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      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>The governing documents, conflict of interest policy and financial statements are available upon request for the same period of disclosure as set forth in IRC Section 6104(d).</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, line 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>ECU Health Capital Contribution 7,000,000.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XII, Line 2C</FormAndLineReferenceDesc>
        <ExplanationTxt>This process has not changed from the prior year.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>University Health Systems of Eastern Carolina DBA ECU Health</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>2100 Stantonsburg Road</AddressLine1Txt>
          <CityNm>Greenville</CityNm>
          <StateAbbreviationCd>NC</StateAbbreviationCd>
          <ZIPCd>27835</ZIPCd>
        </USAddress>
        <EIN>562141073</EIN>
        <PrimaryActivitiesTxt>Healthcare</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 12c, III-FI</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Pitt County Memorial Hospital Inc DBA ECU Health Medical Center</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>2100 Stantonsburg Road</AddressLine1Txt>
          <CityNm>Greenville</CityNm>
          <StateAbbreviationCd>NC</StateAbbreviationCd>
          <ZIPCd>27835</ZIPCd>
        </USAddress>
        <EIN>560585243</EIN>
        <PrimaryActivitiesTxt>Hospital</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ECU Health</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>The Outerbanks Hospital Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>2100 Stantonsburg Road</AddressLine1Txt>
          <CityNm>Greenville</CityNm>
          <StateAbbreviationCd>NC</StateAbbreviationCd>
          <ZIPCd>27835</ZIPCd>
        </USAddress>
        <EIN>562112733</EIN>
        <PrimaryActivitiesTxt>Hospital</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>East Carolina Health</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>PCMH Management Inc DBA ECU Health Properties</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>2100 Stantonsburg Road</AddressLine1Txt>
          <CityNm>Greenville</CityNm>
          <StateAbbreviationCd>NC</StateAbbreviationCd>
          <ZIPCd>27835</ZIPCd>
        </USAddress>
        <EIN>561690740</EIN>
        <PrimaryActivitiesTxt>Medical Property Management</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(2)</ExemptCodeSectionTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ECU Health</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>East Carolina Health INC DBA ECU Health Community Hospitals - Central</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>2100 Stantonsburg Road</AddressLine1Txt>
          <CityNm>Greenville</CityNm>
          <StateAbbreviationCd>NC</StateAbbreviationCd>
          <ZIPCd>27835</ZIPCd>
        </USAddress>
        <EIN>562003393</EIN>
        <PrimaryActivitiesTxt>Hospital</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ECU Health</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Vidant Medical Group LLC DBD ECU Health Physicians</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>2100 Stantonsburg Road</AddressLine1Txt>
          <CityNm>Greenville</CityNm>
          <StateAbbreviationCd>NC</StateAbbreviationCd>
          <ZIPCd>27835</ZIPCd>
        </USAddress>
        <EIN>383740839</EIN>
        <PrimaryActivitiesTxt>Healthcare</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ECU Health</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>East Carolina Health-Bertie DBA ECU Health Bertie Hospital</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>2100 Stantonsburg Road</AddressLine1Txt>
          <CityNm>Greenville</CityNm>
          <StateAbbreviationCd>NC</StateAbbreviationCd>
          <ZIPCd>27835</ZIPCd>
        </USAddress>
        <EIN>562072002</EIN>
        <PrimaryActivitiesTxt>Hospital</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ECU Health</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>East Carolina Health-Chowan DBA ECU Health Chowan Hospital</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>2100 Stantonsburg Road</AddressLine1Txt>
          <CityNm>Greenville</CityNm>
          <StateAbbreviationCd>NC</StateAbbreviationCd>
          <ZIPCd>27835</ZIPCd>
        </USAddress>
        <EIN>562101090</EIN>
        <PrimaryActivitiesTxt>Hospital</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ECU Health</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>East Carolina Health-Heritage DBA ECU Health Edgecombe Hospital</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>2100 Stantonsburg Road</AddressLine1Txt>
          <CityNm>Greenville</CityNm>
          <StateAbbreviationCd>NC</StateAbbreviationCd>
          <ZIPCd>27835</ZIPCd>
        </USAddress>
        <EIN>562093700</EIN>
        <PrimaryActivitiesTxt>Hospital</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ECU Health</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>East Carolina Health-Beaufort DBA ECU Health Beaufort Hospital</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>2100 Stantonsburg Road</AddressLine1Txt>
          <CityNm>Greenville</CityNm>
          <StateAbbreviationCd>NC</StateAbbreviationCd>
          <ZIPCd>27835</ZIPCd>
        </USAddress>
        <EIN>452436270</EIN>
        <PrimaryActivitiesTxt>Hospital</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ECU Health</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Duplin General Hospital DBA ECU Health Duplin Hospital</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>2100 Stantonsburg Road</AddressLine1Txt>
          <CityNm>Greenville</CityNm>
          <StateAbbreviationCd>NC</StateAbbreviationCd>
          <ZIPCd>27835</ZIPCd>
        </USAddress>
        <EIN>566011594</EIN>
        <PrimaryActivitiesTxt>Hospital</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ECU Health</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>East Carolina Health Inc DBA ECU Health Roanoke-Chowan Hospital</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>2100 Stantonsburg Road</AddressLine1Txt>
          <CityNm>Greenville</CityNm>
          <StateAbbreviationCd>NC</StateAbbreviationCd>
          <ZIPCd>27835</ZIPCd>
        </USAddress>
        <EIN>264634725</EIN>
        <PrimaryActivitiesTxt>Hospital</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ECU Health</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Access East Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>2410 Stantonsburg Rd Stanton Square</AddressLine1Txt>
          <CityNm>Greenville</CityNm>
          <StateAbbreviationCd>NC</StateAbbreviationCd>
          <ZIPCd>27834</ZIPCd>
        </USAddress>
        <EIN>561949493</EIN>
        <PrimaryActivitiesTxt>Healthcare</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ECU Health</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Halifax Regional Medical Center Inc DBA ECU Health North Hospital</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>2100 Stantonsburg Road</AddressLine1Txt>
          <CityNm>Greenville</CityNm>
          <StateAbbreviationCd>NC</StateAbbreviationCd>
          <ZIPCd>27835</ZIPCd>
        </USAddress>
        <EIN>560989789</EIN>
        <PrimaryActivitiesTxt>Hospital</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
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        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ECU Health</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Roanoke Valley Health Services</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>2100 Stantonsburg Road</AddressLine1Txt>
          <CityNm>Greenville</CityNm>
          <StateAbbreviationCd>NC</StateAbbreviationCd>
          <ZIPCd>27835</ZIPCd>
        </USAddress>
        <EIN>561925492</EIN>
        <PrimaryActivitiesTxt>Healthcare</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>Line 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ECU Health</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>1</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
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      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>1</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>1</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>1</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>0</SharingOfFacilitiesInd>
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      <ReimbursementPaidToOtherOrgInd>1</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>1</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>
