PRELIMINARY OFFICIAL STATEMENT DATED OCTOBER 18, 2018 New Issue Ratings: Moody’s: Aa3 DTC Book-Entry Only S&P: AA- (See “Ratings” herein) $161,670,000* THE CHARLOTTE-MECKLENBURG HOSPITAL AUTHORITY (North Carolina) Doing Business as Atrium Health Health Care Refunding Revenue Bonds Series 2018A Our Business: Atrium Health is one of the nation’s leading and most innovative healthcare organizations, which provides a full spectrum of healthcare and wellness programs in the Southeast region. Purpose: We will use the proceeds of the 2018A Bonds to (1) refund certain of our outstanding bonds and (2) pay certain expenses of issuing the 2018A Bonds. See “Plan of Finance” on page 28. Security: The 2018A Bonds are limited obligations payable solely from (1) our Revenues, (2) payments from, or Revenues of, other members of the obligated group, and (3) the money and securities held by the trustee in the funds and accounts for the 2018A Bonds created by our bond order and the series resolution. See “Security and Sources of Payment” on page 6. Tax Exemption: In the opinion of bond counsel, interest on the 2018A Bonds is (1) excludable from the gross income of the owners thereof for federal income tax purposes, (2) not an item of tax preference for purposes of the federal alternative minimum tax and (3) exempt from State of North Carolina income taxes. See “Tax Treatment” on page 39. Dated: Date of delivery. Delivery Date: On or about November 13, 2018. Denominations: $5,000 or any multiple thereof. Interest Payment Dates: January 15 and July 15 of each year, commencing January 15, 2019. Due: January 15, as shown on the inside cover. Redemption: The 2018A Bonds are subject to optional, extraordinary and mandatory redemption prior to maturity. See “Description of the 2018A Bonds—Redemption” on page 25. Bond Counsel: Robinson, Bradshaw & Hinson, P.A., Charlotte, North Carolina. Underwriters’ Counsel: Nexsen Pruet, PLLC, Charlotte, North Carolina. Authority’s Counsel: Keith A. Smith, Esq., Executive Vice President and General Counsel of the Authority. Limited Information: Only selected information is presented on this cover. You should read this official statement in its entirety to make an informed decision regarding the 2018A Bonds. Citigroup BofA Merrill Lynch Wells Fargo Securities November __, 2018 The information in this Preliminary Official Statement is subject to completion or amendment. This Preliminary Official Statement is not an offer to sell the 2018A Bonds and is not a solicitation of an offer to buy the 2018A Bonds in any buy the 2018A Bonds in to This Preliminary to sell the 2018A Bonds and is not a solicitation of an offer Official Statement is not an offer in this PreliminaryThe information Official Statement is subject to completion or amendment. or sale of the 2018A Bonds is not permitted.jurisdiction where the offer * Preliminary, Subject to Change The Charlotte-Mecklenburg Hospital Authority (North Carolina) Doing Business as Atrium Health $161,670,000* Health Care Refunding Revenue Bonds Series 2018A MATURITY SCHEDULE $__,___,___ Serial Bonds Year Amount Interest Rate Yield CUSIP Number $__________ ___% Term Bonds maturing January 15, 20__ Yield _.__% CUSIP: $__________ ___% Term Bonds maturing January 15, 20__ Yield _.__% CUSIP: __________________________ *Preliminary, Subject to Change You should rely only on the information contained in this official statement. The Local Government Commission of North Carolina and we have not, and the underwriters have not, authorized any person who offers or sells the 2018A Bonds to provide you with information in addition to or inconsistent with the information contained in this official statement, or to represent anything else about us or the 2018A Bonds. If anyone provides you with additional or inconsistent information, you should not rely on it. Unless we specify an earlier date, the information appearing in this official statement is current as of the date of this official statement shown on the front cover. Our business, financial condition, results of operations or prospects may have changed since that date. The underwriters have provided the following sentence for inclusion in this official statement. The underwriters have reviewed the information in this official statement in accordance with, and as part of, their respective responsibilities to you under the federal securities laws as applied to the facts and circumstances of this transaction, but the underwriters do not guarantee the accuracy or completeness of such information. We are not, and the underwriters are not, offering to sell the 2018A Bonds or soliciting an offer to buy the 2018A Bonds in any jurisdiction where the offer or sale of the 2018A Bonds is not permitted. In reliance upon exemptions, we are not (1) registering the 2018A Bonds under the Securities Act of 1933, as amended, or any state securities laws or (2) qualifying our bond order or the series resolution under the Trust Indenture Act of 1939. Neither the Securities and Exchange Commission nor any other federal or state securities commission or regulatory authority has recommended, approved or disapproved the 2018A Bonds or determined if this official statement is adequate, accurate or complete. Any representation to the contrary is a criminal offense. In connection with this offering, the underwriters may overallot or effect transactions which stabilize or maintain the market price of the 2018A Bonds at a level above that which might otherwise prevail in the open market. The underwriters may discontinue any such stabilizing at any time. Certain statements included or incorporated by reference in this Official Statement constitute “forward-looking statements.” Such statements are generally identifiable by the terminology used such as “plan,” “project,” “expect,” “anticipate,” “intend,” “believe,” “estimate,” “budget” or other similar words. The achievement of certain results or other expectations contained in such forward-looking statements involve known and unknown risks, uncertainties and other factors that may cause actual results, performance or achievements described to be materially different from any future results, performance or achievements expressed or implied by such forward-looking statements. We do not plan to issue any updates or revisions to those forward-looking statements if or when their expectations, or events, conditions or circumstances on which such statements are based, occur. [THIS PAGE INTENTIONALLY LEFT BLANK] TABLE OF CONTENTS Page INTRODUCTION AND SUMMARY ........................................................................................................ 1 Our Business ................................................................................................................................... 1 Obligated Group; Designated Affiliates; Combined Group ............................................................ 1 Use of Proceeds .............................................................................................................................. 2 Issuance of the 2018A Bonds ......................................................................................................... 2 Our Outstanding Bonds; Additional Bonds .................................................................................... 2 Security and Sources of Payment for Our Bonds ........................................................................... 4 Bondholders’ Risks ......................................................................................................................... 5 Trustee ........................................................................................................................................... 5 Financial Statements – Independent Auditors ................................................................................ 5 Continuing Disclosure .................................................................................................................... 5 Role of the Local Government Commission of North Carolina ..................................................... 5 Definitions ...................................................................................................................................... 5 Limitation of Summaries; Obtaining Copies of Documents ........................................................... 6 SECURITY AND SOURCES OF PAYMENT ........................................................................................... 6 Limited Obligation; Revenue Pledge .............................................................................................. 6 The Obligated Group ...................................................................................................................... 7 Designated Affiliates; Combined Group......................................................................................... 8 Limitation on Liens; Negative Pledge ............................................................................................ 9 Assumption and Replacement of Bond Order .............................................................................. 10 BONDHOLDERS’ RISKS ........................................................................................................................ 12 Risks Relating to Our Bonds ......................................................................................................... 12 Risks Relating to Our Business ....................................................................................................