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The parent companies of two of the largest not-for-profit senior living and care organizations in the country announced their intention to merge Tuesday.

Sioux Falls, SD-based Sanford Health, which includes the Evangelical Lutheran Good Samaritan Society, and Minneapolis-based Fairview Health Services, which includes Ebenezer Senior Living, Minnesota’s largest senior living operator, announced a plan to combine to create a new health system to provide access to “high-quality, equitable health care, accelerate population health and value-based care, and drive clinical innovation to benefit rural urban and indigenous communities across the Midwest.”

The systems will unite under the Sanford Health name, but both entities will remain nonprofits and maintain their own regional presence, leadership and regional boards. Sanford Health CEO Bill Gassen will serve as president and CEO of the combined system and Fairview Health Services CEO James Hereford will serve as co-CEO for one year.

A Sanford Health spokesperson told McKnight’s that Tuesday’s announcement will not affect the day-to-day operations of either organization and that the two organizations will remain separate and will continue to operate business as usual.

“Our aligned missions and deep commitment to health, healing and community position us well to transform the future of healthcare and positively impact the well-being of the patients, residents and communities we serve for decades to come,” the spokesperson said. 

“With Sanford Health, Fairview Health Services has found a partner that shares our midwestern values and our commitment to affordable, accessible and equitable care delivery,” Hereford said in a statement. “Our complementary capabilities mean that together, we are uniquely positioned to improve clinical outcomes, develop new care delivery models, expand opportunity for employees and clinicians across our broader operational footprint, and apply our combined resources to positively impact the wellbeing of our patients and communities today and for decades to come.”

Gassen said the organizations are united by a “shared commitment to advance the health and well-being” of its communities.

“As a combined system, we can do more to expand access to complex and highly specialized care, utilize innovative technology and provide a border range of virtual services, unlock greater research capabilities and transform the care delivery experience to ensure every patient receives the best care, no matter where they live,” he said.

The boards of both health systems signed a non-binding letter of intent to combine under a single integrated health system. The goal is to sign a definitive agreement and close the transaction in 2023, pending necessary reviews and closing conditions.

The integrated system will extend services across 56 hospitals and 600 care sites, a health plant, a specialty pharmacy and Medicare Advantage options.

Sanford Health, the nation’s largest rural healthcare system, merged with Good Samaritan in 2019. The two organizations first partnered through a joint venture called Prospera in 2016 with five senior living communities in North Dakota.

Sanford Health has 47 medical centers, 45,000 employees, 2,800 physicians and advanced practice providers, and more than 200 Good Samaritan Society senior living and care locations.

Good Samaritan is the second largest not-for-profit multi-site senior living and care organization in the country based on total number of units, according to the 2022 LeadingAge Ziegler 200 lists. It ranked No. 3 for assisted living, No. 4 for independent living and No. 1 for skilled nursing.

The Fairview Health Services system includes 31,000 employees across 11 hospitals, more than 80 primary and specialty care clinics, 36 retail and specialty pharmacies, rehabilitation centers, a physician network, Ebenezer facilities and medical transportation services.

Ebenezer provides independent living, assisted living, memory care, skilled nursing, active adult and affordable senior housing, along with enhanced and transitional care and adult day services. The company also made the LZ 200 list of largest not-for-profit multi-site senior living and care organizations in the country, at No. 158 overall, No. 56 for assisted living, No. 197 for independent living and No. 104 for skilled nursing.

Ebenezer also is ranked No. 1 on a separate list in the 2022 LZ 200 publication as far as number of managed-only units and No. 5 on a list combining market rate and managed units.