A Record of putting Profits Before Patients

North Memorial executives fiercely claim that their independence allows them to “[look] at healthcare differently.”[1] Yet, again and again, North Memorial executives have embraced profit-focused corporate healthcare policies, shortchanged patients and employees, and left vulnerable communities behind – just like other healthcare giants.

Does North Memorial Prioritize Patients or Its Public Image?

North Memorial Hospital touts its Trauma I status as one of its strengths, as CEO J. Kevin Croston has noted that “people in town … think about the trauma program and think about the urgent/emergent reputation of the hospital” when they think of North Memorial.[2] North Memorial is frequently cited in the media in relation to the many injured patients transported to its emergency department due to accidents or acts of violence.[3]

However, hospital executives have spent significant sums of money to change this public perception. Between 2017 and 2019 North Memorial paid advertising agency BrandFire $8.6M[4] to rebrand the healthcare system into a fun company that does not take itself too seriously.[5] Such expenses raise serious questions about hospital executives’ priorities and whether such money could have been better spent on patient care.

These concerns are amplified by recent patient safety complaints which suggest that North Memorial’s profit-driven model results in less-than-ideal conditions for both patients and workers. In one report, the Centers for Medicare and Medicaid Services (CMS) found that North Memorial “failed to provide care in a safe setting for 4 of 10 patients reviewed.” Interviews conducted by CMS revealed that workers did not feel safe or properly trained in a unit with increasing numbers of mental health patients and were concerned with the wellbeing of other patients.[6]

North Memorial's Record of Putting Profits Before Patients

Prioritizing Profits Over Patients
  • North Memorial executives spar with other healthcare systems in an ugly battle to win approval for a new hospital in Maple Grove. North Memorial COO David Cress goes so far as to accuse Tri-Care, a partnership of Children's, Park Nicollet, and Allina Hospitals & Clinics, of engaging in propaganda.[7] Ultimately, North Memorial partners with its competitor, Fairview, to jointly build and own the hospital.[8]
  • SEIU, a union representing many of Minnesota’s healthcare workers, raises concerns that North Memorial is engaging in “medical redlining” by building Maple Grove at the expense of its Robbinsdale facility. A research report reveals that the hospital system shifted nearly all capital investments to the new hospital and may financially burden the Robbinsdale facility by siphoning off more affluent patients.[9] SEIU files a lawsuit against the State of Minnesota for “overlooking the public interest,” suggesting services may be cut at hospitals in less affluent areas.[10]
Prioritizing Profits Over Patients
February 2007
  • A Star Tribune article details the increasing “suburbanization” of healthcare in Minnesota, pointing to the recently approved Maple Grove Hospital. Journalist David Phelps points out that “[m]oving to the suburbs also looks good for a provider's bottom line as it attracts more affluent patients taking advantage of well-paying specialty services.”[11]
Cutting Healthcare Services and Worker Protections
December 2008
  • North Memorial executives eliminate 380 jobs, approximately 7.6 percent of its workforce, citing rising levels of uncompensated care.[12] This move takes place during a national economic downturn, when many individuals lost their jobs and health insurance.
Cutting Healthcare Services and Worker Protections
May 2009
  • Just months after initial cuts, North Memorial executives announce 100 additional layoffs as well as reduced hours. CEO David Cress denies that these changes will compromise patient safety.[13]
Cutting Worker Protections
July 2009
  • Maple Grove Hospital opens as one of the few non-union facilities in the Twin Cities. Journalist Chris Newmarker writes: “Maple Grove Hospital CEO Andy Cochrane said he wants to promote positive relations with workers and is studying ways to reward years of service in health care, while not necessarily recognizing seniority.” Workers expect hospital executives will remain opposed to unionization, pointing to broken promises about the new facility and contentious negotiations in Robbinsdale.[14]
Cutting Healthcare Services and Worker Protections
January 2010
  • Following large staff cuts of 10 percent in prior years, COO Pam Lindemoen brags that 2009 “has been a huge turnaround for us.” Per a Star Tribune article, hospital officials claim to have become “nimbler about deploying resources.”[15]
Cutting Healthcare Services and Worker Protections
September 2010
  • North Memorial President and CEO David Cress is arrested and charged with soliciting prostitution.[16]
  • Citing reduced demand for healthcare services, North Memorial Hospital executives cut 200 jobs.[17] Around the same time, Maple Grove Hospital grows its workforce. Jack Militello, director of the University of St. Thomas' healthcare MBA program, criticizes the hospital system for failing to differentiate itself from its competitors, stating, “[t]his is the real moment when you need strategy. This is the key issue at this moment, how to build demand in the market, a very competitive market.” [18]

North Memorial's Strategy Questioned
November 2010
  • Not even one year into operation, Moody's downgrades bond ratings for Maple Grove Hospital. North Memorial’s bonds are downgraded as well.[19] A Moody’s analyst identifies that the opening of Maple Grove resulted in “sizeable volume declines at the main campus located in Robbinsdale.”[20]

Aggressive Debt Collection and Legally Questionable Practices
April-July 2012
  • Minnesota Attorney General Lori Swanson sues North Memorial Hospital, Maple Grove Hospital, and Fairview’s contracted debt collector, Accretive, for deceiving and harassing patients as well as violating patient privacy laws. The suit followed an investigation into the theft on an unencrypted laptop from an Accretive employee containing sensitive information on 23,500 Fairview and North Memorial patients.[21] Maple Grove and North Memorial (Accretive’s last client in the state) ultimately cut ties with the company, which was banned from operating in Minnesota for two years.[22]
  • Separate from Accretive’s $2.5M settlement, North Memorial later agrees to pay $1.55M for failing to enter into a business associate agreement with Accretive and failing to complete a risk analysis to address all potential risks and vulnerabilities to its stored electronic protected health information.[23]

Cutting Healthcare Services and Worker Protections
July 2013
  • North Memorial Hospital executives announce they are closing a floor, resulting in layoffs. According to hospital spokesperson Wendy Jerde, this move is part of a restructuring plan to downsize the hospital and shift resources to outpatient clinics.[24] Months earlier, Chief Medical Officer J. Kevin Croston was quoted in the Star Tribune as saying, “[w]ould we like more outpatient presence? Absolutely. In my dreams we would have double the outpatient presence. But we have what we have, and we are trying to grow it where we can.”[25] Even still, North Memorial closes an urgent care clinic in Eagan, claiming the facility is too far from its core service area.[26]

Cutting Healthcare Services and Worker Protections
June 2014
  • Healthcare workers picket to protest plans by executives to further cut staffing levels at North Memorial Hospital. Minnesota Nurses Association (MNA) President Linda Hamilton notes that nurses are now expected to spend just 11 minutes per visit with a patient, down from the previous standard of 20 minutes, posing a threat to patient care.[27]
  • Following the informational picket, MNA and SEIU allege in an Unfair Labor Practice filing that hospital officials fired, harassed, and retaliated against workers who participated in the picket.[28] An administrative law judge at the National Labor Relations Board (NLRB) rules against North Memorial, finding that the hospital violated federal labor law in numerous instances, including surveilling, interrogating, and ultimately firing an employee.[29]

Prioritizing Profits Over Patients
October 2014
  • Loren Taylor, CEO of North Memorial Health Care, announces his retirement. He is replaced by J. Kevin Croston, MD.[30]
  • Incoming CEO J. Kevin Croston, MD doubles down on North Memorial’s strategy of prioritizing outpatient care, stating, “[h]istorically, [it] was always assumed that [the best place for patient care] was the hospital. But as it turns out, that's just the most expensive care setting, and more care needs to be done in an ambulatory care setting or in the outpatient world.”[31]

North Memorial's Choices Questioned
July 2015
  • A 48-year-old man from Minneapolis, John Powell, sues North Memorial, and Brooklyn Center and Robbinsdale police departments, after he is misidentified by police and injected with ketamine by paramedics, leaving him unconscious. North Memorial settles the lawsuit in 2018.[32]

Prioritizing Profits Over Patients
April 2017
  • After years of cuts, North Memorial launches a new corporate branding campaign making fun of universally frustrating experiences many patients have in healthcare settings.[33] That year, North Memorial paid advertising agency BrandFire over $3.9M, making the company one of the hospital’s highest paid independent contractors.[34]

Prioritizing Profits Over Patients
June 2017
  • In an article detailing hospital executives’ reactions to healthcare reform and a proposed federal budget, journalist Jim Spencer writes, “[a]t North Memorial Health, Croston says the country's collective sense of entitlement to health care anytime anywhere at any price is wishful thinking.”[35]

Prioritizing Profits Over Patients
August 2017
  • North Memorial purchases Multicare, seen as one of the last independent primary care practices in the Twin Cities. Multicare’s chief executive, Matt Brandt, claims that doctors wanted to remain independent, but faced economic trends that incentivize consolidation, lamenting “[l]arge health systems get reimbursed significantly more on a per-visit basis than Multicare does.”[36]
  • North Memorial establishes a helicopter base miles away from an established base for its competitor Life Link III. According to Tom Judge, executive director of LifeFlight of Maine, duplication of coverage is a national trend that may result in increased costs to consumers. Terry Hill, senior adviser to the Duluth-based National Rural Health Resource Center, tells the Duluth News-Tribune that “[a]ir ambulance rates have become very lucrative,” especially since flights may only be partially covered by insurance, if covered at all.[37]

North Memorial's Strategy Questioned
October 2018
  • Moody's revises the outlook on North Memorial Health Care's and Maple Grove Hospital's outstanding revenue bonds to negative from stable due to modest operating performance.[38]

Prioritizing Profits Over Patients
March 2019
  • A report released by the Minnesota Nurses Association reveals that North Memorial executives set charges for patient services at nearly 3.5 times the actual cost of providing care in 2016. Using data from Medicare Cost Reports, researchers found North Memorial’s average charge-to-cost ratio of 346 percent was well above the statewide average of 212 percent. Maple Grove Hospital is identified as one of the most expensive hospitals in the state based on its charge-to-cost ratio.[39]

Complaints Made Against North Memorial
March 2020
  • The family of a pastor who died after surgery sues Mayo Clinic and North Memorial, alleging that mistakes made during surgery and during transportation in a North Memorial air ambulance led to her death.[40]

Cutting Worker Protections
June-July 2020
  • The death of a North Memorial phlebotomist due to COVID-19 raises questions about whether hospital executives provided adequate personal protective equipment at the time she caught the illness. According to SEIU Healthcare Minnesota President Jamie Gulley, “[i]ndividuals were not permitted to wear N95 masks, including their own N95 masks, in the department prior to this,” a decision reversed after her death. Hospital officials deny that the policy change was prompted by her passing.[41]

Cutting Worker Protections
August 2020
  • Following a complaint, OSHA inspectors hit North Memorial hospital with a penalty for failing to train workers on how to use a powered air-purifying respirator and not providing an adequate medical evaluation.[42]

Prioritizing Profits Over Patients
November 2020
  • A report by National Nurses United reveals that North Memorial executives continued to charge over three times the actual cost of providing care. Researchers found that North Memorial’s average charge-to-cost ratio of over 300 percent in fiscal year 2018 was well above the statewide average of 220 percent.[43]

Prioritizing Profits Over Patients
December 2020
  • A Star Tribune review of Minnesota Department of Revenue records between 2014 and 2019 finds that North Memorial Ambulance collected $11.4M from taxpayers in connection with a state recapture program that does not verify claims.[44]

Prioritizing Profits Over Patients
September 2021
  • To create a “medical destination campus,” North Memorial executives announce they are investing $191M in Maple Grove Hospital. To justify the continued focus on Maple Grove, CEO J. Kevin Croston, MD says, “[w]e believe that people don’t want to go into the city if they don’t have to. They don’t want to go through the traffic and the hassle. This is a perfect location for that.” Hospital officials indicate that their long-term plan for the “campus” includes non-patient care purposes, including a hotel for hosting medical conferences and an innovation center to host medical device companies.[45]

North Memorial's Choices Questioned
April 2022
    • The U.S. Equal Employment Opportunity Commission sues North Memorial, alleging the hospital system violated the Americans with Disabilities Act when it refused to hire an applicant who is deaf because of her disability and failed to provide her a reasonable accommodation.[46]


[1] North Memorial Health Care, “About Us,” North Memorial Health, https://northmemorial.com/about-us/.

[2] Christopher Snowbeck, “North Memorial Adjusts to the New Health Care Landscape,” Star Tribune, October 31, 2014, https://www.startribune.com/north-memorial-adjusts-to-the-new-health-care-landscape/281118532/.

[3] Brittney Ermon, “As Violence Surges, Hospitals Dealing with More Shooting Victims,” KSTP.com, April 28, 2022, https://kstp.com/kstp-news/top-news/as-violence-surges-hospitals-dealing-with-more-shooting-victims/.

[4] North Memorial Health Care, Return of Organization Exempt From Income Tax For the 2019 Calendar Year (filed November 16, 2020), https://projects.propublica.org/nonprofits/organizations/410729979/202033219349304073/full;

North Memorial Health Care, Return of Organization Exempt From Income Tax For the 2018 Calendar Year (filed November 15, 2019), https://projects.propublica.org/nonprofits/organizations/410729979/201943199349302729/full;

North Memorial Health Care, Return of Organization Exempt From Income Tax For the 2017 Calendar Year (filed November 21, 2018), https://projects.propublica.org/nonprofits/display_990/410729979/03_2019_prefixes_39-44%2F410729979_201712_990_2019031116164483.

[5] BrandFire, “North Memorial: An Award-Winning Healthcare Campaign,” BrandFire, https://brandfire.com/work/northmemorialhealth/.

[6] Association of Health Care Journalists, “Report No. 27775,” http://www.hospitalinspections.org/report/27775

[7] Bob Geiger, “Health-Care Firms Compete to Build Maple Grove Hospital,” Finance and Commerce, March 31, 2005.

[8] Natasha Orrick, “Maple Grove Hospital Board Mapping out Staff, CEO Needs,” Minneapolis / St. Paul Business Journal, March 10, 2008;

Ben Steverman, “Issue Update; Suburbs Win Some, Lose Some in Legislature,” Star Tribune, May 31, 2006, Metro edition, sec. West;

Patrick Sweeney, “2 Firms Unite for Hospital Proposal; CEOs Make Pitch for Maple Grove Facility,” St. Paul Pioneer Press, October 11, 2005, sec. Business.

[9] Steve Share, “Report Raises Concerns about Maple Grove Hospital,” Workday Minnesota, June 29, 2006, https://workdayminnesota.org/report-raises-concerns-about-maple-grove-hospital/.

[10] Jeremy Olson, “Union Suing over New Hospital; SEIU: Public Interest Overlooked by State,” St. Paul Pioneer Press, August 2, 2006.

[11] David Phelps, “Woodbury Chosen for New Cancer Care Center; The Suburban Location Is Part of a Trend of Putting Health Care Facilities Outside Central Cities,” Star Tribune, February 27, 2007, Metro edition, sec. Business.

[12] Karen Caffarini, “Cash-Strapped Hospitals Laying off Record Number of Workers,” American Medical News, January 26, 2009, sec. Business;

Chen May Yee, “As Patients Lose Benefits, Health Groups Cut Jobs; Slow Business and Bad Debt Are Taking a Toll on an Industry Once Thought to Be ‘Recession Proof,’” December 9, 2008, Metro edition, sec. News.

[13] Chen May Yee, “100 Jobs Cut at North Memorial,” Star Tribune, May 19, 2009, Metro edition, sec. Business.

[14] Chris Newmarker, “Unions Vow to Organize Maple Grove Hospital,” Minneapolis / St. Paul Business Journal, July 19, 2009, https://www.bizjournals.com/twincities/stories/2009/07/20/story2.html.

[15] Chen May Yee, “Heathy Bottom Lines,” Star Tribune, January 12, 2010, Metro edition, sec. Business.

[16] Josephine Marcotty, “North Memorial Suspends CEO Cress,” Star Tribune, September 2, 2010, https://www.startribune.com/north-memorial-suspends-ceo-cress/102111219/.

[17] Christopher Snowbeck, “North Memorial Will Cut 200 Jobs,” St. Paul Pioneer Press, September 10, 2010, sec. Business.

[18] Chris Newmarker, “North Memorial Tries to Stem Financial Bleeding,” Minneapolis / St. Paul Business Journal, December 10, 2010.

[19] “Report: Maple Grove Hospital Bonds Downgraded,” Minneapolis / St. Paul Business Journal, November 24, 2010.

[20] Moody’s Investors Service, “Moody’s Downgrades to Baa1 From A3 the Long-Term Rating Assigned to North Memorial Health Care’s (MN) Outstanding Bonds; Outlook is Negative,” November 24, 2010, http://www.moodys.com:18000/research/MOODYS-DOWNGRADES-TO-Baa1-FROM-A3-THE-LONG-TERM-RATING-Rating-Update–RU_16751406.

[21] Tony Kennedy, “State Expands Accretive Suit,” Star Tribune, June 20, 2012, Metro edition, sec. News;

Leslie Brooks Suzukamo, “Maple Grove Hospital Cuts Ties with Accretive Health,” St. Paul Pioneer Press, June 21, 2012, sec. Business.

[22] Tony Kennedy and Maura Lerner, “Hospital Billing Firm Is Banned from State,” Star Tribune, July 31, 2012, Metro edition, sec. News.

[23] Tony Kennedy and Maura Lerner, “Hospital Billing Firm Is Banned from State,” Star Tribune, July 31, 2012, Metro edition, sec. News;

U.S. Department of Health & Human Services, “$1.55 Million Settlement Underscores the Importance of Executing HIPAA Business Associate Agreements,” Press Release, U.S. Department of Health & Human Services, March 16, 2016, https://wayback.archive-it.org/3926/20170127185635/https://www.hhs.gov/about/news/2016/03/16/155-million-settlement-underscores-importance-executing-hipaa-business-associate-agreements.html.

[24] Sonya Goins, “Reorganization Underway at North Memorial,” Northwest Community Television – Channel 12, October 4, 2015, https://web.archive.org/web/20151004031637/http://www.twelve.tv/news/newsitem.aspx?newsid=1424&newsitemid=22269.

[25] Lee Schafer, “North Memorial Scrambles as Reform Upends Health Care,” Star Tribune, January 20, 2013, Metro edition, sec. Business.

[26] Katharine Grayson, “North Memorial Health Care Closes Eagan Clinic, Plans New Plymouth Location,” Minneapolis / St. Paul Business Journal, January 11, 2013, https://www.bizjournals.com/twincities/news/2013/01/11/north-memorial-closes-eagan-clinic.html.

[27] Michael Moore, “Nurses, Support Workers Unite for Safe Staffing at North Memorial Hospital,” Workday Minnesota (blog), June 27, 2014, https://workdayminnesota.org/nurses-support-workers-unite-for-safe-staffing-at-north-memorial-hospital/.

[28] Minnesota Nurses Association, “North Memorial Hospital Harassed, Retaliated Against Employees: NLRB,” Press Release, Targeted News Service, October 30, 2014;

Jeremy Olson, “Nurses Union Wins Labor Complaint against North Memorial,” Star Tribune, September 4, 2015, https://www.startribune.com/nurses-union-wins-labor-complaint-against-north-memorial/324546971/.

[29] Minnesota Nurses Association, “MNA Wins ULP Against North Memorial,” Press Release, September 4, 2015.

[30] North Memorial Health Care, “North Memorial Health Care Announces 2015 Retirement of Loren Taylor, CEO; Names Kevin Croston, MD, as Successor,” Press Release, PR Newswire, October 3, 2014, https://www.bloomberglaw.com/product/blaw/document/NCVO393MMTC0?criteria_id=4e67d1989a3e2f28e0149a4d7e9b28e5&searchGuid=6c74b3ae-67d4-4acc-bdc5-afaff36c4212.

[31] Christopher Snowbeck, “North Memorial Adjusts to the New Health Care Landscape,” Star Tribune, October 31, 2014, https://www.startribune.com/north-memorial-adjusts-to-the-new-health-care-landscape/281118532/.

[32] Andy Mannix, “Lawsuit Says Police Detained Innocent Man at North Memorial, Urged Paramedics to Use Ketamine to Sedate Him,” Star Tribune, July 12, 2018, https://www.startribune.com/lawsuit-says-police-detained-innocent-man-at-north-memorial-urged-paramedics-to-use-ketamine-to-sedate-him/487951331/.

[33] North Memorial Health, “North Memorial Health Launches New Brand,” April 4, 2017, PR Newswire, https://www.prnewswire.com/news-releases/north-memorial-health-launches-new-brand-300433759.html.

[34] North Memorial Health Care, Return of Organization Exempt From Income Tax For the 2017 Calendar Year (filed November 21, 2018), https://projects.propublica.org/nonprofits/display_990/410729979/03_2019_prefixes_39-44%2F410729979_201712_990_2019031116164483.

[35] Jim Spencer, “Hospitals Unnerved by Health Proposals,” Star Tribune, June 19, 2017, Metro edition, sec. News.

[36] Christopher Snowbeck, “North Memorial Expands Care,” Star Tribune, August 4, 2017, Metro edition, sec. Business.

[37] John Lundy, “Does the Iron Range Need Two Air Ambulance Bases?,” Duluth News-Tribune, August 19, 2017.

[38] Moody’s Investors Service, “Rating Action: Moody’s Affirms North Memorial Health’s & Maple Grove Hospital’s (MN) Baa1; Outlook to Negative,” October 25, 2018, https://emma.msrb.org/ER1161991-ER908537-ER1309010.pdf.

[39] Minnesota Nurses Association and National Nurses United, “Minnesota’s Most — and Least — Expensive Hospitals,” March 4, 2019, https://mnnurses.org/wp-content/uploads/2019/03/190304_MNA_Most-LeastExpensive_report.pdf.

[40] Kristine Goodrich, “Lawsuit Blames Mayo, North Memorial for St. James Woman’s Death,” Mankato Free Press, March 3, 2020, https://www.mankatofreepress.com/news/local_news/lawsuit-blames-mayo-north-memorial-for-st-james-womans-death/article_b9322e8a-59ac-11ea-b6be-33553dec6d37.html.

[41] Joe Carlson, “COVID-19 Death of North Memorial Worker Prompts OSHA Probe,” Star Tribune, July 20, 2020, https://www.startribune.com/covid-19-death-of-north-memorial-worker-prompts-osha-probe/571828111/.

[42] Joe Carlson, “Minnesota’s OSHA Hits Two Twin Cities Hospitals with Penalties over COVID-19,” Star Tribune, August 24, 2020, https://www.startribune.com/minnesota-s-osha-hits-two-twin-cities-hospitals-with-penalties-over-covid-19/572201042/.

[43] National Nurses United, “Fleecing Patients: Hospitals Charge Patients More Than Four Times the Cost of Care,” November 2020, https://www.nationalnursesunited.org/sites/default/files/nnu/graphics/documents/1120_CostChargeRatios_Report_FINAL_PP.pdf.

[44] Marissa Evans, “State Takes Minnesotans’ Tax Refunds for Debts Owed to Hospitals,” Star Tribune, December 11, 2020, https://www.startribune.com/state-takes-minnesotans-tax-refunds-for-debts-owed-to-hospitals/573167371/.

[45] Corey Bork, “Maple Grove Hospital Plans Major Expansion, Targets Spring 2022 Groundbreaking,” CCX Media, September 23, 2021, https://ccxmedia.org/news/maple-grove-hospital-plans-major-expansion-targets-spring-2022-groundbreaking/.

[46] U.S. Equal Employment Opportunity Commission, “EEOC Sues North Memorial Health for Disability Discrimination Against Deaf Applicant,” Press Release, April 1, 2022, https://www.eeoc.gov/newsroom/eeoc-sues-north-memorial-health-disability-discrimination-against-deaf-applicant.