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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 instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
PROVIDENCE ST JOSEPH HEALTH
 
Employer identification number
81-1244422
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 AIDEA 2011A
  		92-6001185 011903DZ1 11-17-2011 126,601,436 SEE PART VI   X   X   X
B CHFFA 2019B
  		52-1643828 13032UUP1 10-01-2019 150,006,043 SEE PART VI   X   X   X
C CHFFA 2009C&D
  		52-1643828 13032UGR3 08-27-2009 421,100,000 SEE PART VI   X   X   X
D CHFFA 2019C
  		52-1643828 13032UUU0 10-15-2019 393,290,698 SEE PART VI   X   X   X
Part Ⅱ
Proceeds
A B C D
1 Amount of bonds retired .................. 122,720,000      
2 Amount of bonds legally defeased ..............     295,920,280  
3 Total proceeds of issue .................. 126,618,614 150,006,043 426,930,280 393,290,698
4 Gross proceeds in reserve funds .............        
5 Capitalized interest from proceeds .............        
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ............... 1,601,436   4,480,280  
8 Credit enhancement from proceeds .............        
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 125,000,000   180,000,000  
11 Other spent proceeds ............. 17,178 150,006,043 242,450,000  
12 Other unspent proceeds .............       393,290,698
13 Year of substantial completion ............. 2012 2012 2009 2009
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue of tax-exempt
bonds (or, if issued prior to 2020, a current refunding issue)? ........ 		  X X   X   X  
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2020, 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  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2021
Page 2

Schedule K (Form 990) 2021
Page 2
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
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?                
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 % 0 % 0 % 0 %
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 % 0 % 0 % 0 %
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
Schedule K (Form 990) 2021
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Schedule K (Form 990) 2021
Page 3
Part Ⅳ
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
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? ........                
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
DATE REBATE COMPUTATION PERFORMED ISSUER NAME: AIDEA 2011A DATE THE REBATE COMPUTATION WAS PERFORMED: 01/19/2017 ISSUER NAME: CHFFA 2009C&D DATE THE REBATE COMPUTATION WAS PERFORMED: 05/29/2020 ISSUER NAME: CHFFA 2019C DATE THE REBATE COMPUTATION WAS PERFORMED: 11/12/2021 ISSUER NAME: CHFFA 2013A-D DATE THE REBATE COMPUTATION WAS PERFORMED: 07/22/2021 ISSUER NAME: CHFFA 2014A DATE THE REBATE COMPUTATION WAS PERFORMED: 07/10/2019 ISSUER NAME: CHFFA 2014B DATE THE REBATE COMPUTATION WAS PERFORMED: 08/06/2019 ISSUER NAME: CHFFA 2016B DATE THE REBATE COMPUTATION WAS PERFORMED: 11/12/2021 ISSUER NAME: LHFDC 2008B DATE THE REBATE COMPUTATION WAS PERFORMED: 06/19/2018 ISSUER NAME: LHFDC 2016C DATE THE REBATE COMPUTATION WAS PERFORMED: 11/16/2021 ISSUER NAME: MFFA 2016F DATE THE REBATE COMPUTATION WAS PERFORMED: 11/16/2021 ISSUER NAME: OFA 2011C DATE THE REBATE COMPUTATION WAS PERFORMED: 01/19/2017 ISSUER NAME: OFA 2013A DATE THE REBATE COMPUTATION WAS PERFORMED: 11/01/2018 ISSUER NAME: OFA 2015C DATE THE REBATE COMPUTATION WAS PERFORMED: 10/21/2020 ISSUER NAME: WHCFA 2011B DATE THE REBATE COMPUTATION WAS PERFORMED: 09/08/2021 ISSUER NAME: WHCFA 2012A-D DATE THE REBATE COMPUTATION WAS PERFORMED: 09/18/2017 ISSUER NAME: WHCFA 2014C DATE THE REBATE COMPUTATION WAS PERFORMED: 10/03/2019 ISSUER NAME: WHCFA 2014D DATE THE REBATE COMPUTATION WAS PERFORMED: 01/06/2020 ISSUER NAME: WHCFA 2015A DATE THE REBATE COMPUTATION WAS PERFORMED: 09/14/2020 ISSUER NAME: WHCFA 2016DE DATE THE REBATE COMPUTATION WAS PERFORMED: 11/16/2021
PART I - PURPOSE OF BOND AIDEA 2011A THE PROCEEDS DERIVED FROM THE SALE OF BONDS ARE TO BE USED FOR CERTAIN CONSTRUCTION, EXPANSION, REMODELING, RENOVATION, FURNISHING, EQUIPPING OF THE FOLLOWING HEALTH CARE FACILITIES: PROVIDENCE ALASKA MEDICAL CENTER (PAMC) & LONG TERM CARE FACILITY. CHEFFA 2019B THE PROCEEDS DERIVED FROM THE SALE OF BONDS ARE TO BE USED TO REFUND THE CHFFA REVENUE BONDS ORIGINALLY EXECUTED AND DELIVERED ON JULY 29, 2009. PROCEEDS ORIGINALLY UTILIZED FOR CERTAIN CONSTRUCTION, EXPANSION, REMODELING, RENOVATION, FURNISHING, EQUIPPING OF THE FOLLOWING HEALTH CARE FACILITIES: PROVIDENCE HOLY CROSS MEDICAL CENTER. CHFFA 2009C&D THE PROCEEDS DERIVED FROM THE SALE OF THE 2009A BONDS ARE TO BE USED TO FUND CERTAIN COST OF ISSUANCE AND TO ESTABLISH A PROJECT FUND IN THE SUM OF $180,000,000. PROJECT FUNDS TO BE UTILIZED FOR CERTAIN CONSTRUCTION, EXPANSION, REMODELING, RENOVATION, FURNISHING, EQUIPPING OF THE FOLLOWING HEALTH CARE FACILITIES: MISSION HOSPITAL, ST. JOSEPH HOSPITAL OF EUREKA, AND ST. JUDE MEDICAL CENTER. ORIGINAL ISSUE DATE AUGUST 27, 2009 ORIGINAL CUSIP 13033LCA3. IN ADDITION, THE PROCEEDS DERIVED FROM THE SALE OF BONDS ARE TO BE USED TO REFUND THE CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY INSURED REVENUE BONDS ORIGINALLY EXECUTED AND DELIVERED ON JANUARY 29, 2004 ORIGINAL CUSIP 130911VQ0 & REFUNDED MAY 15, 2008 CUSIP 130795TU1 & REFUNDED AGAIN AUGUST 27, 2009 CUSIP 133033LCN5. CHEFFA 2019C THE PROCEEDS DERIVED FROM THE SALE OF BONDS WERE USED TO REFUND THE CHFFA SERIES A&B REVENUE BONDS ORIGINALLY EXECUTED AND DELIVERED ON AUGUST 27, 2009 (CHFFA A&B) & TO REFUND THE CHFFA SERIES B&C REVENUE BONDS ORIGINALLY EXECUTED AND DELIVERED ON JULY 24, 2013 (CHFFA B&C). PROCEEDS ORIGINALLY UTILIZED FOR CERTAIN CONSTRUCTION, EXPANSION, REMODELING, RENOVATION, FURNISHING, EQUIPPING OF THE FOLLOWING HEALTH CARE FACILITIES: ST. JOSEPH HOSPITAL ORANGE, MISSION HOSPITAL, ST. MARY MEDICAL CENTER, SANTA ROSA MEMORIAL HOSPITAL, ST. JOSEPH HOSPITAL OF EUREKA, AND ST. JUDE MEDICAL CENTER. IN ADDITION, PROCEEDS WERE PARTIALLY UTILIZED FOR CERTAIN COST OF ACQUISITION OF THE FOLLOWING HEALTH CARE FACILITIES: HOAG HOSPITAL NEWPORT BEACH. CHFFA 2013A-D THE PROCEEDS DERIVED FROM THE SALE OF THE 2013A-D BONDS ARE TO BE USED TO FUND CERTAIN COST OF ISSUANCE, REFINANCING OF OUTSTANDING INDEBTEDNESS OF HOAG MEMORIAL HOSPITAL PRESBYTERIAN AND TO ESTABLISH A PROJECT FUND IN THE SUM OF $110,684,400. PROCEEDS TO BE UTILIZED FOR CERTAIN COST OF ACQUISITION, CONSTRUCTION, EXPANSION, REMODELING, RENOVATION, FURNISHING, EQUIPPING OF THE FOLLOWING HEALTH CARE FACILITIES: HOAG HOSPITAL NEWPORT BEACH, ST. JOSEPH HOSPITAL, ORANGE, ST. JUDE MEDICAL CENTER , ST. MARY MEDICAL CENTER, SANTA ROSA MEMORIAL HOSPITAL AND ST. JOSEPH HOSPITAL OF EUREKA. ORIGINAL ISSUE DATE JULY 24, 2013. CHFFA 2014A THE PROCEEDS DERIVED FROM THE SALE OF THE 2014A BONDS WERE USED TO FUND CERTAIN COST OF ISSUANCE & REFINANCE THE CHFFA 2008C BONDS, WHICH HAD PREVIOUSLY ADVANCE REFUNDED THE 1998 BONDS AND CURRENT REFUNDED THE 2001ABC BONDS & FINANCED ACQUISITION OF TARZANA MC. PROCEEDS OF THE PRIOR BONDS WERE UTILIZED FOR CONSTRUCTION, EXPANSION, REMODELING, RENOVATION, FURNISHING, EQUIPPING OF THE FOLLOWING HEALTH CARE FACILITIES: PROVIDENCE ST. JOSEPH MC, PROVIDENCE HOLY CROSS MS, PROVIDENCE LCM MC'S IN TORRANCE & SAN PEDRO. ON 10/1/2019 THE PROCEEDS ALLOCATED TO TARZANA MC WERE REMEDIATED. CHFFA 2014B THE PROCEEDS DERIVED FROM THE SALE OF THE 2014B BONDS WERE USED TO REFUND CERTAIN COST OF ISSUANCE AND REFUND PH&S COMMERCIAL PAPER BORROWING ASSOCIATED WITH THE ACQUISITION OF THE FOLLOWING HEALTH CARE FACILITY: PROVIDENCE ST. JOHN'S HEALTH CENTER. CHFFA 2016A THE PROCEEDS DERIVED FROM THE SALE OF BONDS ARE TO BE USED TO REFUND THE CHFFA INSURED REVENUE BONDS ORIGINALLY EXECUTED AND DELIVERED ON APRIL 17, 2007 AND CONVERTED MARCH 27, 2008. PROCEEDS ORIGINALLY UTILIZED FOR CERTAIN CONSTRUCTION, EXPANSION, REMODELING, RENOVATION, FURNISHING, EQUIPPING OF THE FOLLOWING HEALTH CARE FACILITIES: MISSION HOSPITAL, QUEEN OF THE VALLEY MEDICAL CENTER, ST. JUDE MEDICAL CENTER, ST. JOSEPH HOSPITAL (ORANGE), ST. MARY REGIONAL MEDICAL CENTER AND SANTA ROSA MEMORIAL HOSPITAL. CHFFA 2016B THE PROCEEDS DERIVED FROM THE SALE OF THE 2016B-1,2 &3 BONDS WERE USED TO REFUND THE SJHS 2011A-D BONDS, ORIGINALLY USED TO FUND CERTAIN COST OF ISSUANCE AND CONSTRUCTION, EXPANSION, REMODELING, RENOVATION, FURNISHING, EQUIPPING OF THE FOLLOWING HEALTH CARE FACILITIES: QUEEN OF THE VALLEY MEDICAL CENTER, ST. JOSEPH HOSPITAL OF EUREKA AND ST. JUDE MEDICAL CENTER. LHFDC 2008B THE PROCEEDS DERIVED FROM THE SALE OF BONDS ARE TO BE USED TO REFUND THE LHFDC INSURED REVENUE BONDS ORIGINALLY EXECUTED AND DELIVERED ON DECEMBER 1, 1998. REFUNDED ON JUNE 19, 2008 WITH CUSIP 549208D49, CONVERTED JULY 14, 2011. LHFDC 2016C THE PROCEEDS DERIVED FROM THE SALE OF BONDS ARE TO BE USED TO CURRENT REFUND THE LHFDC REVENUE BONDS ISSUANCE OF MAY 15, 2008 WITH CUSIP 549208DX1, CONVERTED AUGUST 27, 2009. MFFA 2016F THE PROCEEDS DERIVED FROM THE SALE OF BONDS REFUNDED THE MFFA 2006B BONDS WHICH WERE ORIGINALLY USED FOR CERTAIN CONSTRUCTION, EXPANSION, REMODELING, RENOVATION, FURNISHING, EQUIPPING OF THE FOLLOWING HEALTH CARE FACILITIES: PROVIDENCE ST. JOSEPH MEDICAL CENTER MONTANA LOCATED IN POLSON, MT. OFA 2011C THE PROCEEDS DERIVED FROM THE SALE OF BONDS REFUNDED THE SERIES 1999 & 2005 BONDS AND ADVANCE REFUNDED THE OFA SERIES 2002 BONDS. OFA 2013A THE PROCEEDS DERIVED FROM THE SALE OF BONDS ADVANCE REFUNDED THE HFAMC SERIES 2004 BONDS FOR WHICH WERE PROCEEDS ORIGINALLY UTILIZED FOR CERTAIN CONSTRUCTION, EXPANSION, REMODELING, RENOVATION, FURNISHING, EQUIPPING OF THE FOLLOWING HEALTH CARE FACILITIES: PROVIDENCE PORTLAND MEDICAL CENTER. OFA 2015C THE PROCEEDS DERIVED FROM THE SALE OF BONDS ARE TO BE USED FOR CERTAIN CONSTRUCTION, EXPANSION, REMODELING, RENOVATION, FURNISHING, EQUIPPING OF THE FOLLOWING HEALTH CARE FACILITIES: PROVIDENCE ST. VINCENT MEDICAL CENTER. WHCFA 2011B THE PROCEEDS DERIVED FROM THE SALE OF BONDS ADVANCE REFUNDED THE WHCFA SERIES 2001A BONDS FOR WHICH PROCEEDS WERE ORIGINALLY UTILIZED FOR CERTAIN CONSTRUCTION, EXPANSION, REMODELING, RENOVATION, FURNISHING, EQUIPPING OF THE FOLLOWING HEALTH CARE FACILITIES: PROVIDENCE PORTLAND MEDICAL CENTER PROVIDENCE MEDICAL CENTER EVERETT & PROVIDENCE ST. PETER HOSPITAL. WHCFA 2012A-D CURRENTLY REFUND ALL OUTSTANDING SWEDISH HEALTH SERVICES WHCFA BONDS. THE PROCEEDS DERIVED FROM THE SALE OF BONDS CURRENTLY REFUND SWEDISH HEALTH SERVICES WHCFA BONDS SERIES 1998, 2009ABC, & 2011ABCD, FOR WHICH WERE PROCEEDS ORIGINALLY UTILIZED FOR CERTAIN CONSTRUCTION, EXPANSION, REMODELING, RENOVATION, FURNISHING, EQUIPPING OF THE FOLLOWING HEALTH CARE FACILITIES: SWEDISH HEALTH SYSTEM - FIRST HILL CAMPUS, BALLARD CAMPUS, CHERRY HILL MEDICAL CENTER, & ISSAQUAH CAMPUS. WHCFA 2014C THE PROCEEDS DERIVED FROM THE SALE OF BONDS ARE TO BE USED FOR CERTAIN CONSTRUCTION, EXPANSION, REMODELING, RENOVATION, FURNISHING, EQUIPPING OF THE FOLLOWING HEALTH CARE FACILITIES: SWEDISH EDMONDS & TO REFINANCE A BORROWING RELATED TO THE CONSTRUCTION AT: PROVIDENCE REGIONAL MEDICAL CENTER EVERETT. WHCFA 2014D THE PROCEEDS DERIVED FROM THE SALE OF BONDS CURRENT REFUNDED THE WHCFA SERIES 2006A, SERIES 2006B, SERIES 2010 & SERIES 2012 BONDS FOR WHICH PROCEEDS WERE ORIGINALLY UTILIZED FOR CERTAIN CONSTRUCTION, EXPANSION, REMODELING, RENOVATION, FURNISHING, EQUIPPING OF THE FOLLOWING HEALTH CARE FACILITIES: KADLEC REGIONAL MEDICAL CENTER IN ADDITION CREATED A PROJECT FUND FOR SAME IN THE AMOUNT OF $9,840,477.94. WHCFA 2015A THE PROCEEDS DERIVED FROM THE SALE OF BONDS ARE TO BE USED FOR CERTAIN CONSTRUCTION, EXPANSION, REMODELING, RENOVATION, FURNISHING, EQUIPPING OF THE FOLLOWING HEALTH CARE FACILITIES: KADLEC REGIONAL MEDICAL CENTER & PROVIDENCE SACRED HEART MEDICAL CENTER. WHCFA 2016DE THE PROCEEDS DERIVED FROM THE SALE OF BONDS ARE TO BE USED TO CURRENTLY REFUND WHCFA SERIES 2006A, WHICH HAD ADVANCE REFUNDED THE SERIES 1998 BONDS. THIS ISSUE IS HELD IN TWO PRIVATE PLACEMENTS WITH WELLS FARGO & BANK OF AMERICA.
PART I - PURPOSE OF BOND (CONTINUED) WHCFA 2018B THE PROCEEDS DERIVED FROM THE SALE OF BONDS ARE TO BE USED TO CURRENTLY REFUND WHCFA SERIES 2006CDE, WHICH WERE USED TO CURRENTLY REFUND WHCFA SERIES 2002AB & WHCFA 1994 & 1995 BONDS. WHCFA 2021B CURRENTLY REFUND ALL OUTSTANDING SWEDISH HEALTH SERVICES WHCFA BONDS.THE PROCEEDS DERIVED FROM THE SALE OF BONDS CURRENTLY REFUND SWEDISH HEALTH SERVICES WHCFA BONDS SERIES 1998, 2009ABC, & 2011ABCD, FOR WHICH WERE PROCEEDS ORIGINALLY UTILIZED FOR CERTAIN CONSTRUCTION, EXPANSION, REMODELING, RENOVATION, FURNISHING, EQUIPPING OF THE FOLLOWING HEALTH CARE FACILITIES: SWEDISH HEALTH SYSTEM - FIRST HILL CAMPUS, BALLARD CAMPUS, CHERRY HILL MEDICAL CENTER, & ISSAQUAH CAMPUS. PFA 2021C THE PROCEEDS DERIVED FROM THE SALE OF BONDS ARE TO BE USED FOR CERTAIN CONSTRUCTION, EXPANSION, REMODELING, RENOVATION, FURNISHING, EQUIPPING OF THE FOLLOWING HEALTH CARE FACILITIES: PROVIDENCE ALASKA MEDICAL CENTER (PAMC) & LONG TERM CARE FACILITY.
Schedule K (Form 990) 2021

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