One of the country’s largest senior living operators may be on the verge of getting even bigger in an effort to meet the challenges of an era of “unprecedented change” in healthcare.

Talks are progressing between the Evangelical Lutheran Good Samaritan Society, the second-largest overall not-for-profit senior living operator in the country, and Sanford Health, one of the largest healthcare systems in the country, their leaders told employees Thursday.

The two organizations first announced that they were exploring a possible merger in November.

“After more than a month of dialogue and careful consideration, we are pleased to report that these discussions have been both positive and productive,” Good Samaritan President and CEO David J. Horazdovsky and Sanford President and CEO Kelby Krabbenhoft said Thursday in a letter to employees.

Horazdovsky and Krabbenhoft said they are co-chairing a committee that will develop a single mission statement and covenant that will be presented to the boards of both organizations later this month.

“Pending the boards’ approval to continue exploring this opportunity, the next step in this process is the development of synergy teams comprised of key executives, physicians and clinical leaders, operational and communications leadership from Sanford and the Society,” they added. “These teams will begin meeting early next month to develop the structural framework of our relationship and define how our organizations could come together collectively, to meet the needs of more people, in even greater ways.”

Good Samaritan confirmed in a statement to McKnight’s Senior Living that discussions are ongoing, with both organizations believing that “healthcare and its delivery and payment systems are undergoing tremendous, unprecedented change — change that requires new ways of thinking.” No timeline has been established for additional activities, the statement said.

Both organizations are headquartered in Sioux Falls, SD. They already operate a joint venture together called Prospera, first announced in July 2016, with five senior living communities in North Dakota.

Good Samaritan has more than 200 locations across 24 states. In addition to being the second-largest overall not-for-profit senior living operator in the country, according to the 2017 LeadingAge Ziegler 150, the organization topped the rankings for operators in the assisted living and skilled nursing categories, with 2,274 units and 10,434 beds, respectively.

Sanford, in addition to 44 hospitals and almost 300 clinics in nine states and four countries, has three senior living communities in South Dakota and an affordable seniors housing property in Minnesota, according to its website.

“Both organizations have a history of working together to create integrated healthcare delivery and providing specific services to seniors,” Horazdovsky said in November. “This exploration is a natural progression in how two industry leaders will address the significant challenges in meeting the needs of those we serve.”