After discussions and the formation of synergy teams that strategized how the organizations could combine, final votes were taken by both parties to the agreement.

[15] The merger would make Sanford Health a subsidiary of Intermountain Healthcare with the resulting system consisting of 70 hospitals with 89,000 employees.

[16] In early December, the merger was postponed indefinitely after Bill Gassen abruptly replaced Sanford Health CEO Kelby Krabbenhoft after he made anti-mask statements.

Krabbenhoft also said the pandemic was not a crisis during which South Dakota's hospitalizations related to the disease were at all-time highs.

[23][24] In April 2013, Sanford CEO Kelby Krabbenhoft conceded merger discussions would be indefinitely postponed.

[26] The proposed merger called for each company to maintain their own non-profit status and regional brands in their respective markets.

[30][28] On July 27, 2023, the two healthcare systems announced they were abandoning merger discussions, citing a lack of stakeholder support.

It provides comprehensive pediatric specialties and subspecialties to infants, children, teens, and young adults aged 0–21 throughout the region.

[35] The hospital has a rooftop helipad and is an ACS verified level II pediatric trauma center, the only one in the state.

[39] In January 2018, it was announced that Sanford would establish World Clinics in Costa Rica, Ireland, New Zealand, South Africa, and Vietnam and expand its presence in China and Ghana.

[40] The Sanford Fieldhouse in Sioux Falls, South Dakota, houses 85,000 square feet of indoor sports fields.

Sanford is a major sponsor of the Summit League, an NCAA Division I athletic conference whose membership now includes all of the four largest universities in the Dakotas plus one in Nebraska.

Also in that year, regional media reported that Sanford-tied boosters of Augustana University, also located in Sioux Falls, were making a serious attempt to move the school's athletic program from NCAA Division II to the Summit League.