BISMARCK — CommonSpirit Health and Altru Health System have signed a non-binding letter of intent to explore a potential agreement for the sale of CHI St. Alexius Health hospitals in Bismarck, Turtle Lake and Garrison.

In a statement announcing the letter of intent, Altru wrote the two organizations share the vision and commitment in ensuring high-quality, patient-centered care, and builds on recent collaboration between the organizations, including the transition of CHI St. Alexius Health Devils Lake to Altru.

“Altru has a long history of serving communities across North Dakota and northwest Minnesota, and our organizations share a deep respect for the people we serve and the responsibility that comes with delivering local healthcare,” said Todd Forkel, Altru CEO. “We look forward to working more closely with CommonSpirit to strengthen access to care for patients and families well into the future.”

The two entities plan to engage in further discussions in coming months to work toward a definitive agreement, pending customary regulatory review and approvals. The release indicated both systems will continue to provide uninterrupted care to their respective patients during the evaluation process.

Altru, an independent, nonprofit healthcare organization based in Grand Forks, has more than 300 providers and 65 specialties of care with 20 practice locations throughout northwest Minnesota and northeast North Dakota.

CHI St. Alexius currently has seven other locations apart from the three involved in the potential sale, including Mandan, Williston, and Dickinson. CHI St. Alexius Health had previously discontinued primary care services at its Minot Medical Plaza in November 2025.

“This is a natural next step in exploring how we can continue to support strong, sustainable healthcare for the region,” said Tim Bricker, CommonSpirit Health Central Region president.