The Canton-Potsdam Hospital is part of the St. Lawrence Health System, with hospitals in Potsdam, Gouverneur and Massena. (Provided photo — Christopher Lenney, Watertown Daily Times)

POTSDAM — After more than three years of working toward an agreement, St. Lawrence Health System and Rochester Regional Health have finalized an affiliation.

The two hospital systems in 2018 signed a non-binding letter of intent to affiliate, and hospital administrators on Tuesday announced they had been granted all regulatory approvals for the alignment to be official.

The multi-hospital, 20,000-employee Rochester system has the capacity to support the 2,000-employee St. Lawrence system, according to a joint news release issued Tuesday. SLHS will maintain control of its three hospitals — Canton-Potsdam, Gouverneur and Massena — and network of rural outpatient facilities, and Rochester Regional will provide access to its electronic record system and population health management programs.

“The lengthy and collaborative due diligence approval process allowed both health systems to fully appreciate the synergies that exist, and to confirm our shared vision for bringing the highest quality health care to those who need it,” SLHS President and CEO David Acker said in a statement. “Everyone served by St. Lawrence should expect to receive the same familiar care and quality for which we are known.”

Rochester Regional President and CEO Eric Bieber called the affiliation “a deliberate decision” by both systems, adding that the process involved identifying a complement — “culturally, financially and clinically.”

Rochester Regional has additionally agreed to invest in capital improvement projects and assist with physician recruitment and retainment in the north country.

“Embracing innovation, smart growth and strong fiscal performance are among the many attributes Rochester Regional Health and St. Lawrence Health System have in common,” Bieber said.

With 195 full-time medical employees, SLHS has an estimated annual $300 million net operating revenue. Rochester Regional, which was formed in 2014 from the merging of Rochester General Hospital and Unity Health System, is a more than $2 billion organization.

“Being a part of a bigger organization, we benefit from those economies of scale,” Acker said in 2018. “We benefit from that larger and more developed support service infrastructure.”