welcoming all as Christ and caring for the needs of our communities,” Kunze said. “As we continue our sponsorship of St. Alexius, we are encouraged by our shared commitment with Altru to honor that legacy and preserve the Catholic identity and mission that have guided this ministry for generations. Our hope and intent is that St. Alexius will continue to be a place of healing, compassion and service for all who need care.”

Tim Bricker, president of CommonSpirit Health’s Central Region, emphasized the continuity of mission, noting that CommonSpirit has developed “tremendous confidence in Altru’s commitment to high-quality, compassionate care.”

What Changes for Patients and Communities

The signing does not change current patient care or day-to-day operations at any of the three hospitals. Both organizations will continue planning for an orderly transition, with additional information shared as the transaction moves toward closing. Turtle Lake sits approximately 61 miles directly north of Bismarck, while Garrison is about 75 miles northwest, meaning the acquisition will consolidate healthcare delivery across a wide swath of rural North Dakota under one Grand Forks-based system.

For the 3,100-plus staff and providers already employed by Altru, the deal adds the St. Alexius teams to their network. The Altru Health System press release notes the agreement builds on an established relationship between the organizations, including their prior work together in Devils Lake.

Regulatory review remains the next hurdle before the early 2027 closing target, but with the definitive agreement now signed, the transition from exploration to execution is officially underway.