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        <FormAndLineReferenceDesc>Part V, Line 4:</FormAndLineReferenceDesc>
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    <IRS990ScheduleK documentId="RetDoc1053100001">
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>Public Finance Authority</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>273866124</BondIssuerEIN>
        <CUSIPNum>74444VANO</CUSIPNum>
        <BondIssuedDt>2019-10-16</BondIssuedDt>
        <IssuePriceAmt>54143526</IssuePriceAmt>
        <PurposeDesc>New Construction; Refund bond issue dated 11/1/11.</PurposeDesc>
        <DefeasedInd>0</DefeasedInd>
        <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
        <PoolFinancingInd>0</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>North Carolina Medical Care Commission</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>521309402</BondIssuerEIN>
        <CUSIPNum>65820YSD9</CUSIPNum>
        <BondIssuedDt>2020-10-07</BondIssuedDt>
        <IssuePriceAmt>55199446</IssuePriceAmt>
        <PurposeDesc>New Construction</PurposeDesc>
        <DefeasedInd>0</DefeasedInd>
        <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
        <PoolFinancingInd>0</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <TotalProceedsAmt>54143526</TotalProceedsAmt>
        <InReserveFundAmt>906030</InReserveFundAmt>
        <IssuanceCostsFromProceedsAmt>694461</IssuanceCostsFromProceedsAmt>
        <CapitalExpendituresAmt>22175765</CapitalExpendituresAmt>
        <SubstantialCompletionYr>2021</SubstantialCompletionYr>
        <RefundingTaxExemptBondsInd>1</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>0</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>0</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>1</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <TotalProceedsAmt>55199446</TotalProceedsAmt>
        <InReserveFundAmt>517805</InReserveFundAmt>
        <IssuanceCostsFromProceedsAmt>943505</IssuanceCostsFromProceedsAmt>
        <CapitalExpendituresAmt>47739285</CapitalExpendituresAmt>
        <SubstantialCompletionYr>2023</SubstantialCompletionYr>
        <RefundingTaxExemptBondsInd>0</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>0</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>0</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>1</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>0</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>0</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>0</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>0</AnyResearchAgreementsInd>
        <BondIssMeetPrvtSecPymtTestInd>0</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>0</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>0</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <OwningBondFinancedPropertyInd>0</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>0</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>0</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>0</AnyResearchAgreementsInd>
        <BondIssMeetPrvtSecPymtTestInd>0</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>0</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>0</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>1</Form8038TFiledInd>
        <VariableRateIssueInd>0</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>0</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>0</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>0</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>1</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <Form8038TFiledInd>1</Form8038TFiledInd>
        <VariableRateIssueInd>0</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>0</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>0</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>0</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>1</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>0</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <ProceduresCorrectiveActionInd>0</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
    </IRS990ScheduleK>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>The Board has contracted with PHI Management Services, LLC to provide executive level management and advisory services for the period May 1, 2016 to December 31, 2018. The Board signed an agreement to amend the original contract with PHI Management Services, LLC to extend the term of services from January 1, 2019 to December 31, 2030.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>The 990 is presented to the board for their review and comments prior to filing.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>Board members are asked annually to sign a conflict of interest statement and are asked to disclose any interests which may give rise to conflicts.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 15a</FormAndLineReferenceDesc>
        <ExplanationTxt>The Vice President of Human Resources of PHI Management Services, Inc. compiles comparability data from an independent salary consultant to calculate a wage for executive positions and from an independent salary survey to calculate a wage at market average for all other positions. All wages are calculated following a budgeted amount which is approved by the Board.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>The Organization is regulated by the Insurance Commission and the financial statements are part of the Disclosure required by them.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part IX, line 24e</FormAndLineReferenceDesc>
        <ExplanationTxt>Repairs &amp; maintenance: Program service expenses 1,533,544. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,533,544. Contract Medical Services: Program service expenses 1,234,070. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,234,070. Supplies: Program service expenses 978,087. Management and general expenses 0. Fundraising expenses 0. Total expenses 978,087. Contractual dietary: Program service expenses 879,887. Management and general expenses 0. Fundraising expenses 0. Total expenses 879,887. Miscellaneous: Program service expenses 453,752. Management and general expenses 112,371. Fundraising expenses 0. Total expenses 566,123. Insurance: Program service expenses 428,782. Management and general expenses 101,621. Fundraising expenses 0. Total expenses 530,403. Charitable care: Program service expenses 448,926. Management and general expenses 0. Fundraising expenses 0. Total expenses 448,926. Medical supplies and drugs: Program service expenses 421,630. Management and general expenses 0. Fundraising expenses 0. Total expenses 421,630. Office expenses: Program service expenses 102,687. Management and general expenses 44,872. Fundraising expenses 0. Total expenses 147,559. Amortization of bond issue costs: Program service expenses 91,176. Management and general expenses 0. Fundraising expenses 0. Total expenses 91,176. Dues and Subscriptions: Program service expenses 27,146. Management and general expenses 6,723. Fundraising expenses 0. Total expenses 33,869.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>
