Matt Hager, a member of the Jacobson Memorial Hospital board, testifies to lawmakers during the special session on Jan. 21, 2026. (Photo by Jacob Orledge/North Dakota Monitor)
By: Jacob Orledge
BISMARCK, N.D. (North Dakota Monitor) – Lawmakers are recommending a green light for a bill aiming to save a local hospital in southwest North Dakota.
Senate Bill 2403 would authorize the Bank of North Dakota to issue an emergency low-interest operating loan of up to $5 million to a hospital in financial distress. The bill was proposed by a trio of District 31 lawmakers to stabilize the Jacobson Memorial Hospital in Elgin.
The hospital is in danger of closing its doors and is operating payroll to payroll due to years of financial mismanagement and leadership turnover, a representative of the hospital’s board testified Wednesday.
“Keeping this hospital operational will save lives,” said Rep. Karen Rohr, R-Mandan, one of the bill sponsors.
Some lawmakers expressed concern the most recent audit and other financial information available for Jacobson Memorial Hospital is from 2023. Sen. Sean Cleary, R-Bismarck, and Rep. Keith Kempenich, R-Bowman, said they hope the state-owned Bank of North Dakota will scrutinize the hospital’s financials before approving a loan.
“I do think we should approve this bill. It’s an important one,” Cleary said. “But I do have serious concerns that we don’t have more up-to-date financial information about this organization.”
The Joint Appropriations Committee recommended a do pass for the bill with an amendment. While the original bill proposed $10 million for the program, enough for two $5 million loans in case another hospital needs support, the amendment cut the funding in half.
Matt Hager, who joined the hospital’s board 11 months ago, told lawmakers Wednesday the board is in the process of implementing cost-cutting measures and reforming billing practices, and parted ways with the former CEO in November.
But the hospital is $4 million in debt with interest rates between 7% and 15%, according to documents submitted by Hager. The loan authorized by the bill would be capped at 2% interest and would enable the hospital to restructure its debt, allow its business reforms to take effect, and give it time to take advantage of the Rural Health Transformation Program funding in the coming years.
“We can completely turn the tide and take Jacobson from surviving to thriving,” Hager said.
The hospital expects to reach positive cash flow by December 2026, the board member testified.
The Jacobson Memorial Hospital provides care to residents of Grant, Morton, Sioux, Hettinger and Adams counties. The hospital employs 130 people, representing 5% of Grant County’s population, and contributes an estimated $11.2 million to the local economy directly and indirectly, according to numbers provided by Hager.
The hospital’s closure would likely have a domino effect and force the shutdown of clinics in Elgin, Richardton and Glen Ullin. The patients responsible for an estimated 800 emergency room visits annually would have to travel an hour or more to the next nearest hospital. The local ambulance service, staffed and operated by the hospital, covers 900 square miles and also would likely close, according to Hager’s testimony.
“If we do not receive your approval today, we will not quit,” Hager said. “We will continue to pursue every avenue while operating the hospital as efficiently as possible.”
The bill will now go to the floor for consideration by the full Senate, which convenes at 8:30 a.m. Thursday.
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