Throughout the past decade, hospital mergers and consolidations have been a consistent and accelerating trend occurring across the nation. Although the trend is expected to continue as a key industry response to the economic climate and healthcare reform, the results of mergers often fall short of desired outcomes. 1,2 The literature reflects a plethora of evidence of failed mergers, including tactical suggestions to overcome the barriers; however, the evidence of theory to ground a successful merger is mainly anecdotal and episodic.