A major change is coming to health care in the Valley.

After a big move to a new facility last month, Rockingham Memorial Hospital officials announced Thursday they're on a path to become affiliated with Sentara Healthcare, which is based out of Norfolk.

Sentara operates more than 100 health care sites in Virginia and North Carolina.

Officials with RMH and Sentara say, when patients come to the hospital after the affiliation is finalized, they shouldn't see an immediate impact on care.

Sentara is the largest integrated health care provider in southeastern Virginia and northeastern North Carolina. It was founded in Norfolk in 1888.

It is a nonprofit health care organization that currently operates eight hospitals.

In 2005, the company established the Sentara Cardiovascular Research Institute to advance the understanding and treatment of the disease.

In talking about the affiliation, RMH officials say the economics of health care is a major factor in this move.

RMH has operated independently since 1912.

Jim Krauss, president and CEO of RMH, says the hospital's board started studying affiliation about 18 months ago.

About four to five months ago, he says talks got serious.

"To best assure that we have quality health care available at an affordable price for this community, they decided that it was in the best interest of this community for RMH to become part of a not-for-profit community hospital system," says Krauss.

Krauss says it's become increasingly difficult for independent hospitals to be successful long-term.

"Because of the complexities of health care, what's going on with health care reform, and other pressures, there will be consolidation in Virginia, and we want to be part of that," says Sentara Healthcare CEO David Bernd.

In this affiliation, Sentara officials say they'll control the finances.

RMH will have a local board that will still have control over things like quality of care issues.

The hospital holds about around $250 million in debt, according to Krauss. Much of that is from construction of the new hospital site.

Krauss says the hospital is still generating money and having no trouble making payments on that debt.

"Sentara being a large organization, more depth, more resources, if for some reason, the future causes us to struggle in some way, they'll be there with their strength to back us up and to support us in meeting our bond covenants," says Krauss.

Officials say it'll take about six months or more for this deal to be finalized, adding the affiliation will most likely happen early next year.

WHSV asked Sentara's CEO if there is much of a difference between this affiliation and an actual merger. Bernd says, from a practical standpoint, there isn't.

Sandy Steever, editor of Health Care M&A Information Service, says this move is part of a larger trend in the country that's been going on for the last 15 years.

The trend is expected to continue.

"I think if you don't take the concerns of the local community into account in a merger or in an affiliation, there's really no reason to go through with it. And, I think most systems do that thoughtfully. There could be some so-called loss of local control, but you gain strength by becoming part of a larger system," says Steever.

According to a news release from RMH, 95 percent of Virginia hospitals are part of health care systems.