This article examines hospital reorganization and restructuring activities following merger for two study periods: 1983-1988 and 1989-1996. In both periods, hospitals rated strengthening hospital financial position as the most important reason for merger. There were also similarities in reorganizing actions, especially reductions in service duplication, consolidation of departments and programs, reductions in medical and support FTEs, and reductions in administrative staffing. Hospital mergers during 1989-1996, however, focused increasingly on reducing nursing FTEs and less on converting acquired hospitals to new service lines.