Dignity Health and Catholic Health Initiatives, two major not-for-profit health systems, signed a letter of intent to explore a merger in October 2016, and finally tied the knot in December. Although Catholic Health is the larger of the two, with 101 hospitals, its financial picture isn’t a rosy as its partner’s.

Dignity Health, based in San Francisco, is a 22-state network of more than 9,000 physicians and other advanced practice clinicans and 63,000 employees. It operates 39 acute-care hospitals and 250 ancillary care sites such as urgent and occupational care, imaging centers, home health and primary care clinics.

In fiscal 2017, which ended on June 30, it reported revenue of $12.9 billion,  $384 million in net income and a $67 million operating loss.

Catholic Health Initiatives, already one of the largest U.S. health systems, operates in 17 states and comprises 101 hospitals, including 29 critical-access facilities; community health services; home-health agencies. In fiscal 2017, it reported revenue of $15.5 billion and $930.7 million of operating EBIDA.

Their combined revenue will exceed $28 billion, creating the largest nonprofit health system in the country. The new entity, which will be named later in 2018, will span 28 states, with more than 700 locations, 139 hospitals and employ more than 25,000 physicians. Their current hospital service areas don’t overlap.

Both CEOs, CHI’s Kevin Lofton and Dignity’s Lloyd Dean, will co-lead the combined health system, each with their own responsibilities and decision-making authority. Lofton will have authority for mission, advocacy, sponsorship and governance, system partnerships and information technology. Dean will have authority for all of operations, including clinical, financial and human resources.

The new organization, which will be headquartered in Chicago, will be renamed in the second half of 2018.

In October 2017, in preparation for this merger, Dignity Health spun off its urgent care and occupational therapy subsidiary, U.S. HealthWorks, to be combined Concentra Group, which is jointly owned by Select Medical Holdings (NYSE: SEM) and Welsh, Carson, Anderson & Stowe. In May 2017, CHI divested substantially all of its Louisville, Kentucky operations.