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Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax-Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet Attach to Form 990.
SchKMediumBulletGo to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2017
Open to Public
Inspection
Name of the organization
West Virginia University Hospitals Inc
 
Employer identification number
55-0643304
Part Ⅰ
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer		 (i) Pool
financing
Yes No Yes No Yes No
A West Virginia Hospital Finance Authority
  		62-1256910 000000000 10-02-2012 20,325,000 2012 E - Refund 2009 B Bonds allocated to WVUH-East entities   X   X   X
B West Virginia Hospital Finance Authority
  		62-1256910 956622E91 10-03-2013 158,374,566 2013 A - New construction and renovations to WVUH   X   X   X
C West Virginia Hospital Finance Authority
  		62-1256910 000000000 08-19-2015 18,500,000 2015A - New construction and refinance of loans incurred at acquisition of PVH   X   X   X
D West Virginia Hospital Finance Authority
  		62-1256910 956622L85 06-15-2016 119,678,674 2016 A - Refund 2003 BD, 2008 E, and 2009 C and 2009 C issuances - 18m to WVUH-East   X   X   X
Part Ⅱ
Proceeds
A B C D
1 Amount of bonds retired .................. 400,000     2,463,014
2 Amount of bonds legally defeased ..............        
3 Total proceeds of issue .................. 20,325,000 158,374,566 18,500,000 119,678,674
4 Gross proceeds in reserve funds .............        
5 Capitalized interest from proceeds .............   23,654,112    
6 Proceeds in refunding escrows ...............       384
7 Issuance costs from proceeds ............... 60,000 1,388,439 166,267 923,368
8 Credit enhancement from proceeds .............        
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds .............   133,332,015 1,325,000  
11 Other spent proceeds ............. 20,265,000   17,008,733 118,754,922
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2012 2016 2016 2016
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? ....                
15 Were the bonds issued as part of an advance refunding issue? .....                
16 Has the final allocation of proceeds been made? .......... X     X X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X   X  
Part Ⅲ
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............   X   X X   X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2017
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Schedule K (Form 990) 2017
Page 2
Part Ⅲ
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? ............. X     X   X   X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X       X   X  
c Are there any research agreements that may result in private business use of bond-financed property? .............   X   X   X   X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet     0.680 % 0.070 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet        
6 Total of lines 4 and 5 .............     0.680 % 0.070 %
7 Does the bond issue meet the private security or payment test? ...   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?............. X     X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. .. 2.040 %      
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? ............. X              
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........ 		X   X   X     X
Part Ⅳ
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X   X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X   X X   X  
b Exception to rebate? ........   X   X   X   X
c No rebate due? ......... X   X     X   X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? ..... X     X X     X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider ..........  
  		 
  		 
  		 
 
c Term of hedge .........        
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
Schedule K (Form 990) 2017
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Schedule K (Form 990) 2017
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Part Ⅳ
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X X     X X  
b Name of provider ..........  
  		Cantor Fitzgerald & Co
  		 
  		Cantor Fitzgerald & Co
 
c Term of GIC .........   170.0000000000 %   196.0000000000 %
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........     X       X  
6 Were any gross proceeds invested beyond an available temporary period?   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X   X   X  
Part Ⅴ
Procedures To Undertake Corrective Action
--------------------------------------------------------------------------------------------------------------- A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part Ⅵ
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
Part I Line B The 2013 A Series Bonds were issued as one series but were allocated within the Obligated Group to WVUH issue price 158,374,566 and CCMH issue price- 47,037,860. The total issue price for the 2013 A Series Bonds was 205,412,426 consistent with total issue price reported on Form 8038 for October 3, 2013 issuance, CUSIP 956622E91. Only the portion of proceeds allocated to WVUH has been reported on this return Part I, Line B this Schedule K. The CCMH allocated portion of the 2013 A Series Bonds was used for refunding of its 2004 A Series bonds and expansion and renovation projects as reported on the tax return filed by CCMH.
Part III Line 8c Column A - The items disposed of in 2014 were disposed of because they were fully depreciated. Those disposals were 1.49 of the bond gross proceeds. In 2013 items sold were fully depreciated at the time of the sale, these items were .55 of the bond gross proceeds, to meet remeidal actions requirements the proceeds received were put back into the purchase of like items.
Part IV Line 2a Column C, D - 2015, and 2016 A Series issuances are not yet required to have rebate calculations, all issuances are expected to meet the exception to rebate.
Part IV Line 2c Column A B - Rebate calculations for 2012 E Series and 2013 A Series issuances were prepared during 2017 and found that no rebate is due.
Part I Line D The 2016 A Bonds were issued on behalf of the West Virginia United Health System Obligated Group with an issue price of 288,869,596 per Form 8038. The 2016 A Bonds were issued to refund certain outstanding bonds. Per internal allocations based on the balances of the refunded bonds in the general ledger proceeds allocated to WVUH and WVUH-East, 119,678,674 in total, have been reported on this return Part I, Line D of the second Schedule K. The proceeds allocated to WVUH, 101,624,324, were used to refund the 2003D, 2008E, and 2009C issuances as an advanced refundings The proceeds allocated to WVUH-East, 18,054,350, were used to refund 2008E as an advanced refunding. The remaining proceedes from this issuance are reported on Form 990 for CCMC and UHC.
Schedule K (Form 990) 2017

Additional Data


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