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Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax-Exempt Bonds
right arrow Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
right arrow Attach to Form 990.
right arrowGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2022
Open to Public
Inspection
Name of the organization
St Elizabeth Medical Center Inc
 
Employer identification number
61-0445850
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 KENTUCKY ECONOMIC DEVELOPMENT FINANCE AUTHORITY
  		52-1643102   12-09-2009 38,150,000 PARTIAL REFUNDING OF BONDS ISSUED 6/11/03   X   X   X
B KENTUCKY BOND DEVELOPMENT CORPORATION
  		47-2650498   12-30-2015 50,000,000 RENOVATIONS TO HOSPITAL   X   X   X
C KENTUCKY BOND DEVELOPMENT CORPORATION
  		47-2650498   12-30-2015 50,000,000 RENOVATIONS TO HOSPITAL   X   X   X
D KENTUCKY BOND DEVELOPMENT CORPORATION
  		47-2650498 491210AW0 05-12-2016 98,494,028 ADVANCE REFUNDING OF SERIES 2009A BONDS   X   X   X
KENTUCKY BOND DEVELOPMENT CORPORATION
  		47-2650498   06-26-2019 75,000,000 RENOVATIONS TO HOSPITAL   X   X   X
NATIONAL FINANCE AUTHORITY
  		52-1304598 63609WAP7 10-20-2021 57,508,798 RENOVATIONS TO HOSPITAL   X   X   X
Part Ⅱ
Proceeds
A B C D
1 Amount of bonds retired .................. 16,925,000 8,850,000 6,700,000 16,270,000
2 Amount of bonds legally defeased .............. 0 0 0 0
3 Total proceeds of issue .................. 38,150,000 50,716,101 50,015,016 101,059,194
4 Gross proceeds in reserve funds ............. 0 0 0 0
5 Capitalized interest from proceeds ............. 0 0 0 0
6 Proceeds in refunding escrows ............... 0 0 0 0
7 Issuance costs from proceeds ............... 360,000 245,000 222,000 1,123,044
8 Credit enhancement from proceeds ............. 0 0 0 0
9 Working capital expenditures from proceeds ............. 0 0 0 0
10 Capital expenditures from proceeds ............. 0 50,471,101 49,793,016 0
11 Other spent proceeds ............. 37,790,000 0 0 99,936,150
12 Other unspent proceeds ............. 0 0 0 0
13 Year of substantial completion ............. 2003 2018 2018 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) 2022

Schedule K (Form 990) 2022
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? 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 ....right arrow 0 % 0.02 % 0.02 % 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 ......... right arrow 0 % 0 % 0 % 0 %
6 Total of lines 4 and 5 ............. 0 % 0.02 % 0.02 % 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) 2022

Schedule K (Form 990) 2022
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 .......... See Statement
  		 
  		See Statement below
  		 
 
c Term of hedge ......... 3000 %   3000 %  
d Was the hedge superintegrated? ......   X       X    
e Was the hedge terminated? ........   X       X    
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 V Procedures to Undertake Corrective Action St. Elizabeth Medical Center, Inc. d/b/a St. Elizabeth Healthcare has written procedures to ensure that any potential violations of federal tax requirements are timely identified. If self-remediation is not available under applicable regulations, St. Elizabeth Healthcare would contact its bond counsel regarding the IRS's Voluntary Closing Agreement Program.
Schedule K, Part III, Line 4 Research Agreement Revenue The amount of revenue from the Research Agreements is de minimis representing less than 0.0495% of the Total Operating Revenue.
Schedule K, Part II, Line 3 TOTAL PROCEEDS OF ISSUE SERIES 2015A - DIFFERENCE BETWEEN ISSUE PRICE (ISSUE DATE 12/30/2015) IN PART I, LINE B, COLUMN E AND TOTAL PROCEEDS OF ISSUE IN PART II, COLUMN B, LINE 3 IS INVESTMENT EARNINGS DURING THE PROJECT PERIOD. SERIES 2015B - DIFFERENCE BETWEEN ISSUE PRICE (ISSUE DATE 12/30/2015) IN PART I, LINE C, COLUMN E AND TOTAL PROCEEDS OF ISSUE IN PART II, COLUMN C, LINE 3 IS INVESTMENT EARNINGS DURING THE PROJECT PERIOD. SERIES 2016 - DIFFERENCE BETWEEN ISSUE PRICE (ISSUE DATE 5/12/2016) IN PART I, LINE D, COLUMN E AND TOTAL PROCEEDS OF ISSUE IN PART II, COLUMN D, LINE 3 IS INVESTMENT EARNINGS DURING THE PROJECT PERIOD. SERIES 2019A - DIFFERENCE BETWEEN ISSUE PRICE (ISSUE DATE 06/26/2019) IN PART I, LINE A, COLUMN E AND TOTAL PROCEEDS OF ISSUE IN PART II, COLUMN A, LINE 3 IS INVESTMENT EARNINGS DURING THE PROJECT PERIOD. SERIES 2021A - DIFFERENCE BETWEEN ISSUE PRICE (ISSUE DATE 10/20/2021) IN PART I, LINE A, COLUMN E AND TOTAL PROCEEDS OF ISSUE IN PART II, COLUMN A, LINE 3 IS INVESTMENT EARNINGS DURING THE PROJECT PERIOD.
Schedule K, Part IV, Line 2c DATE REBATE COMPUTATION PERFORMED COLUMN A - SERIES 2009 (ISSUE DATE 12/09/2009) - JUNE 4, 2014 COLUMN B - SERIES 2015A (ISSUE DATE 12/30/2015) - FEBRUARY 11, 2021 COLUMN C - SERIES 2015B (ISSUE DATE 12/30/2015) - FEBRUARY 11, 2021 COLUMN D - SERIES 2016 (ISSUE DATE 05/12/2016) - THE SERIES 2016 BONDS WERE AN ADVANCE REFUNDING WITH AN ESCROW YIELD THAT WAS BELOW THE SERIES 2016 BOND YIELD. THEREFORE, A REBATE COMPUTATION WAS NOT REQUIRED.
Schedule K, Part IV, Line 4b SCHEDULE K, PART IV, COLUMN A, LINE 4B FIFTH THIRD FINANCIAL RISK SOLUTIONS
Schedule K, Part IV, Line 4b SCHEDULE K, PART IV, COLUMN C, LINE 4B PNC BANK, NATIONAL ASSOCIATION
Schedule K, Part IV, Line 2c COLUMN A Issuer name: KENTUCKY ECONOMIC DEVELOPMENT FINANCE AUTHORITY The calculation for computing no rebate due was performed on 06/04/2014
Schedule K, Part IV, Line 2c COLUMN B Issuer name: KENTUCKY BOND DEVELOPMENT CORPORATION The calculation for computing no rebate due was performed on 02/11/2021
Schedule K, Part IV, Line 2c COLUMN C Issuer name: KENTUCKY BOND DEVELOPMENT CORPORATION The calculation for computing no rebate due was performed on 02/11/2021
Schedule K (Form 990) 2022

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