However, in the early 2000s, it was clear a new facility needed to be built to accommodate a growing number of patients and the ability to expand further in a more open area.

The hospital chose an 84-acre (34 ha) campus adjacent to their current Outpatient Care Center on Pantops Mountain for the new facility.

Engineering firms include Graef, Anhult, Schloemer & Associates of Milwaukee; Ring & DuChateau of Milwaukee; Rummel, Klepper & Kahi LLP of Richmond, VA and Hughes, Good, O'Leary and Ryan of Atlanta, GA.

In September 2010, Martha Jefferson Hospital sold its downtown Charlottesville building to Octagon Partners.

The merger was finalized on June 1, 2011, making Martha Jefferson the tenth hospital of Sentara Healthcare's not-for-profit integrated health system, which is based in Norfolk, Virginia.