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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
2018
Open to Public
Inspection
Name of the organization
MULTICARE HEALTH SYSTEM
 
Employer identification number
91-1352172
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 WASHINGTON HEALTH CARE FACILITIES SERIES 2009 AB
  		91-1108929 93978E3U4 05-01-2009 100,000,000 CONSTRUCTION OF THE GOOD SAMARITAN TOWER   X   X   X
B WASHINGTON HEALTH CARE FACILITIES SERIES 2010 A
  		91-1108929 93978E6W7 01-05-2010 105,127,578 USED TO REFUND THE WHCA SERIES 1998 ISSUED ON 08/13/1998   X   X   X
C WASHINGTON HEALTH CARE FACILITIES SERIES 2012 A
  		91-1108929 93978HHB4 11-13-2012 140,628,741 AUBURN AQUISITION,TG CAMPUS REFRESH,COVINGTON EMERGENCY DEPARTMENT   X   X   X
D WASHINGTON HEALTH CARE FACILITIES SERIES 2015 AB
  		91-1108929 93978HNH4 04-16-2015 420,539,219 REFUND THE SERIES 2004 & SERIES 2008 BONDS, CONSTRUCTION AT AUBURN & COVINGT   X   X   X
Part Ⅱ
Proceeds
A B C D
1 Amount of bonds retired ..................   64,820,000   11,495,000
2 Amount of bonds legally defeased ..............        
3 Total proceeds of issue .................. 100,000,000 105,127,578 140,628,741 420,539,219
4 Gross proceeds in reserve funds .............        
5 Capitalized interest from proceeds .............        
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ............... 1,032,608   1,336,000 3,145,115
8 Credit enhancement from proceeds ............. 556,507 574    
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 98,410,885   139,292,741 192,374,556
11 Other spent proceeds .............   105,127,004   225,019,548
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2010 2010 2013 2017
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? ....   X X     X X  
15 Were the bonds issued as part of an advance refunding issue? .....   X   X   X   X
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) 2018
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Schedule K (Form 990) 2018
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   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? X   X   X   X  
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 0.180 % 0 % 0.070 % 3.500 %
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 0 % 0 % 0 % 0 %
6 Total of lines 4 and 5 ............. 0.180 % 0 % 0.070 % 3.500 %
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. ..        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............                
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) 2018
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Schedule K (Form 990) 2018
Page 3
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 ..........  
  		 
  		 
  		 
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
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
SCHEDULE K, PART IV, LINE 2C FOR THE WASHINGTON HEALTH CARE FACILITIES AUTHORITY REVENUE BONDS SERIES 2009 A,B MULTICARE HEALTH SYSTEM ENGAGED RITZ & ASSOCIATES PROFESSIONAL ASSOCIATION TO PERFORM A FIVE-YEAR ARBITRAGE REBATE CALCULATION ON 05/03/2019 AND THE RESULT WAS THERE IS NO REBATE DUE TO THE IRS.
SCHEDULE K, PART I, COLUMN C THE FOLLOWING CUSIPS WERE ISSUED FOR THE FOLLOWING BOND SERIES: $48,145,000 WA HEALTH CARE FACILITIES AUTHORITY REVENUE BONDS MULTICARE HEALTH SYSTEM SERIES 2009A MATURITY/CUSIP 8/15/2044/ 93978HET8 $49,985,000 WA HEALTH CARE FACILITIES AUTHORITY REVENUE BONDS MULTICARE HEALTH SYSTEM SERIES 2009B MATURITY/CUSIP 8/15/2040/ 93978HEU5 8/15/2041/ 93978HEV3 8/15/2042/ 93978HEW1 8/15/2043/ 93978HEX9 8/15/2044/ 93978HEY7 $100,150,000 WA HEALTH CARE FACILITIES AUTHORITY REVENUE BONDS MULTICARE HEALTH SYSTEM SERIES 2010A MATURITY/CUSIP 8/15/2018/ 93978E6S6 8/15/2019/ 93978E6T4 8/15/2020/ 93978E6U1 8/15/2021/ 93978E6V9 8/15/2022/ 93978E6W7 $60,000,000 WA HEALTH CARE FACILITIES AUTHORITY REVENUE BONDS MULTICARE HEALTH SYSTEM SERIES 2012A MATURITY/CUSIP 8/15/2042/ 93978HHB4 8/15/2046/ 93978HHA6 $87,710,000 ISSUER BOND DESCRIPTION MULTICARE HEALTH SYSTEM SERIES 2015A MATURITY/CUSIP 8/15/2018/ 93978HMN2 8/15/2019/ 93978HMP7 8/15/2020/ 93978HMQ5 8/15/2021/ 93978HMR3 8/15/2022/ 93978HMS1 8/15/2023/ 93978HMT9 8/15/2024/ 93978HMU6 8/15/2025/ 93978HMV4 8/15/2026/ 93978HMW2 8/15/2027/ 93978HMX0 8/15/2028/ 93978HMY8 8/15/2029/ 93978HMZ5 8/15/2030/ 93978HNA9 8/15/2031/ 93978HNB7 8/15/2032/ 93978HNC5 8/15/2033/ 93978HND3 8/15/2034/ 93978HNE1 8/15/2035/ 93978HNF8 8/15/2040/ 93978HNG6 8/15/2045/ 93978HNH4 $285,680,000 ISSUER REVENUE BONDS MULTICARE HEALTH SYSTEM SERIES 2015B MATURITY/CUSIP 8/15/2018/ 93978HNM3 8/15/2019/ 93978HNN1 8/15/2020/ 93978HNP6 8/15/2021/ 93978HNQ4 8/15/2022/ 93978HNR2 8/15/2023/ 93978HNS0 8/15/2024/ 93978HNT8 8/15/2025/ 93978HNU5 8/15/2026/ 93978HNV3 8/15/2027/ 93978HNW1 8/15/2028/ 93978HNX9 8/15/2029/ 93978HNY7 8/15/2030/ 93978HNZ4 8/15/2031/ 93978HPA7 8/15/2032/ 93978HPB5 8/15/2033/ 93978HPC3 8/15/2034/ 93978HPD1 8/15/2035/ 93978HPE9 8/15/2039/ 93978HPF6 8/15/2043/ 93978HPG4
Schedule K (Form 990) 2018

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