If MeritCare and South Dakota-based Sanford Health merge into one giant regional health care provider, MeritCare's board must OK the move.
But that 12-member group didn't always have the final word.
Up until four years ago, a consortium of 37 area Protestant churches ultimately held the power to decide board appointees, amend bylaws and transfer major assets.
But in the summer of 2005, the faithbased corporate members who had the authority to make major decisions for almost a century voted 35-2 to end their corporate membership.
The move resulted in the formation of an ecumenical spiritual advisory group. MeritCare's ownership, as in the case of Sanford Health, a large regional health system based in Sioux Falls, S.D., rests with a nonprofit corporation.
MeritCare's identity as a Lutheran-affiliated hospital long outlasted the role of member churches as owners, despite the hospital's origins as the Lutheran-affiliated St. Luke's Hospital in 1908.
Formal Lutheran ownership of St. Luke's ended in 1949, when the Lutheran Hospital Association disbanded. That organization held the hospital's bonds, which funded a series of expansions in the 1930s, according to historical papers released Monday by MeritCare.
Therefore, the question of whether MeritCare should merge with Sanford Health will be up to the boards of directors of both health systems.
"Both organizations are solely accountable to their boards of trustees," Merit-Care spokesman Darren Huber said.
Coincidentally, Sanford Health, previously Sioux Valley Hospital, originated as a Lutheran hospital in 1894.
Still, if the Sanford merger takes place, MeritCare's ecumenical advisory group will continue.
"We would continue that in the event of a merger," Huber said. "The faith advisory group is very important to the organization, and we see no changes."
MeritCare's switch to the ecumenical religious advisory group was the latest in a series of steps over the years that moved the organization away from its Lutheran roots.
The creation of Merit-Care in the late 1980s resulted from the merger of St. Luke's Hospital with affiliated Fargo Clinic. The former St. Luke's Association became MeritCare Health System in 1993.
Ties to the hospital's member Lutheran churches also became less pronounced at the time, a former hospital chaplain said.
"There's no formal religious connection at all anymore," said the Rev. Art Johnson, who served as the chaplain of St. Luke's from the 1960s to 1992, when he retired.
But member churches readily went along with the change, Johnson said, because of significant changes in the delivery of health care, which increasingly demanded large, integrated organizations combining doctors and hospitals.
"There was such a need for consolidation that people said just go with the flow," Johnson said. "By that time it was a physician-driven organization."
Ellen Chaffee, chairwoman of MeritCare's board of directors, said the optimal delivery of health care will drive the board's decision in whether to approve the merger.
"All of us on the board have the mission of Merit-Care at the top of the list," she said. "There's no reason to proceed unless it's to the benefit of MeritCare. Our role as a board is to help enable the institution to pursue its mission now and for a long time to come."
The board has met to discuss parameters to guide its decision, but no formal discussion of the merits of a merger has taken place, Chaffee said.
"It was just a discussion," she said. "There were no votes taken."