Grand Forks-based Altru Health System to acquire Devils Lake hospital

DEVILS LAKE – Altru Health System, a 3,400-employee entity based in Grand Forks, has come to terms with CommonSpirit Health to acquire CHI St. Alexius Hospital in Devils Lake.

The announcement came Friday morning, June 28, at an event attended by officials from Altru and CommonSpirit, Sen. John Hoeven and Mayor Jim Moe, and culminates more than a year of efforts to bring changes to the northeast North Dakota community’s health care options.

“I think (residents of the Devils Lake region) will be very, very pleased and very relieved, starting with the employee base there. They have been concerned with how this will work out because it’s their jobs and livelihood,” Hoeven, R-N.D., said.

During Friday's event, no hard timeline was presented for Altru to take over, but the hope is to get the transaction closed by the end of the year.

"Today is a great day," Altru CEO Todd Forkel said during Friday's event. "You can feel the excitement here."

Moe said "everything's going to work out" and added that the acquisition is in the best interest of the community.

"It's a great day for Devils Lake," he said.

Friday’s news is the latest development in a long conversation about health care in Devils Lake, a discussion that gained traction in 2022 and has in recent months included public meetings attended by residents, health care leaders and Hoeven.

In January 2022, Dick Johnson, who at the time was mayor of Devils Lake, wrote a newspaper op-ed that demanded better health care options for the community and region. Notably, he was critical of what he considered a degradation of facilities, especially at St. Alexius Health, the Devils Lake hospital owned and operated by CommonSpirit Health.

In a subsequent interview with the Grand Forks Herald , he said “this has been going on for years and there haven’t been significant improvements to the situation at the hospital. In a community our size with 7,300 people, and the Spirit Lake Nation that probably has another 7,000 people, we need good health care.”

In October 2022, the city of Devils Lake, the Spirit Lake Tribe, Altru and Essentia Health signed a letter of intent to work together to create a new medical campus in the community.

In August 2023, Hoeven pressed for progress when he held a public roundtable meeting to hear complaints from residents as well as frustration about what he said was lack of conversations with CommonSpirit. By October, Tim Bricker, president of CommonSpirit's Central Region, committed to a meeting with Hoeven and other local leaders.

That led to a commitment from CommonSpirit to make improvements at the hospital. In January 2024, the Herald reported that St. Alexius was in the midst of making those improvements , most notably work on the hospital’s emergency room.

Hoeven credits Bricker for “advocating to do the right thing” and working on the sale to Altru. He also commended Altru CEO Todd Forkel and President Joshua Deere for their work to leverage the relationships that already exist between Altru and Devils Lake, where Altru operates a clinic.

“Todd Forkel and Josh Deere understood that with the relationships they already had, the facility they already have there, their service area – the most sense was to do a joint venture or, best of all, for Altru to buy the hospital,” Hoeven said.

Forkel, Hoeven said, “showed incredible leadership and caring about the Lake Region. He treated them just like he treats people here in Grand Forks.”

Altru’s move to purchase St. Alexius is a pivot from the 2022 letter of intent signed by Altru, the city, the tribe and Essentia, but Hoeven said the sticking point came down to rules that regulate locations of hospitals listed as critical access, a designation for certain rural hospitals. According to Rural Health Information, an online site that declares itself “your first stop for rural health information,” critical-access status was created in the 1990s after a spate of hospital closures nationwide.

The designation “is designed to reduce the financial vulnerability of rural hospitals and improve access to health care by keeping essential services in rural communities,” according to the RHI website. “To accomplish this goal, (critical-access hospitals) receive certain benefits, such as cost-based reimbursement for Medicare services.”

But since critical-access hospitals cannot be located within 25 miles of each other, building a second hospital in Devils Lake would be financially unfeasible.

“You’d still have a situation where two hospitals are competing in a community that can’t support (them both),” Hoeven told the Herald. “After listening to all of those options, it was clear to me that we needed to go back to CommonSpirit and say, ‘either we get something done where you step up and commit to these improvements on a timeline and a magnitude that gets it done, or you have to sell to someone … or work with Altru.’ ”

Hoeven listed a number of recent hospital projects in towns throughout North Dakota – among them Jamestown, Hazen, Grafton, Cando and Rugby – and lamented what he considered a lack of forward movement in Devils Lake.

“Devils Lake sits there and they aren’t making any progress and they are the regional center for the Lake Region,” he said.

The purchase of St. Alexius comes as Altru builds a new $470 million hospital in Grand Forks . In late May, the structure was considered more than 94% complete and on track to be structurally finished sometime around October. The first patients will be admitted in early 2025.

The purchase of St. Alexius means Altru now will operate two general hospitals for the first time in the company’s history. Altru also maintains regional clinics in Devils Lake and Drayton, North Dakota, and the Minnesota communities of Erskine, Thief River Falls and Crookston.

It also has clinics in Warroad, Greenbush and Roseau, Minnesota, that will transition to LifeCare Medical Center, the hospital based in Roseau. The transition will occur in July.

CommonSpirit, according to its website, operates more than 2,200 care sites in 24 states. Its national office is in Illinois.