Sacred Heart Province is the USA-Midwest Province of an international congregation, Sisters of St. Francis of Penance and Christian Charity. The province was established in Denver, Colorado, with additional ministries in Alliance, Nebraska, and outlying areas of Nebraska and South Dakota. The Marycrest campus in Denver, on which the motherhouse was located, was sold in 2012. At the time of the Health Dimensions Group (HDG) engagement in 2020, the province comprised 25 sisters, the youngest of whom was 55; it no longer accepted new members.

Marian Residence, the province’s facility for aged and infirm sisters, was located in Alliance. Nine sisters lived at the residence. Marian Residence was adjacent to St. Francis Convent, where one sister lived; it was expected she would transition to assisted living in the near future, at which time the province planned to sell St. Francis Convent.

Back in 2005, in anticipation of the decrease of the number of retired sisters needing care services, the province had sought to develop options for short- and long-term provision of ongoing support and health services for sisters residing at the Alliance campus. The province engaged HDG to conduct a market and demographics assessment and situational audit to facilitate master planning and strategy development. Based on the results of the review, HDG developed several options for consideration by the province to meet the needs of members while also balancing cost factors.

Province leadership previously determined that plans to sell or close Marian Residence would begin as the point approached of having only four sisters residing there; those sisters remaining would be moved to other licensed care communities. In 2020, with nine sisters at the residence, the province requested that HDG update the 2005 study and provide insight and recommendations on viable options for the province to continue to operate Marian Residence or, alternatively, to close the facility.


To assist Sacred Heart Province in finding a solution, HDG formulated and executed a multiphase approach to ensure the safety and appropriate transfer of the sisters to an appropriate setting and level of care. Phases included:

  • Leadership Stability
  • Operational Assessment
  • Market Scan
  • Financial Projections

Leadership Stability

HDG initiated a search and secured new leadership for the campus that possessed the necessary experience to oversee the closure of operations. The new leader was provided a network of HDG consulting specialists to serve as a lifeline in navigating the many decisions related to a wind-down and closure. The support included a suite of personnel with diverse experiences in regulatory compliance, finance, clinical reimbursement, and revenue cycle management.

Operational Assessment

HDG completed an on-site operational assessment to set a baseline of current operations, as well as an operational risk analysis to ensure the needs of all the sisters were being met. HDG’s consultants interviewed staff members to verify information and ascertain how operations were impacted by current protocols and systems. In addition, the site review allowed HDG to observe the provision of services and obtain an understanding of the community’s dynamics.

Market Scan

The Sisters of St. Francis were considering relocating the sisters currently living at Marian Residence to a similar care community in the Alliance or Denver area. The on-site assessment provided HDG with insight into the elements of care and amenities, as well as Catholic faith-based practices, which would best meet the needs of each sister currently residing at Marian Residence upon moving to an alternate facility. HDG next conducted a market scan to identify suitable care communities closest to Alliance and in the Denver area. HDG consultants researched care providers in these markets and provided a report of alternative placement options.

Financial Projections

In addition, HDG completed a financial review of Marian Residence operations and the development of a pro forma to project operating costs until the care community was closed.


Through attrition and relocation, sisters who did not care to relocate were given the opportunity to live at Marian Residence until their ultimate passing. Of the remaining four sisters, one chose to relocate back to Denver and three chose to relocate within their Alliance community, vacating the Marian Residence on May 19, 2022.

During the HDG oversight and relocation period, the health care center received zero citations and ultimately closed in full compliance in early 2022.

About Health Dimensions Group

Minneapolis-based Health Dimensions Group (HDG) is a leading management and consulting firm, providing services to post-acute, longterm care, and senior living providers, as well as hospitals and health systems across the nation. HDG has been serving health care organizations for more than 20 years with a firm commitment to its values of hospita