Sanford Health - North Memorial Health Transaction Review Summary

On May 1, 2026 Sanford Health and North Memorial Health submitted to the Minnesota Attorney General’s Office (AGO) notice and required materials pursuant to Minnesota’s Health Care Transaction Review law (Minn. Stat. 145D.01) regarding the proposed transaction of Sanford Health acquiring North Memorial Health.

Overview of the Review

The AGO’s review of the proposed transaction, working in collaboration with the Minnesota Department of Health (MDH), included:

• reviewing initial and supplemental materials provided by the parties upon request of the AGO and MDH;
• touring Robbinsdale and Maple Grove hospitals and North’s Ambulance Services Headquarters in Brooklyn Center; 
• hosting public meetings on June 8 and July 7 in Robbinsdale, MN and Minneapolis, MN attended by hundreds of people to receive public input from approximately 70 community members;
• reviewing more than 300 written comments;
• interviewing dozens of third parties such as employers, insurers, unions, and agencies; and
• considering findings from an MDH solicited Cost & Market Impact Review.

Summary of the Resolution of the Review

The AGO has reached a 10-year oversight agreement with Sanford Health and North Memorial Health relating to Sanford Health’s acquisition of North Memorial Health.

Pursuant to Minnesota’s Health Care Transaction Review law, Sanford Health, North Memorial Health, and the AGO have entered into a Memorandum of Understanding (MOU) that outlines the terms of the 10-year oversight agreement, including defined commitments and annual reporting requirements on the status of those commitments. The AGO retains full authority to intervene if the commitments are not met or if the transaction violates Minnesota law. Further, Sanford has provided additional commitments to the Attorney General and the public outside of the regulatory review.

(For additional detail on the MOU see Sanford Health and North Memorial Health Transaction Frequently Asked Questions (FAQs).)

Commitments in the Memorandum of Understanding (MOU) include:

• Sanford Health will invest $600M in North Memorial Health over the next 10 years:
  • $100M for maintenance, Emergency Medical Services, and infrastructure upgrades to the Robbinsdale Hospital with $25M invested within the next three years;
  • $500M to expand the Maple Grove Hospital, home to the largest Family Birth Center in the state, delivering 5,000+ babies a year, with construction beginning no later than Q1 2027.
• Sanford Health will preserve critical hospital and emergency services at Robbinsdale Hospital and across the State of Minnesota for at least 10 years:
  • Robbinsdale Hospital will retain its Level I trauma center status and retain existing service lines, including the emergency department, cardiac and cath lab services, labor and delivery, ICU, stroke care, acute rehab services, reproductive health and gender affirming care, mental health services, and oncology services for at least the next 10 years;
  • Maintain existing service lines at all North Memorial Health and Sanford Minnesota locations;
  • Maintain and enhance existing behavioral and mental health care services at Minnesota locations and explore ways to expand or restore those services where services are inadequate;
  • Maintain reproductive health care and gender-affirming care services consistent with applicable law and regulations; and
  • Maintain existing levels of air and ground emergency transportation service in Minnesota.
• Sanford Health commits to workforce protections:
  • Maintain North Memorial Health existing collective bargaining agreements as agreed to in the Affiliation Agreement;
  • All North Memorial Health employees in good standing and who meet Sanford’s standard hiring criteria will retain their current employment at closing; and
  • North Memorial Health employees will be offered health insurance benefit options that are comparable to the existing options that each employee has available to him or her as of the Closing Date and will be migrated to Sanford’s standard health insurance benefit options over time. 
• Sanford Health will support health care workforce education and training:
  • Work with Masonic Cancer Center at the University of Minnesota to support National Cancer Institute (NCI) designation;
  • Maintain participation in current medical education and training programs at North Memorial Health including general surgery residency;
  • Maintain participation in existing medical education and training collaborations amongst Minnesota health care providers;
  • Support North Memorial Health Family Residency Program through the University of Minnesota Residency Program located at Broadway Family Practice Clinic;
  • Continue participation of North Memorial Health in the Metro Minnesota Council on Graduate Medical Education (MMCGME); and
  • Explore expansion of medical education and training programs.
• Sanford Health will maintain or enhance charity care, community benefits, and access and participation in Medicare, Medicaid and any other means-tested government health care programs.
• Sanford Health will not enforce noncompete provisions that predate the transaction. 
• Sanford Health’s accountability:
  • For the next 10 years Sanford Health will submit annual reports to the AGO detailing its compliance with the terms of the MOU and provide thorough explanations of any departure from the terms. The AGO will work with Sanford Health on issuing a public report of Sanford’s compliance with the MOU;
  • Sanford Health leadership will meet with the Attorney General quarterly; and
  • Sanford Health Board of Trustees will meet with the Attorney General annually.

In addition to the terms of the MOU, Sanford Health and North Memorial Health made the following public commitments to the Attorney General and Public:

• Sanford Health Commits to Increase Minnesota Engagement
  • Maintain Minnesota corporate presence, including a physical office in the Twin Cities metropolitan area where leadership will be routinely present and accessible, while maintaining headquarters in South Dakota;
  • Recruit actively from Minnesota’s network of educational institutions and professional networks in clinical and non-clinical roles;
  • Build on partnerships with Minnesota non-profit organizations, government agencies, and the state’s educational institutions that advance health care excellence alongside medical research, education, and training.
• Sanford Health Commits to Invest $15M Toward Minnesota Rural Health Care Network solutions
  • Recognizing the pressures on rural Minnesotans to seek affordable and accessible health care, Sanford Health is committing funds to an AG-facilitated solution-oriented process to improve rural health care in Minnesota.
• Sanford Health Commits to Participate in AG-led Discussions with Hennepin County Medical Center
  • Address shared interest in the sustainability of Level I trauma services and safety-net capacity in the Twin Cities metropolitan area.