Sanford Health folded Good Samaritan's senior care into a $5B, 44-hospital system
Completed New Year's Day 2019: Good Samaritan's senior-living network joined Sanford, creating a ~50,000-employee nonprofit with $5B+ revenue in 26 states.
What was changed
On New Year's Day 2019, Sanford Health completed its merger with Good Samaritan Society, combining two of Sioux Falls, South Dakota's largest employers. The affiliation blended Good Samaritan's senior care services into Sanford Health's system of 44 hospitals across nine states, creating a combined nonprofit offering healthcare, research and insurance in 26 states and nine countries.
The strategic logic, as Healthcare Dive reported at completion: systems are using M&A to compete at multiregional scale as costs rise, reimbursements fall and inpatient volumes soften. By adding senior care, Sanford gains another vehicle for engaging older Americans as they need more care and specialised services outside the hospital — and positions itself against seniors-focused startups like Aspire and Oak Street Health.
The governance was laid out early: Good Samaritan members approved the merger in June 2018 and regulators cleared it in August. David Horazdovsky continued as CEO of Good Samaritan and joined Sanford's leadership team, while Sanford's chief administrative officer Randy Bury became president of Sanford Health. CEO Kelby Krabbenhoft said the combined organization 'will create a national model on how to deliver exceptional care through the full spectrum of life'.
The combined entity employs nearly 50,000 people, including 1,382 physicians across more than 80 specialty areas, with annual revenue of more than $5 billion: 44 hospitals, some 200 senior living facilities, and a health plan covering 190,000 people.
Why it worked
It is a completed, measurable combination rather than an announcement: final scale — $5B revenue, 50,000 employees, 200 senior facilities — was reported at close.
The deal reads the demographics correctly: senior living is where the health system's future patients already are, and owning that step keeps the relationship continuous.
Leadership integration was explicit and mutual — Good Samaritan's CEO kept his post and a board seat at the parent's table, which is rarer than it should be in hospital M&A.
It is one data point in the late-2010s wave of provider consolidation, with the antitrust pushback — state oversight laws in Tennessee, Virginia and West Virginia — visible in the same report.
What can be applied
Where ageing patients actually live is the growth market: adding senior care lets a hospital system keep serving people long before and after they need a bed.
Aftermath
The merger took effect 1 January 2019, with member approval from June 2018 and regulatory clearance from August already behind it. Horazdovsky stayed on as Good Samaritan's CEO while joining Sanford's leadership team, and Randy Bury, previously Sanford's chief administrative officer, became president of Sanford Health. The combined nonprofit positions itself to compete with seniors-focused startups like Aspire and Oak Street Health as care keeps moving out of the hospital.