2024-08-15T14:21:11-05:00 2023-09-30 621517792 PYA P C 2220 SUTHERLAND AVE KNOXVILLE TN 37919 990 2022-10-01 581954432 NORTHSIDE HOSPITAL INC NORT 4048518000 1000 JOHNSON FERRY ROAD NE ATLANTA GA 303421611 SHANNON A BANNA VP FINANCE / CFO 4048518000 2024-08-15 1 0 DEBORAH O ERNSBERGER P00364912 8656730844 2022 2024-08-08 14:25:15Z ROBERT T QUATTROCCHI 1000 JOHNSON FERRY ROAD NE ATLANTA GA 303421611 6841156789 0 X WWW.NORTHSIDE.COM X 1991 GA TO BE A CENTER OF EXCELLENCE IN PROVIDING HIGH-QUALITY HEALTH CARE. 17 9 33026 871 23807643 2399015 23595029 2974934 5963223334 6550611666 26859042 38423118 146813762 249147071 6160491167 6841156789 3415425 4772858 0 0 2771439748 3035381445 0 0 0 3251794277 3696895244 6026649450 6737049547 133841717 104107242 4492033881 5135977946 1302554809 1685402128 3189479072 3450575818 X NORTHSIDE HOSPITAL, INC. ("NORTHSIDE") IS COMMITTED TO THE HEALTH AND WELLNESS OF OUR COMMUNITY. AS SUCH, WE DEDICATE OURSELVES TO BEING A CENTER OF EXCELLENCE IN PROVIDING HIGH-QUALITY HEALTH CARE. WE PLEDGE COMPASSIONATE SUPPORT, PERSONAL GUIDANCE AND UNCOMPROMISING STANDARDS 0 0 5498658990 4772858 6504223319 AS NOTED IN ITS MISSION, NORTHSIDE IS DEDICATED TO MAINTAINING OUR POISTION AS REGIONAL LEADERS IN SELECT MEDICAL SPECIALTIES. THESE SELECT SPECIALTIES, OR PROGRAM SERVICES, INCLUDE CARDIOLOGY SERVICES, ONCOLOGY SERVICES, RADIOLGOY SERVICES, SURGICAL SERVICES, AND WOMEN'S SERVICES. IN FUTHERANCE OF ITS CHARITABLE MISSION, NORTHSIDE INVESTED IN THE CONTINUED GROWTH, EXPANSION AND INCREASED ACCESS TO THESE VITAL PROGRAM SERVICES. SEE SCHEDULE O FOR CONTINUATION 5498658990 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 1 1806 0 1 33026 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 17 9 0 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 1 GA X X SHANNON A BANNA 4048518000 1000 JOHNSON FERRY ROAD ATLANTA GA 30342 X DALE M BEARMAN MD CHAIR 1.00 1.00 X 0 0 0 MARK J SWEENEY VICE CHAIR/SECRETARY 1.00 1.00 X 0 0 0 ANTHONY J SALVATORE TREASURER 1.00 1.00 X 0 0 0 WAYNE L AMBROZE JR MD BOARD MEMBER 40.00 X 459342 0 22597 THURBERT E BAKER BOARD MEMBER 1.00 1.00 X 0 0 0 CARLTON BUCHANAN MD BOARD MEMBER 1.00 1.00 X 0 0 0 KEITH CARNES MD BOARD MEMBER 40.00 X 453944 0 19149 NORWOOD DAVIS BOARD MEMBER 1.00 X 0 0 0 GENEVIEVE FAIRBROTHER MD BOARD MEMBER 1.00 X 0 0 0 IQBAL GARCHA MD BOARD MEMBER 40.00 X 584977 0 16509 WILLIAM G HASTY JR BOARD MEMBER 1.00 X 0 0 0 TERRI JONDAHL BOARD MEMBER 1.00 X 0 0 0 J MICHAEL LEVENGOOD BOARD MEMBER 1.00 1.00 X 0 0 0 BARBARA PARE' BOARD MEMBER 1.00 1.00 X 0 0 0 WAYNE SIKES BOARD MEMBER 1.00 1.00 X 0 0 0 JOSEF VENABLE MD BOARD MEMBER 1.00 1.00 X 0 0 0 ROBERT T QUATTROCCHI PRESIDENT & CEO NSH, INC. 40.00 1.00 X X 4966543 0 33658 SHANNON BANNA VP/CFO NSH, INC./ASST. TREASURER 40.00 1.00 X 940609 0 9967 JORGE J HERNANDEZ VICE PRESIDENT/ASST. SECRETARY 40.00 1.00 X 960219 0 22992 JANIS DUBOW VICE PRESIDENT 40.00 X 646928 0 11205 WILLIAM HAYES CEO, NORTHSIDE HOSPITAL-CHEROKEE 40.00 X 849726 0 18267 DEBORAH MITCHAM BILBRO CEO, NORTHSIDE HOSPITAL GWINNETT 40.00 X 1032571 0 13063 ROBERT PUTNAM VICE PRESIDENT 40.00 X 1045934 0 20066 TINA WAKIM VICE PRESIDENT/COO 40.00 X 760236 0 22133 CHARLES DECOOK MD ORTHOPEDIC SURGEON 40.00 X 1839666 0 30448 JIMMY J JIANG MD ORTHOPEDIC HAND SURGEON 40.00 X 2591258 0 33460 KENNETH KRESS MD ORTHOPEDIC SURGEON 40.00 X 1386367 0 17464 DAVID A LANGFORD MD THORACIC SURGEON 40.00 X 1311887 0 19668 CHRISTOPHER A POTTS MD ORTHOPEDIC SURGEON 40.00 X 1698034 0 20491 21528241 0 331137 4316 0 1 0 PREMIER HEALTHCARE PROFESSIONALS INC 100 COLONY PARK DR 300 CUMMING GA 30040 STAFFING SERVICES 104398661 BAKER & HOSTETLER LLP 1170 PEACHTREE STREET NE STE 2400 ATLANTA GA 30309 LEGAL SERVICES 34116720 ADEX HEALTHCARE STAFFING 13902 N DALE MABRY HWY 210 TAMPA FL 33618 STAFFING SERVICES 29764974 ATLANTA GASTROENTEROLOGY ASSOCIATES 550 PEACHTREE ST STE 1620 ATLANTA GA 30308 SEE SCHEDULE O 23806788 ATLANTA CANCER CARE PC 1100 JOHNSON FERRY ROAD STE 150 SANDY SPRINGS GA 30342 SEE SCHEDULE O 23558815 658 1067072 102764 1805098 2974934 NET PATIENT REVENUE 621990 6495821883 6233190656 12551137 250080090 RENTAL INCOME 531120 30976191 30976191 CAFETERIA & VENDING 722514 9009614 9009614 PARKING REVENUE 812930 7604452 7604452 BILLING REVENUE 561000 5584142 2165907 3418235 1615384 1615384 6550611666 38423118 38423118 MISCELLANEOUS 900003 237370881 230946854 6424027 PASSTHROUGH INVESTMENT 621300 11776190 9109618 2666572 249147071 6841156789 6504223319 23807643 310150893 X 4758495 4758495 14363 14363 11202767 9039097 2163670 2475667062 1997523993 478143069 89104933 71895468 17209465 309042785 249355169 59687616 150363898 121323056 29040842 8543944 8543944 41446017 41446017 1777123 1777123 2776865 2776865 733171499 623424699 109746800 11271863 4571319 6700544 105145872 42642046 62503826 80292288 32562642 47729646 190415889 77223412 113192477 3185000 1291681 1893319 2475427 1003913 1471514 247061711 145409000 101652711 88391789 35847405 52544384 SUPPLIES 1546725424 1540486067 6239357 BAD DEBT EXPENSE 461834119 461834119 MINOR EQUIPMENT PURCHAS 41493012 16827545 24665467 RECRUITMENT 10415734 4224115 6191619 120471668 48857442 71614226 6737049547 5498658990 1238390557 0 76953 70128 571731697 448668439 615088279 561542685 626381 514213 108384033 113037556 87972154 100212050 4623916734 2313282066 2009034495 2310634668 658242215 766838043 317282941 353093606 123594733 481366558 4492033881 5135977946 701537139 734433994 4025817 4773854 5601322 311862 591390531 945882418 1302554809 1685402128 X 3182854988 3445093464 6624084 5482354 3189479072 3450575818 4492033881 5135977946 X 104107242 80127403 76862101 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 585992 585992 0 PART II-B, LINE 1: IN FURTHERANCE OF ITS EXEMPT PURPOSE TO BE A CENTER OF EXCELLENCE IN PROVIDING HIGH-QUALITY HEALTH CARE AND ITS COMMITMENT TO THE HEALTH AND WELLNESS OF OUR COMMUNITY, NORTHSIDE PROVIDES INFORMATION TO FEDERAL, STATE AND LOCAL GOVERNMENT OFFICIALS AND REPRESENTATIVES ON MATTERS DIRECTLY RELATED TO HEALTHCARE. IN ADDITION, NORTHSIDE PAYS MEMBERSHIP DUES TO PROFESSIONAL AND TRADE ASSOCIATIONS SUCH AS THE AMERICAN HOSPITAL ASSOCIATION, GEORGIA HOSPITAL ASSOCIATION, AND THE GEORGIA ALLIANCE FOR COMMUNITY HOSPITALS. A PORTION OF THESE DUES IS DESIGNATED FOR LOBBYING ACTIVITIES BY THESE ORGANIZATIONS. NORTHSIDE DOES NOT DIRECT ANY OF THESE ORGANIZATIONS' LOBBYING ACTIVITIES. IN ADDITION, CONNECT SOUTH, A SERVICE VENDOR, IS RETAINED TO MONITOR LEGISLATION IN THE GEORGIA GENERAL ASSEMBLY. 19886656 4999810 353737 8307414 16932789 19297796 4285036 -279016 3417160 19886656 10609127 14559204 638990 6509525 19297796 10973195 786795 171961 1322824 10609127 10180369 1829101 286184 1322459 10973195 0.30920 0.69080 0 1 1 507015340 507015340 2379052191 1091226037 1287826154 1536852443 1222056029 314796414 200996760 200996760 2310634668 RETIREMENT PLAN OBLIGATIONS 170366253 OTHER ASSETS 311000305 481366558 RESERVE FOR MALPRACTICE 490864933 PERIODIC CAPITAL FINANCING LIABILITY -1021867 REAL ESTATE FINANCING LIABILITY 144279899 RENT/LEASE RELATED LIABILITIES 59186748 OTHER LIABILITIES 252572705 CURRENT PORTION CAPITAL LEASE -4375616 CURRENT PORTION OF LONG TERM DEBT 4687478 CURRENT PORTION OF NOTES PAYABLE -311862 945882418 X PART V, LINE 4: NORTHSIDE HOSPITAL, INC., NORTHSIDE HOSPITAL FOUNDATION, INC., AND GWINNETT HOSPITAL SYSTEM FOUNDATION, INC. HAVE ENDOWMENT FUNDS THAT CONSIST OF SEVERAL DONOR-RESTRICTED INDIVIDUAL FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. THE ORGANIZATIONS ADOPTED A POLICY REGARDING THE ENDOWMENTS WHOSE GENERAL PURPOSE IS TO PRESERVE THE CAPITAL AND PURCHASING POWER OF THE ORGANIZATIONS AND TO PRODUCE SUFFICIENT INVESTMENT EARNINGS FOR CURRENT AND FUTURE SPENDING NEEDS. PART X, LINE 2: NORTHSIDE HOSPITAL, INC., AND SUBSIDIARIES CONSOLIDATED FINANCIAL STATEMENTS AS OF AND FOR THE YEARS ENDED SEPTEMBER 30, 2023 AND 2022, AND INDEPENDENT AUDITOR'S REPORT: NORTHSIDE QUALIFIES AS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN RECORDED. 1 1 X 1 X 300.000000000000 1 X 1 1 1 0 1 1 358575324 0 358575324 0.05320 506158903 451564282 54594621 0.00810 864734227 451564282 413169945 0.06130 88 323946 2654396 290519 2363877 0.00040 55 5802 18729633 11129183 7600450 0.00110 3 6131 59037708 41196324 17841384 0.00260 1 1233 546386 546386 0.00010 10 4188 5027001 17586 5009415 0.00070 157 341300 85995124 52633612 33361512 0.00490 157 341300 950729351 504197894 446531457 0.06620 1 2090 2090 0.00000 1 311 10773 10773 0.00000 2 311 12863 12863 0.00000 1 120683996 565940991 778931274 -212990283 X 1 1 1 GWINNETT ENDOSCOPY CENTER LLC OUTPATIENT CENTER 0.15000 0.55000 2 MIDTOWN ENDOSCOPY CENTER LLC OUTPATIENT CENTER 0.15000 0.55000 3 NORTHERN CRESCENT ENDOSCOPY SUITE LLC OUTPATIENT CENTER 0.51000 0.30000 4 NORTHWEST ENDOSCOPY CENTER LLC OUTPATIENT CENTER 0.15000 0.55000 5 SOUTHERN CRESCENT ENDOSCOPY LLC OUTPATIENT CENTER 0.15000 0.55000 6 WOODSTOCK ENDOSCOPY CENTER LLC OUTPATIENT CENTER 0.51000 0.30000 7 WEST METRO ENDOSCOPY CENTER LLC OUTPATIENT CENTER 0.15000 0.55000 8 ENT SURGERY CENTER OF ATLANTA LLC AMBULATORY SURGERY 0.68330 0.31670 9 PEACHTREE ORTHOPAEDIC SURGERY CENTER AT PERIMETER LLC AMBULATORY SURGERY 0.15000 0.85000 10 UROLOGY SURGICAL PARTNERS LLC AMBULATORY SURGERY 0.70000 0.30000 11 THE HAND & UPPER EXTREMITY SURGERY CENTER OF GA LLC AMBULATORY SURGERY 0.51000 0.49000 12 PANOLA ENDOSCOPY CENTER LLC OUTPATIENT CENTER 0.15000 0.55000 13 ADVANCED CENTER FOR JOINT SURGERY LLC ORTHOPEDIC SURGERY 0.51000 0.49000 14 THOMAS EYE SURGERY CENTER LLC EYE SURGERY 0.40000 0.60000 15 GWINNETT SURGERY CENTER LLC AMBULATORY SURGERY 0.70000 0.30000 16 HUDES ENDOSCOPY CENTER LLC OUTPATIENT CENTER 0.15000 0.55000 5 1 NORTHSIDE HOSPITAL 1000 JOHNSON FERRY ROAD ATLANTA GA 30342 060-604 X X X A 2 NORTHSIDE HOSPITAL GWINNETT 1000 MEDICAL CENTER BOULEVARD LAWRENCEVILLE GA 30046 067-460 X X X X A 3 NORTHSIDE HOSPITAL - FORSYTH 1200 NORTHSIDE FORSYTH DRIVE CUMMING GA 30041 058-604 X X X A 4 NORTHSIDE HOSPITAL - CHEROKEE 450 NORTHSIDE CHEROKEE BLVD CANTON GA 30115 028-552 X X X A 5 NORTHSIDE HOSPITAL DULUTH 3620 HOWELL FERRY ROAD DULUTH GA 30096 067-628 X X X X A FACILITY REPORTING GROUP - A 0 0 1 X X X X X X X X X 21 1 1 0 1 X SEE EXPLANATION FOR LINE 7D X X 1 21 0 1 0 1 X 300.000000000000 300.000000000000 X X X X X X 1 1 X X X X 1 X SEE RESPONSE TO 16J X SEE RESPONSE TO 16J X SEE RESPONSE TO 16J X X X X X X X 1 X 0 X X X X X 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: NORTHSIDE HOSPITAL, - FACILITY 3: NORTHSIDE HOSPITAL - FORSYTH, - FACILITY 4: NORTHSIDE HOSPITAL - CHEROKEE, - FACILITY 2: NORTHSIDE HOSPITAL GWINNETT, - FACILITY 5: NORTHSIDE HOSPITAL DULUTH GROUP A-FACILITY 1 -- ALL HOSPITALS PART V, SECTION B, LINE 5: NORTHSIDE IDENTIFIED AND REACHED OUT TO A TOTAL OF 65 COMMUNITY STAKEHOLDERS WHO BROADLY REPRESENTED THE INTERESTS OF NORTHSIDE'S COMMUNITY, INCLUDING STAKEHOLDERS WHO REPRESENT MEDICALLY UNDERSERVED, UNINSURED, AND DISPARATE POPULATIONS, UNDERSTAND THE HEALTH NEEDS OF THE COMMUNITY AND WHO HAVE A SPECIAL KNOWLEDGE OF, OR EXPERTISE IN, PUBLIC HEALTH. NORTHSIDE THEN DEVELOPED THE STAKEHOLDER ASSESSMENT DISCUSSION GUIDE TO LEARN ABOUT THE NEEDS AND RESOURCES WITHIN THE COMMUNITY (A COPY OF WHICH IS INCLUDED AS APPENDIX A TO NORTHSIDE'S CHNA) AND CONDUCTED TELEPHONE INTERVIEWS WITH A QUALIFIED REPRESENTATIVE OF EACH IDENTIFIED STAKEHOLDER. IN TOTAL, NORTHSIDE COMPLETED INTERVIEWS WITH THE FOLLOWING 24 OF THE 65 STAKEHOLDERS IDENTIFIED:(1) CIMA INTERNATIONAL WOMEN'S SERVICES (2) ATLANTA CANCER CARE FOUNDATION (3) COBB AND DOUGLAS PUBLIC HEALTH (4) GEORGIA HIGHLANDS MEDICAL SERVICES (5) CROSSROADS ATLANTA (6) DEPARTMENT OF PUBLIC HEALTH NORTHEAST GEORGIA (7) GOOD SAMARITAN ATLANTA (8) DAWSON FAMILY CONNECTION (9) GWINNETT, NEWTON, & ROCKDALE HEALTH DEPARTMENTS GWINNETT COUNTY (10) GOOD SAMARITAN COBB (11) HEALTHMPOWERS (12) GOOD SAMARITAN GWINNETT (13) HEALTHY MOTHERS, HEALTHY BABIES COALITION OF GEORGIA (INTERVIEW CONDUCTED IN 2020)(14) HEALTHY MOTHERS, HEALTH BABIES COALITION OF GEORGIA (INTERVIEW CONDUCTED IN 2021)(15) GOOD SAMARITAN HEALTH & WELLNESS CENTER (16) GWINNETT COALITION (17) HOPE CLINIC (18) NAVIGATE RECOVERY (19) MEDLINK GWINNETT (20) NEXT GENERATION YOUTH DEVELOPMENT (21) MEDSHARE (22) NORTH FULTON COMMUNITY CHARITIES (23) VIEW POINT HEALTH (24) UNITED WAY FORSYTH GROUP A-FACILITY 1 -- ALL HOSPITALS PART V, SECTION B, LINE 6A: THE NORTHSIDE HOSPITAL, INC. SYSTEM COMPRISES FIVE HOSPITAL FACILITIES: (1) NORTHSIDE HOSPITAL-ATLANTA, (2) NORTHSIDE HOSPITAL-CHEROKEE (3) NORTHSIDE HOSPITAL-DULUTH, (4) NORTHSIDE HOSPITAL-FORSYTH, AND (5) NORTHSIDE HOSPITAL-GWINNETT. GIVEN THE SIGNIFICANT OVERLAP IN SERVICE AREAS AMONG ITS FIVE FACILITIES, NORTHSIDE CONDUCTED A JOINT CHNA (OR SYSTEM-LEVEL CHNA). GROUP A-FACILITY 1 -- ALL HOSPITALS PART V, SECTION B, LINE 7D: HOSPITAL WEBSITE:WWW.NORTHSIDE.COM/COMMUNITY-WELLNESS/IN-THE-COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENT GROUP A-FACILITY 1 -- ALL HOSPITALS PART V, SECTION B, LINE 11: BASED ON THE RESULTS OF NORTHSIDE'S FY2022-FY2024 CHNA, NORTHSIDE HOSPITAL, INC. ADOPTED AN IMPLEMENTATION STRATEGY WHICH OUTLINED SEVERAL INITIATIVES TO HELP ADDRESS THE PRIORITY HEALTH NEEDS IDENTIFIED IN THE COMMUNITY. IDEALLY, NORTHSIDE WOULD HAVE UNLIMITED RESOURCES TO ADDRESS ALL OF THE COMMUNITY'S IDENTIFIED NEEDS. HOWEVER, IT IS NOT REALISTIC FOR ANY SINGLE ORGANIZATION TO ADDRESS ALL OF A COMMUNITY'S NEEDS, HENCE THE IMPORTANCE OF PRIORITIZING THE IDENTIFIED NEEDS. NORTHSIDE SELECTED THOSE NEEDS THAT IMPACT THE GREATEST NUMBER OF POPULATION IN THE COMMUNITY; THOSE NEEDS THAT DISPROPORTIONATELY IMPACT THE MOST VULNERABLE POPULATIONS; THOSE NEEDS THAT ARE MOST SEVERE AND/OR PREVALENT; AND THOSE NEEDS THAT NORTHSIDE HAS THE WHEREWITHAL TO ADDRESS. PAGES 143-151 OF THE CHNA PROVIDE A DETAILED DESCRIPTION OF HOW NORTHSIDE PRIORITIZED THE NEEDS IDENTIFIED IN THE CHNA IN ORDER TO ADDRESS THEM. ADDITIONALLY, NORTHSIDE INTENDS TO UTILIZE MYRIAD COMMUNITY BENEFIT STRATEGIES TO ADDRESS THE PRIORITIZED HEALTH NEEDS. (PAGE 13 OF THE CHNA). GROUP A-FACILITY 1 -- ALL HOSPITALS PART V, SECTION B, LINE 13B: IN ADDITION TO FPG NORTHSIDE ALSO USES MEDICAL INDIGENCY AS WELL AS PROPENSITY TO PAY TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. GROUP A-FACILITY 1 -- ALL HOSPITALS PART V, SECTION B, LINE 16J: THE FULL URL TO ACCESS THE FINANCIAL ASSISTANCE POLICY IS:WWW.NORTHSIDE.COM/PATIENTS-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE GROUP A-FACILITY 1 -- ALL HOSPITALS PART V, SECTION B, LINE 20E: NORTHSIDE FOLLOWS A VERY DETAILED AND ROBUST PROCESS PRIOR TO INITIATING ECAS. AS INDICATED IN RESPONSE TO QUESTION 20, NORTHSIDE (1) PROVIDES A WRITTEN NOTICE ABOUT UPCOMING ECAS AND A PLAIN LANGUAGE SUMMARY OF THE FAP AT LEAST 30 DAYS BEFORE INITIATING ANY ECAS, (2) NORTHSIDE MAKES REASONABLE EFFORTS TO ORALLY (AND VIA OTHER MEANS) NOTIFY INDIVIDUALS ABOUT THE FAP AND FAP APPLICATION PROCESS, AND (3) NORTHSIDE MAKES PRESUMPTIVE ELIGIBILITY DETERMINATIONS TO QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE. NORTHSIDE PROMPTLY PROCESSES ALL COMPLETE FAP APPLICATIONS. NORTHSIDE ALSO EVALUATES ALL INCOMPLETE FAP APPLICATIONS, AND IN CONNECTION WITH SUCH INCOMPLETE APPLICATIONS, TAKES THE FOLLOWING STEPS: IF NORTHSIDE DETERMINES THAT A PATIENT HAS SUBMITTED AN INCOMPLETE FAP APPLICATION, NORTHSIDE WILL (A) IMMEDIATELY SUSPEND ANY ECAS THAT MAY HAVE BEEN INITIATED AGAINST THE PATIENT AFTER THE EXPIRATION OF THE NOTIFICATION PERIOD BUT BEFORE THE EXPIRATION OF THE APPLICATION PERIOD; (B) PROVIDE THE PATIENT WITH WRITTEN NOTICE THAT DESCRIBES THE ADDITIONAL INFORMATION AND/OR DOCUMENTATION THE INDIVIDUAL MUST SUBMIT TO COMPLETE THE FAP APPLICATION AND INCLUDE A COPY OF THE FAP WITH THE WRITTEN NOTICE; AND (C) MAKE A NOTE IN THE BILLING SYSTEM INDICATING THAT ECAS SHOULD NOT BE INITIATED (OR RE-INITIATED) ON THE PATIENT'S ACCOUNT UNTIL THE EXPIRATION OF THE APPLICATION PERIOD, AND ONLY IF AT THAT POINT THE PATIENT HAS NOT SUBMITTED THE NECESSARY INFORMATION TO COMPLETE THE FAP APPLICATION.NORTHSIDE DEFINES THE NOTIFICATION PERIOD" TO MEAN THE PERIOD DURING WHICH IT MUST NOTIFY AN INDIVIDUAL ABOUT THE FAP AND BEGINS ON THE DATE THE FIRST POST-DISCHARGE BILLING STATEMENT FOR CARE WAS PROVIDED TO THE PATIENT AND ENDS ON THE 120TH DAY AFTER THE PATIENT WAS PROVIDED WITH THE FIRST POST-DISCHARGE BILLING STATEMENT FOR CARE. NORTHSIDE DEFINES THE "APPLICATION PERIOD" TO MEAN THE PERIOD DURING WHICH NORTHSIDE MUST ACCEPT AND PROCESS A FAP APPLICATION SUBMITTED BY A PATIENT. THE "APPLICATION PERIOD" BEGINS ON THE DATE CARE IS PROVIDED TO THE PATIENT AND ENDS ON THE LATER OF THE 240TH DAY AFTER THE DATE THAT THE FIRST POST-DISCHARGE BILLING STATEMENT FOR CARE IS PROVIDED OR EITHER (I) IN THE CASE OF INDIVIDUAL WHO NORTHSIDE HAS PROVIDED A NOTICE OF AT LEAST 30 DAYS PRIOR TO INITIATING ONE OR MORE ECAS, THE 30TH DAY AFTER THE DATE SUCH NOTICE IS PROVIDED, OR (II) IN THE CASE OF A PATIENT WHO NORTHSIDE HAS PRESUMPTIVELY DETERMINED TO BE ELIGIBLE FOR LESS THAN THE MOST GENEROUS ASSISTANCE AVAILABLE UNDER NORTHSIDE'S FINANCIAL ASSISTANCE PROGRAM, A REASONABLE TIME AFTER THE PATIENT HAS HAD A CHANCE TO APPLY FOR MORE GENEROUS FINANCIAL ASSISTANCE. GROUP A-FACILITY 3 -- NORTHSIDE HOSPITAL - FORSYTH PART V, SECTION B, LINE 16J: THE FULL URL TO ACCESS THE FINANCIAL ASSISTANCE POLICY IS:WWW.NORTHSIDE.COM/PATIENTS-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE GROUP A-FACILITY 4 -- NORTHSIDE HOSPITAL - CHEROKEE PART V, SECTION B, LINE 16J: THE FULL URL TO ACCESS THE FINANCIAL ASSISTANCE POLICY IS:WWW.NORTHSIDE.COM/PATIENTS-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE GROUP A-FACILITY 2 -- NORTHSIDE HOSPITAL GWINNETT PART V, SECTION B, LINE 16J: THE FULL URL TO ACCESS THE FINANCIAL ASSISTANCE POLICY IS:WWW.NORTHSIDE.COM/PATIENTS-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE GROUP A-FACILITY 5 -- NORTHSIDE HOSPITAL DULUTH PART V, SECTION B, LINE 7D: HOSPITAL WEBSITE:WWW.NORTHSIDE.COM/COMMUNITY-WELLNESS/IN-THE-COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENT GROUP A-FACILITY 5 -- NORTHSIDE HOSPITAL DULUTH PART V, SECTION B, LINE 16J: THE FULL URL TO ACCESS THE FINANCIAL ASSISTANCE POLICY IS:WWW.NORTHSIDE.COM/PATIENTS-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE 332 1 - NHCI GEORGIA CANCER SPECIALISTS 308 COLISEUM DRIVE STE 102 MACON GA 31217 PHYSICIAN SERVICES/OUTPATIENT SERVICES 2 - NHCI GEORGIA CANCER SPECIALISTS 101 RIVERSTONE VISTA STE 102 BLUE RIDGE GA 30513 PHYSICIAN SERVICES/OUTPATIENT SERVICES 3 - NHCI SUBURBAN HEMATOLOGY-ONCOLOGY ASSOCIAT 3855 PLEASANT HILL ROAD STE 480 DULUTH GA 30096 PHYSICIAN SERVICES 4 - NHCI SUBURBAN HEMATOLOGY-ONCOLOGY ASSOCIAT 1700 TREE LANE STE 490 SNELLVILLE GA 30078 PHYSICIAN SERVICES 5 - NHCI GEORGIA CANCER SPECIALISTS 308 DEEP SOUTH FARM ROAD STE 200 BLAIRSVILLE GA 30512 PHYSICIAN SERVICES/OUTPATIENT SERVICES 6 - NHCI GEORGIA CANCER SPECIALISTS 747 SOUTH 8TH STREET STE C GRIFFIN GA 30224 PHYSICIAN SERVICES/OUTPATIENT SERVICES 7 - GEORGIA UROLOGY 3790 PLEASANT HILL ROAD STE 150 DULUTH GA 30096 PHYSICIAN SERVICES 8 - GWINNETT CONSULTANTS IN CARDIOLOGY 755 WALTHER RD NW LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 9 - NHCI GEORGIA CANCER SPECIALISTS 820 N COBB STREET MILLEDGEVILLE GA 31061 PHYSICIAN SERVICES/OUTPATIENT SERVICES 10 - ATLANTA ADVANCED SURGERY CENTER 5505 PEACHTREE DUNWOODY RD STE 150 ATLANTA GA 30342 PHYSICIAN SERVICES 11 - NSC SURGERY CENTER 460 NORTHSIDE CHEROKEE BLVD STE 200 CANTON GA 30115 PHYSICIAN SERVICES 12 - RADIATION ONCOLOGY - LAWRENCEVILLE 311 PHILIP BLVD LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 13 - NHCI GEORGIA CANCER SPECIALISTS - ADMINIST 1835 SAVOY DR STE 203 ATLANTA GA 30341 PHYSICIAN SERVICES 14 - OUTPATIENT SURGERY CENTER 1055 HAW CREEK PARKWAY STE 1 CUMMING GA 30041 PHYSICIAN SERVICES 15 - MIDTOWN OUTPATIENT SURGERY CENTER 1110 WEST PEACHTREE STREET STE 1200 ATLANTA GA 30309 PHYSICIAN SERVICES 16 - NHCI RADIATION ONCOLOGY - MACON 308 COLISEUM DRIVE STE 100 MACON GA 31217 RADIATION THERAPY CENTER AND PHYSICIAN SERVICES 17 - NORTHSIDE RADIATION ONCOLOGY - MIDTO 1110 WEST PEACHTREE STREET STE P100 ATLANTA GA 30309 PHYSICIAN SERVICES 18 - MEDICAL ASSOCIATES OF NORTH GEORGIA 320 HOSPITAL ROAD STE A CANTON GA 30114 PHYSICIAN SERVICES 19 - NHCI GEORGIA CANCER SPECIALISTS 1000 COWLES CLINIC WAY GREENSBORO GA 30642 PHYSICIAN SERVICES/OUTPATIENT SERVICES 20 - NORTHSIDE MIDTOWN BREAST CARE IMAGING 1110 WEST PEACHTREE STREET STE 850 ATLANTA GA 30309 PHYSICIAN SERVICES 21 - LAUREATE MEDICAL GROUP 6135 BARFIELD ROAD STE 200 ATLANTA GA 30328 PHYSICIAN SERVICES 22 - ARTHRITIS AND TOTAL JOINT SPECIALIST 2000 HOWARD FARM DRIVE STE 200 CUMMING GA 30041 PHYSICIAN SERVICES 23 - NORTHSIDE DEKALB IMAGING 2859 NORTH DECATUR ROAD DECATUR GA 30033 PHYSICIAN SERVICES 24 - PRESTON RIDGE RADIATION ONCOLOGY 3330 PRESTON RIDGE RD STE 100 ALPHARETTA GA 30005 PHYSICIAN SERVICES 25 - NORTHSIDE RADIATION ONCOLOGY - DULUTH 698 DULUTH HWY STE 101 LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 26 - NORTHSIDE HOSPITAL CARDIOVASCULAR IN 575 PROFESSIONAL DRIVE STE 400 LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 27 - NORTHEAST GEORGIA DIAGNOSTIC CLINIC 1240 JESSE JEWELL PKWY BLDG B UNIT 500 GAINESVILLE GA 30501 PHYSICIAN SERVICES 28 - NORTHSIDEMCGINNIS FERRY IMAGING 6630 MCGINNIS FERRY ROAD STE D JOHNS CREEK GA 30097 PHYSICIAN SERVICES 29 - SPORTS MEDICINE SOUTH OF GWINNETT LL 1900 RIVERSIDE PARKWAY LAWRENCEVILLE GA 30043 PHYSICIAN SERVICES 30 - 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NORTHSIDE GWINNETT FAMILY MEDICINE 771 OLD NORCROSS ROAD STE 350 LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 200 - GEORGIA COLON & RECTAL ASSOCIATES-CH 470 NORTHSIDE CHEROKEE BLVD STE 365 CANTON GA 30115 PHYSICIAN SERVICES 201 - NORTH ATLANTA MEDICAL ASSOCIATES 2545 LAWRENCEVILLE HIGHWAY STE 200 DECATUR GA 30033 PHYSICIAN SERVICES 202 - PEACHTREE CORNERS INTERNAL MEDICINE 5277 PEACHTREE PARKWAY NORCROSS GA 30092 PHYSICIAN SERVICES 203 - SURGICAL SPECIALISTS OF ATLANTA - AL 3400 OLD MILTON PKWY BLDG A STE 560 ALPHARETTA GA 30005 PHYSICIAN SERVICES 204 - SLEEP DISORDERS CENTER OF GEORGIA 993C JOHNSON FERRY ROAD STE 301 ATLANTA GA 30342 PHYSICIAN SERVICES 205 - NORTHSIDE DULUTH BREAST SPECIALISTS 3855 PLEASANT HILL ROAD STE 280 DULUTH GA 30096 PHYSICIAN SERVICES 206 - NORTHSIDE SUWANEE PRIMARY CARE 1120 PEACHTREE INDUSTRIAL BLVD STE 208 SUWANEE GA 30024 PHYSICIAN SERVICES 207 - ROSWELL INTERNAL MEDICINE SPECIALIST 1357 HEMBREE ROAD STE 130 ROSWELL GA 30076 PHYSICIAN SERVICES 208 - NHCI GEORGIA CANCER SPECIALISTS 550 PEACHTREE STREET STE 1185 ATLANTA GA 30308 PHYSICIAN SERVICES 209 - NHCI GEORGIA CANCER SPECIALISTS 1501 MILSTEAD RD STE 110 CONYERS GA 30012 PHYSICIAN SERVICES 210 - NORTHSIDE HOSPITAL INFUSION CENTER 575 PROFESSIONAL DR STE 510 520 550 LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 211 - NORTHSIDE SNELLVILLE PRIMARY CARE 2220 WISTERIA DRIVE SW STE 102 SNELLVILLE GA 30078 PHYSICIAN SERVICES 212 - NHCI GEORGIA CANCER SPECIALISTS 790 CHURCH STREET STE 335 MARIETTA GA 30060 PHYSICIAN SERVICES 213 - NORTHEAST GEORGIA DIAGNOSTIC CLINIC 1255 FRIENDSHIP ROAD STE 230 BRASELTON GA 30517 PHYSICIAN SERVICES 214 - NORTHSIDE FAMILY MEDICINE AND URGENT 610 PEACHTREE PARKWAY STE 130 CUMMING GA 30041 PHYSICIAN SERVICES 215 - TOWN LAKE PRIMARY CARE 684 SIXES ROAD STE 105 HOLLY SPRINGS GA 30115 PHYSICIAN SERVICES 216 - GYN SURGICAL SPECIALISTS 1110 WEST PEACHTREE STREET STE 1050 ATLANTA GA 30309 PHYSICIAN SERVICES 217 - PRIMARY CARE OF MILTON 980 BIRMINGHAM ROAD STE 304 MILTON GA 30004 PHYSICIAN SERVICES 218 - NORTH POINT PRIMARY CARE 3180 NORTH POINT PKWY BLDG 200 STE 201 ALPHARETTA GA 30005 PHYSICIAN SERVICES 219 - INTERNAL MEDICINE ASSOCIATES OF LAWRENCEVI 725 WALTHER ROAD STE 200 LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 220 - MEDICAL ASSOCIATES RHEUMATOLOGY - TO 900 TOWNE LAKE PARKWAY STE 202 WOODSTOCK GA 30189 PHYSICIAN SERVICES 221 - NORTH GEORGIA OBGYN SPECIALISTS 433 HIGHLAND PKWY STE 203 EAST ELIJAY GA 30540 PHYSICIAN SERVICES 222 - NORTH ATLANTA MEDICAL ASSOC - STONE 1505 LILBURN STONE MOUNTAIN RD STE 100 STONE MOUNTAIN GA 30087 PHYSICIAN SERVICES 223 - NORTH GEORGIA OBGYN SPECIALISTS - BL 2855 OLD HIGHWAY 5 STE 110 BLUE RIDGE GA 30513 PHYSICIAN SERVICES 224 - NORTHSIDE PRIMARY CARE ASSOCIATES 4450 CALIBRE CROSSING STE 1224 ACWORTH GA 30101 PHYSICIAN SERVICES 225 - GEORGIA COLON & RECTAL ASSOCIATES-GW 721 WELLNESS WAY STE 200 LAWRENCEVILLE GA 30045 PHYSICIAN SERVICES 226 - NHCI GEORGIA CANCER SPECIALISTS ALPHARETTA 3330 PRESTON RIDGE RD STE 110 ALPHARETTA GA 30005 PHYSICIAN SERVICES 227 - NHCI GEORGIA CANCER SPECIALISTS JOHNS CREE 6300 HOSPITAL PARKWAY STE 300 JOHNS CREEK GA 30097 PHYSICIAN SERVICES 228 - INTERNAL MEDICINE SPECIALIST OF ROSW 11685 ALPHARETTA HWY STE 270 ROSWELL GA 30076 PHYSICIAN SERVICES 229 - ARTHRITIS AND TOTAL JOINT SPECIALIST 1475 JESSE JEWELL PKWY NE STE 302 GAINESVILLE GA 30501 PHYSICIAN SERVICES 230 - UNIVERSITY GYNECOLOGIC ONCOLOGY 1100 NORTHSIDE FORSYTH DRIVE STE 420 CUMMING GA 30041 PHYSICIAN SERVICES 231 - NEWTOWN MEDICAL 3400 OLD MILTON PKWY BLDG A STE 200 ALPHARETTA GA 30005 PHYSICIAN SERVICES 232 - NORTHSIDE DACULA PRIMARY CARE 720 DACULA ROAD STE 2B DACULA GA 30019 PHYSICIAN SERVICES 233 - REPRODUCTIVE SURGICAL SPECIALISTS 1800 NORTHSIDE FORSYTH DRIVE STE 380 CUMMING GA 30041 PHYSICIAN SERVICES 234 - PEACHTREE CORNERS INTERNAL MEDICINE 6460 SPALDING DRIVE STE A NORCROSS GA 30092 PHYSICIAN SERVICES 235 - NHCI GEORGIA CANCER SPECIALISTS - JASPER 134 MOUNTAINSIDE VILLAGE PKWY STE 100 JASPER GA 30143 PHYSICIAN SERVICES 236 - NHCI GEORGIA CANCER SPECIALISTS GWINNETT 698 DULUTH HWY STE 201 LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 237 - JOHN ATTOKAREN MD 11600 ATLANTIS PLACE STE B ALPHARETTA GA 30022 PHYSICIAN SERVICES 238 - CARDIOVASCULAR GROUP BUFORD 4745 NELSON BROGDON BLVD STE 300 BUFORD GA 30518 PHYSICIAN SERVICES 239 - NORTHSIDE HOSPITAL ORTHOPEDIC INSTIT 1839 BUFORD HIGHWAY NE STE 100 BUFORD GA 30518 PHYSICIAN SERVICES 240 - SUGARLOAF PRIMARY CARE 1805 HERRINGTON ROAD BUILDING 2 LAWRENCEVILLE GA 30043 PHYSICIAN SERVICES 241 - TRANSPLANT AND ONCOLOGY INFECTIOUS DISEASE 980 JOHNSON FERRY RD STE 740 ATLANTA GA 30342 PHYSICIAN SERVICES 242 - GEORGIA COLON & RECTAL ASSOCIATES-AL 3400 OLD MILTON PKWY BLDG A STE 440 ALPHARETTA GA 30005 PHYSICIAN SERVICES 243 - NORTHSIDE HOSPITAL ORTHOPEDIC INSTITUTE 5670 PEACHTREE DUNWOODY RD STE 1230 ATLANTA GA 30342 PHYSICIAN SERVICES 244 - NHCI GEORGIA CANCER SPECIALISTS CAMP CREEK 3886 PRINCETON LAKES WAY STE 200 ATLANTA GA 30331 PHYSICIAN SERVICES 245 - ARTHRITIS AND TOTAL JOINT SPECIALIST 960 WOODSTOCK PARKWAY STE 200 WOODSTOCK GA 30188 PHYSICIAN SERVICES 246 - GEORGIA CANCER CENTER DOUGLASVILLE 4586 TIMBER RIDGE DR STE 200 DOUGLASVILLE GA 30135 PHYSICIAN SERVICES 247 - ARTHRITIS AND TOTAL JOINT SPECIALISTS - SA 1150 HAMMOND DRIVE STE 400 SANDY SPRINGS GA 30328 PHYSICIAN SERVICES 248 - LANIER FAMILY PRACTICE 1080 SANDERS ROAD STE 100 CUMMING GA 30041 PHYSICIAN SERVICES 249 - ATLANTA CARDIAC AND THORACIC SURGICA 1100 NORTHSIDE FORSYTH DR STE 410 CUMMING GA 30041 PHYSICIAN SERVICES 250 - ATLANTA CARDIAC AND THORACIC SURGICA 460 NORTHSIDE CHEROKEE BLVD STE 140 CANTON GA 30115 PHYSICIAN SERVICES 251 - NHCI GEORGIA CANCER SPECIALISTS COBB 1668 MULKEY ROAD STE 164 AUSTELL GA 30106 PHYSICIAN SERVICES 252 - NORTHSIDE BUFORD PRIMARY CARE 1525 BUFORD HWY BUFORD GA 30518 PHYSICIAN SERVICES 253 - NORTHSIDE JOHNS CREEK PRIMARY CARE 4385 JOHNS CREEK PKWY STE 250 SUWANEE GA 30024 PHYSICIAN SERVICES 254 - TOTAL JOINT SPECIALISTS 1255 FRIENDSHIP ROAD STE 200 BRASELTON GA 30517 PHYSICIAN SERVICES 255 - GEORGIA COLON & RECTAL ASSOCIATES-DE 2801 N DECATUR ROAD STE 120 DECATUR GA 30033 PHYSICIAN SERVICES 256 - NORTHSIDE ORTHOPEDIC SPECIALISTS 2220 WISTERIA DRIVE SW STE 202 SNELLVILLE GA 30078 PHYSICIAN SERVICES 257 - NORTHSIDE CHEROKEE SURGICAL ASSOCIAT 900 TOWNE LAKE PARKWAY STE 412 WOODSTOCK GA 30189 PHYSICIAN SERVICES 258 - NORTHSIDE HOSPITAL PHARMACY 1110 WEST PEACHTREE STREET STE 340 ATLANTA GA 30309 PHYSICIAN SERVICES 259 - GEORGIA COLON & RECTAL ASSOCIATES-MI 1110 WEST PEACHTREE STREET STE 1030 ATLANTA GA 30309 PHYSICIAN SERVICES 260 - HEALTH AND WELLNESS CENTER 100 MEDICAL CENTER BOULEVARD LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 261 - NHCI GEORGIA CANCER SPECIALISTS PAULDING 159 ENTERPRISE PATH STE 505 HIRAM GA 30141 PHYSICIAN SERVICES 262 - NORTHEAST GEORGIA DIAGNOSTIC CLINIC 1255 FRIENDSHIP ROAD STE 220 BRASELTON GA 30517 PHYSICIAN SERVICES 263 - CHEROKEE LUNG AND SLEEP - KENNESAW 6110 PINE MOUNTAIN ROAD STE 102 KENNESAW GA 30152 PHYSICIAN SERVICES 264 - SPORTS MEDICINE SOUTH OF GWINNETT 2069 TERON TRACE STE 300 DACULA GA 30019 PHYSICIAN SERVICES 265 - ATLANTA GYN ONCOLOGY -MARIETTA 780 CANTON ROAD STE 320A MARIETTA GA 30060 PHYSICIAN SERVICES 266 - NORTHSIDE HOSPITAL CARDIOVASCULAR IN 3855 PLEASANT HILL ROAD STE 270B DULUTH GA 30096 PHYSICIAN SERVICES 267 - NORTHSIDE VASCULAR SURGERY 2220 WISTERIA DRIVE SW STE 209 SNELLVILLE GA 30078 PHYSICIAN SERVICES 268 - CHEROKEE LUNG AND SLEEP 433 HIGHLAND PKWY STE 102E CANTON GA 30115 PHYSICIAN SERVICES 269 - BARIATRIC INNOVATIONS OF ATLANTA 470 NORTHSIDE CHEROKEE BLVD STE 170 CANTON GA 30115 PHYSICIAN SERVICES 270 - ATLANTA CARDIAC AND THORACIC SURGICA 1110 W PEACHTREE ST NW STE 1010 ATLANTA GA 30309 PHYSICIAN SERVICES 271 - NORTHSIDE CHEROKEE SURGICAL ASSOCIATES - 4450 CALIBRE CROSSING STE 1110 ACWORTH GA 30101 PHYSICIAN SERVICES 272 - NORTHSIDE CARDIOVASCULAR GROUP 2108 TERON TRACE STE 100E DACULA GA 30019 PHYSICIAN SERVICES 273 - NHCI GEORGIA CANCER SPECIALISTS - CENTRE P 1100 JOHNSON FERRY ROAD STE 600 ATLANTA GA 30342 PHYSICIAN SERVICES 274 - NORTHSIDE DECATUR PRIMARY CARE 1462 MONTREAL ROAD STE 316 TUCKER GA 30084 PHYSICIAN SERVICES 275 - NORTHSIDE CENTER FOR UROGYNECOLOGY 595 HURRICANE SHOALS RD NW STE 301 LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 276 - ADVANCED NEUROSURGERY ASSOCIATES INC 631 PROFESSIONAL DRIVE STE 360 LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 277 - LAUREATE MEDICAL GROUP 6135 BARFIELD ROAD STE 160 ATLANTA GA 30328 PHYSICIAN SERVICES 278 - GWINNETT NEUROLOGY ASSOCIATES 3855 PLEASANT HILL ROAD STE 270D DULUTH GA 30096 PHYSICIAN SERVICES 279 - ATLANTA GYNECOLOGIC ONCOLOGY 3400 OLD MILTON PKWY BLDG A STE 390 ALPHARETTA GA 30005 PHYSICIAN SERVICES 280 - GEORGIA PULMONARY GROUP LAWRENCEVI 500 MEDICAL CENTER BLVD STE 160 LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 281 - ATLANTA COLON & RECTAL SURGERY-EAST 470 NORTHSIDE CHEROKEE BLVD STE 385 CANTON GA 30115 PHYSICIAN SERVICES 282 - GEORGIA PULMONARY GROUP - SNELLVILLE 1800 TREE LANE STE 200 SNELLVILLE GA 30078 PHYSICIAN SERVICES 283 - GEORGIA GYNECOLOGIC ONCOLOGY 1505 NORTHSIDE BOULEVARD STE 3800B CUMMING GA 30041 PHYSICIAN SERVICES 284 - CARDIOVASCULAR GROUP DULUTH 3855 PLEASANT HILL ROAD STE 250 DULUTH GA 30096 PHYSICIAN SERVICES 285 - NORTHSIDE HOSPITAL CARDIOVASCULAR IN 1255 FRIENDSHIP ROAD STE 120 BRASELTON GA 30517 PHYSICIAN SERVICES 286 - MELANOMA & SARCOMA SPECIALIST OF GEORGIA 1505 NORTHSIDE FORSYTH DR STE 3400G CUMMING GA 30041 PHYSICIAN SERVICES 287 - NORTH ATLANTA MEDICAL ASSOCIATES 10700 MEDLOCK BRIDGE ROAD STE 201 DULUTH GA 30097 PHYSICIAN SERVICES 288 - ALPHARETTA FOOT AND ANKLE SPECIALIST 2000 HOWARD FARM DRIVE STE 340B CUMMING GA 30041 PHYSICIAN SERVICES 289 - NORTHSIDE HOSPITAL CARDIOVASCULAR IN 684 SIXES ROAD STE 230 HOLLY SPRINGS GA 30115 PHYSICIAN SERVICES 290 - NORTHSIDE URGENT CARE 7386 FRIENDSHIP SPRINGS BOULEVARD STE 125 FLOWERY BRANCH GA 30542 PHYSICIAN SERVICES 291 - INTERNAL MEDICINE PRACTICE OF NORTHS 10745 WESTSIDE WAY STE 125 150 ALPHARETTA GA 30009 PHYSICIAN SERVICES 292 - ROSWELL URGENT CARE CENTER 660 WEST CROSSVILLE ROAD STE 110 ROSWELL GA 30075 PHYSICIAN SERVICES 293 - NORTHSIDE PULMONARY AND SLEEP MEDICI 4700 NELSON BROGDON BLVD NE STE 125A BUFORD GA 30019 PHYSICIAN SERVICES 294 - NORTHSIDE THORACIC SURGERY 1270 FRIENDSHIP ROAD STE 100J BRASELTON GA 30517 PHYSICIAN SERVICES 295 - GWINNETT EXTENDED CARE CENTER 650 PROFESSIONAL DRIVE LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 296 - ALPHARETTA FOOT AND ANKLE SPECIALIST 3400 OLD MILTON PKWY BLDG A STE 50 ALPHARETTA GA 30005 PHYSICIAN SERVICES 297 - ARTHRITIS AND TOTAL JOINT SPECIALIST 2000 HOWARD FARM DRIVE STE T110 CUMMING GA 30041 PHYSICIAN SERVICES 298 - ATLANTA CARDIAC AND THORACIC SURGICA 308 DEEP SOUTH FARM ROAD STE 101 BLAIRSVILLE GA 30512 PHYSICIAN SERVICES 299 - CARDIOVASCULAR GROUP GAINESVILLE 535 JESSE JEWELL PARKWAY STE C GAINESVILLE GA 30501 PHYSICIAN SERVICES 300 - CARDIOVASCULAR GROUP LAWRENCEVILLE 2200 MEDICAL CENTER BLVD STE 400 LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 301 - CHATTAHOOCHEE SURGICAL GROUP 81 NORTHSIDE DAWSON DRIVE STE 305D DAWSONVILLE GA 30534 PHYSICIAN SERVICES 302 - CHATTAHOOCHEE SURGICAL GROUP 980 SANDERS ROAD STE 100 CUMMING GA 30042 PHYSICIAN SERVICES 303 - CHATTAHOOCHEE SURGICAL GROUP 4700 NELSON BROGDON BLVD NE STE 125B BUFORD GA 30019 PHYSICIAN SERVICES 304 - CHATTAHOOCHEE SURGICAL GROUP 134 ANSLEY DRIVE STE 200 DAHLONEGA GA 30533 PHYSICIAN SERVICES 305 - GENERAL SURGEONS OF GWINNETT 631 PROFESSIONAL DRIVE STE 470 LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 306 - GYN SURGICAL SPECIALISTS 900 TOWNE LAKE PARKWAY STE 302 WOODSTOCK GA 30189 PHYSICIAN SERVICES 307 - GYN SURGICAL SPECIALISTS 980 JOHNSON FERRY ROAD STE 910 ATLANTA GA 30342 PHYSICIAN SERVICES 308 - LAUREATE MEDICAL GROUP 6135 BARFIELD ROAD STE 130B ATLANTA GA 30328 PHYSICIAN SERVICES 309 - LAUREATE MEDICAL GROUP 6600 PEACHTREE DUNWOODY RD STE 310 ATLANTA GA 30328 PHYSICIAN SERVICES 310 - LAUREATE MEDICAL GROUP 6600 PEACHTREE DUNWOODY RD STE 325 ATLANTA GA 30328 PHYSICIAN SERVICES 311 - NORTH GEORGIA DIABETES AND ENDOCRINO 1505 NORTHSIDE BOULEVARD STE 2850 CUMMING GA 30041 PHYSICIAN SERVICES 312 - NORTH POINT PULMONARY ASSOCIATES 3400 OLD MILTON PKWY BLDG C STE 425 ALPHARETTA GA 30005 PHYSICIAN SERVICES 313 - NORTHSIDE CHEROKEE SURGICAL ASSOCIAT 780 CANTON ROAD STE 320B MARIETTA GA 30060 PHYSICIAN SERVICES 314 - NORTHSIDE HOSPITAL ORTHOPEDIC INSTIT 11685 ALPHARETTA HWY STE 250 ROSWELL GA 30076 PHYSICIAN SERVICES 315 - PERIMETER NORTH MEDICAL ASSOCIATES - 900 TOWNE LAKE PARKWAY STE 302B WOODSTOCK GA 30189 PHYSICIAN SERVICES 316 - SOUTHEASTERN NEURO SPECIALISTS - MAR 900 TOWNE LAKE PARKWAY STE 375 WOODSTOCK GA 30189 PHYSICIAN SERVICES 317 - SURGICAL SPECIALISTS OF ATLANTA - MA 4800 OLDE TOWNE PARKWAY STE 110 MARIETTA GA 30068 PHYSICIAN SERVICES 318 - UROLOGY SPECIALISTS OF ATLANTA 5673 PEACHTREE DUNWOODY RD STE 910 ATLANTA GA 30342 PHYSICIAN SERVICES 319 - ELLIJAY SPORTS MEDICINE 433 HIGHLAND PARKWAY STE 102 EAST ELIJAY GA 30540 PHYSICIAN SERVICES 320 - TOTAL JOINT SPECIALISTS 433 HIGHLAND PARKWAY STE 102A EAST ELIJAY GA 30540 PHYSICIAN SERVICES 321 - NORTHSIDE TRAUMA SURGICAL SPECIALISTS 500 MEDICAL CENTER BOULEVARD STE 190 LAWRENCEVILLE GA 30043 PHYSICIAN SERVICES 322 - NHCI GEORGIA CANCER SPECIALISTS 3610 CLEARVIEW PARKWAY ATLANTA GA 30340 PHYSICIAN SERVICES 323 - NORTHSIDE MIDTOWN BREAST CARE IMAGING 1110 WEST PEACHTREE STREET STE 1000 ATLANTA GA 30309 PHYSICIAN SERVICES 324 - NORTHSIDE IMAGING 1110 WEST PEACHTREE STREET STE 900 ATLANTA GA 30309 PHYSICIAN SERVICES 325 - NORTHSIDE WEST PACES IMAGING 3200 DOWNWOOD CIRCLE STE 125 ATLANTA GA 30327 PHYSICIAN SERVICES 326 - NORTHSIDE HOSPITAL HEART INSTITUTE SMYRNA 4298 ATLANTA RD STE 210 SMYRNA GA 30080 PHYSICIAN SERVICES 327 - SURGICAL SPECIALISTS OF ATLANTA 4298 ATLANTA RD STE 320A SMYRNA GA 30080 PHYSICIAN SERVICES 328 - ARTHRITIS AND TOTAL JOINT SPECIALISTS 3500 MCCLURE BRIDGE RD STE 1A DULUTH GA 30096 PHYSICIAN SERVICES 329 - NHCI GEORGIA CANCER CENTER MILLEDGEVILLE 111 FIELDSTONE DRIVE MILLEDGEVILLE GA 31061 PHYSICIAN SERVICES 330 - NORTHSIDE GWINNETT SURGICAL ASSOCIAT 631 PROFESSIONAL DRIVE STE 300 LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 331 - NORTH ATLANTA PULMONARY AND SLEEP 993C JOHNSON FERRY ROAD STE 300 ATLANTA GA 30342 PHYSICIAN SERVICES 332 - SURGICAL SPECIALISTS OF ATLANTA 1110 WEST PEACHTREE ST STE 1010A ATLANTA GA 30309 PHYSICIAN SERVICES PART I, LINE 3C: IN ADDITION TO THE FPG THRESHOLDS, NORTHSIDE'S POLICY ALLOWS FOR MEDICAL INDIGENCY AS WELL AS AN ASSET TEST FOR AN ADDITIONAL OPPORTUNITY TO QUALIFY FOR CHARITY. AN APPLICATION IS COMPLETED BY THE PATIENT AND/OR A SCORING METHODOLOGY IS GATHERED FROM A THIRD PARTY USING ITS PROPRIETARY SOURCE TO DETERMINE PROPENSITY TO PAY. THESE TOOLS ARE USED TO DETERMINE SOMEONE'S QUALIFICATIONS FOR A CHARITY DISCOUNT OR FREE CARE IN ADDITION TO THE FPG THRESHOLDS STATED ABOVE. PART I, LINE 7: THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNT REPORTED ON LINE 7 IS THE COST TO CHARGE RATIO CALCULATED PURSUANT TO THE IRS SCHEDULE H WORKSHEET 2 INSTRUCTIONS. PART I, LN 7 COL(F): BAD DEBT EXPENSE IN THE AMOUNT OF $461,834,119 HAS BEEN REMOVED FROM TOTAL EXPENSE TO COMPUTE THE PERCENTAGE IN COLUMN (F). PART I, LINE 7H THE COST OF RESEARCH PER SCHEDULE H IS LIMITED TO INTERNALLY-FUNDED RESEARCH OR RESEARCH FUNDED BY GOVERNMENT AND NON-PROFIT ENTITIES THAT IS PUBLISHED OR INTENDED TO BE MADE AVAILABLE TO THE PUBLIC. NORTHSIDE INCURS COSTS FOR RESEARCH THAT, ALTHOUGH NOT MADE AVAILABLE TO THE PUBLIC AND THUS NOT INCLUDED IN SCHEDULE H, IS USED INTERNALLY FOR THE BENEFIT OF THE COMMUNITY AS A WHOLE. DURING THE YEAR ENDING SEPTEMBER 30, 2023, NORTHSIDE INCURRED TOTAL RESEARCH COSTS OF $9.2 MILLION. PART II, COMMUNITY BUILDING ACTIVITIES: AS A COMMUNITY HOSPITAL, NORTHSIDE IS ACTIVELY INVOLVED IN IMPROVING THE HEALTH STATUS OF ITS COMMUNITY EITHER THROUGH ITS COMMUNITY BENEFIT ACTIVITIES OR THROUGH ITS COMMUNITY BUILDING ACTIVITIES. THE LATTER INCLUDES ACTIVITIES LIKE PHYSICAL IMPROVEMENTS AND HOUSING; ECONOMIC DEVELOPMENT; COMMUNITY SUPPORT; ENVIRONMENTAL IMPROVEMENTS; LEADERSHIP DEVELOPMENT AND TRAINING FOR COMMUNITY MEMBERS; COALITION BUILDING; COMMUNITY HEALTH IMPROVEMENT ADVOCACY; WORKFORCE DEVELOPMENT; AND OTHERS. NORTHSIDE ALSO WORKS TO ADDRESS SOCIAL DETERMINANTS OF HEALTH ("SDOH") WHICH, AS DEFINED BY HEALTHY PEOPLE 2030, ARE THE CONDITIONS IN THE ENVIRONMENTS WHERE PEOPLE ARE BORN, LIVE, LEARN, WORK, PLAY, WORSHIP, AND AGE THAT AFFECT A WIDE-RANGE OF HEALTH, FUNCTIONING AND QUALITY-OF-LIFE OUTCOMES AND RISKS. SDOH CAN BE GROUPED INTO FIVE (5) DOMAINS: 1) ECONOMIC STABILITY, 2) EDUCATION ACCESS AND QUALITY, 3) HEALTH CARE ACCESS AND QUALITY, 4) NEIGHBORHOOD AND BUILT ENVIRONMENT, AND 5) SOCIAL AND COMMUNITY CONTEXT. EXAMPLES OF SDOH INCLUDE THINGS SUCH AS SAFE HOUSING, TRANSPORTATION AND NEIGHBORHOODS; RACISM, DISCRIMINATION AND VIOLENCE; EDUCATION, JOB OPPORTUNITIES AND INCOME; ACCESS TO NUTRITIOUS FOODS AND PHYSICAL ACTIVITY OPPORTUNITIES; POLLUTED AIR AND WATER AND; LANGUAGE AND LITERACY SKILLS. EFFORTS TO ADDRESS SDOH OFTEN ARE FOUND WITHIN COMMUNITY BUILDING ACTIVITIES; HOWEVER, RECENT GUIDELINES FROM THE CATHOLIC HEALTH ASSOCIATION ("CHA") ADVISE HOSPITALS TO COUNT THESE ACTIVITIES IN PART I IF APPROPRIATE. ADDRESSING SDOH COMPLEMENTS A HOSPITAL'S COMMUNITY BENEFIT PROGRAM ACTIVITIES AS THE TWO WORK TOGETHER TO HELP IMPROVE A COMMUNITY'S OVERALL HEALTH STATUS. GIVEN THE RECENT CHANGE IN REPORTING GUIDANCE FROM CHA, MANY ACTIVITIES THAT ONCE WERE REPORTED IN PART II AS COMMUNITY BUILDING ARE NOW REPORTED IN PART I AS COMMUNITY HEALTH IMPROVEMENT SERVICES.IN FY 2023, NORTHSIDE SUPPORTED TWO (2) DIFFERENT COMMUNITY BUILDING ACTIVITIES INCLUDING ADVOCACY FOR COMMUNITY HEALTH IMPROVEMENTS/SAFETY AND WORKFORCE DEVELOPMENT, PROVIDING $12,863 IN COMMUNITY BUILDING FUNDING. NORTHSIDE HELPED SUPPORT ADVOCACY FOR COMMUNITY HEALTH IMPROVEMENTS/SAFETY THROUGH NORTHSIDE STAFF WHO WERE A PART OF THE GEORGIA MATERNAL MORTALITY REVIEW COMMITTEE (MMRC), A STATE-WIDE INITIATIVE TO IMPROVE MATERNAL HEALTH OUTCOMES. THE MMRC IDENTIFIES MATERNAL DEATHS OCCURRING DURING OR WITHIN A YEAR OF THE END OF A PREGNANCY AND REVIEWS EACH CASE TO DETERMINE PREGNANCY-RELATEDNESS, CAUSES, AND CONTRIBUTING FACTORS, AND TO MAKE RECOMMENDATIONS FOR INTERVENTIONS TO REDUCE FUTURE DEATHS. THIS MULTIDISCIPLINARY COMMITTEE IS COMPRISED OF PHYSICIANS, NURSES, PUBLIC HEALTH WORKERS AND EPIDEMIOLOGISTS. THE MISSION OF MMRC IS TO DEVELOP A BETTER UNDERSTANDING OF THE CAUSES OF MATERNAL DEATH IN GEORGIA, INCREASE AWARENESS OF THE ISSUES SURROUNDING PREGNANCY-ASSOCIATED DEATH, AND PROMOTE CHANGES IN SYSTEMS, COMMUNITIES, AND INDIVIDUALS IN ORDER TO REDUCE THE NUMBER OF DEATHS. NORTHSIDE HELPED SUPPORT AND VARIOUS WORKFORCE DEVELOPMENT PROGRAMS TO IMPROVE FUTURE INTEREST IN HEALTHCARE AS A CAREER THROUGH SEVERAL PROGRAMS WHERE NORTHSIDE EMPLOYEES EITHER SERVED ON NURSING SCHOOL ADVISORY BOARDS TO REVIEW CURRICULUM, GUIDE SCHOOLS ON WHETHER OR NOT THEIR STUDENTS ARE PREPARED UPON ENTERING THE WORKFORCE AND MANY OTHER ADVISORY FUNCTIONS. NORTHSIDE ALSO SUPPORTED LOCAL HEALTH OCCUPATIONS STUDENTS OF AMERICA (HOSA) CHAPTERS BY BEING A LECTURER AT THESE MEETINGS. THE MISSION OF HOSA IS TO EMPOWER HOSA-FUTURE HEALTH PROFESSIONALS TO BECOME LEADERS IN THE GLOBAL HEALTH COMMUNITY, THROUGH EDUCATION, COLLABORATION, AND EXPERIENCE. HOSA ACTIVELY PROMOTES CAREER OPPORTUNITIES IN THE HEALTH INDUSTRY AND TO ENHANCE THE DELIVERY OF QUALITY HEALTH CARE TO ALL PEOPLE. PART II, LINE 8 BIANNUALLY, NORTHSIDE HOSPITAL, INC. ("NORTHSIDE") CONDUCTS A COMMUNITY-BASED PHYSICIAN NEED ANALYSIS FOR NORTHSIDE HOSPITAL-CHEROKEE ("NHC"), NORTHSIDE HOSPITAL-FORSYTH ("NHF"), NORTHSIDE HOSPITAL GWINNETT ("NHG"), AND NORTHSIDE HOSPITAL DULUTH ("NHD"). NHC AND NHF ARE SOLE COUNTY PROVIDERS AND AS SUCH MUST ENSURE THAT APPROPRIATE MEDICAL SERVICES ARE ACCESSIBLE TO THE RESIDENTS OF THE COMMUNITIES SERVED. EACH HOSPITAL'S PHYSICIAN NEED ANALYSIS DEFINES A GEOGRAPHIC AREA COMPLIANT WITH THE FEDERAL PHYSICIAN SELF-REFERRAL LAW, IDENTIFIES NHC, NHF, NHG, AND NHD MEDICAL STAFF MEMBERS WITH AN OFFICE IN THE DEFINED GEOGRAPHIC AREA, IDENTIFIES NON-NORTHSIDE PHYSICIANS WITH AN OFFICE IN THE DEFINED GEOGRAPHIC AREA, AND INCLUDES A QUANTITATIVE ANALYSIS OF EACH COMMUNITY'S PHYSICIAN NEED ("COMMUNITY PHYSICIAN NEED"). BASED ON THE FINDINGS OF THE ANALYSES, NORTHSIDE ENGAGES IN RECRUITMENT EFFORTS DESIGNED TO ENSURE THAT SUFFICIENT QUALIFIED HEALTH PROFESSIONALS ARE AVAILABLE TO MEET THE IDENTIFIED COMMUNITY PHYSICIAN NEED. THROUGH THESE ANALYSES, NORTHSIDE HAS IDENTIFIED A DEFINED NUMERIC NEED FOR ONE-HALF PHYSICIAN FTE OR MORE IN 19 SPECIALTIES IN NHC'S STARK-COMPLIANT GEOGRAPHIC AREA, A NEED FOR ONE-HALF PHYSICIAN FTE OR MORE IN 20 SPECIALTIES IN NHF'S STARK-COMPLIANT GEOGRAPHIC AREA, A NEED FOR ONE-HALF PHYSICIAN FTE OR MORE IN 22 SPECIALTIES IN NHG'S STARK-COMPLIANT GEOGRAPHIC AREA, AND A NEED FOR ONE-HALF PHYSICIAN FTE OR MORE IN 19 SPECIALTIES IN NHD'S STARK-COMPLIANT GEOGRAPHIC AREA. NHC, NHF, NHG, AND NHD ARE CONCENTRATING RECRUITMENT EFFORTS ON PRIMARY CARE AND MEDICAL AND SURGICAL SPECIALTIES WITH AN EMPHASIS ON RECRUITING NEEDED PHYSICIANS INTO FORSYTH, DAWSON, PICKENS, CHEROKEE, AND GWINNETT COUNTIES TO MEET THE IDENTIFIED COMMUNITY PHYSICIAN NEED. PART III, LINE 4: NORTHSIDE DETERMINES ITS ESTIMATES OF EXPLICIT AND IMPLICIT PRICE CONCESSIONS USING A PORTFOLIO APPROACH AS A PRACTICAL EXPEDIENT IN ACCORDANCE WITH FASB ASU 2014-09, REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606). SUBSEQUENT CHANGES IN THE TRANSACTION PRICE THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY ARE RECORDED AS OPERATING EXPENSES IN THE CONSOLIDATED STATEMENTS OF OPERATIONS. THE PROVISION FOR BAD DEBTS FOR THE YEARS ENDED SEPTEMBER 30, 2023 AND 2022 WAS NOT MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS.THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNT REPORTED ON LINES 2 AND 3 WAS A COST TO CHARGE RATIO APPLIED TO BAD DEBT CHARGES WRITTEN OFF, NET OF RECOVERIES. NORTHSIDE HOSPITAL PROVIDES CARE TO THE COMMUNITY, REGARDLESS OF A PATIENT'S ABILITY TO PAY. THE FORGONE CHARGES ARE AT THE EXPENSE OF NORTHSIDE HOSPITAL. PART III, LINE 8: THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNT REPORTED ON LINE 6 WAS A COST TO CHARGE RATIO FROM THE FISCAL YEAR 2023 MEDICARE COST REPORT APPLIED TO MEDICARE CHARGES. THE MEDICARE PROGRAM PAYS AT AMOUNTS WHICH ARE LESS THAN THE COST OF PROVIDING SERVICES. ANY COST NOT REIMBURSED BY MEDICARE IS BORNE BY NORTHSIDE HOSPITAL WHICH EASES THE BURDEN TO THE GOVERNMENT FOR THE PROVISION OF HEALTH CARE UNDER THE MEDICARE PROGRAM. AS SUCH, THIS SHORTFALL IS REPORTED AS A COMMUNITY BENEFIT. PART III, LINE 9B: INFORMATION REGARDING NORTHSIDE'S FINANCIAL ASSISTANCE POLICY IS WIDELY DISTRIBUTED, INCLUDING VIA THE WEBSITE, POSTINGS IN ALL EMERGENCY DEPARTMENTS, REGISTRATION AREAS AND WAITING ROOMS, PRE-ADMISSION CORRESPONDENCE, "ABOUT YOUR BILLING" BROCHURE, PRICE ESTIMATES, PATIENT BILLING STATEMENTS AND ONLINE BILL PAY PORTALS. NORTHSIDE'S FINANCIAL COUNSELING OFFICE STAFF ARE ALSO TRAINED TO ASSIST PATIENTS IN APPLYING FOR FINANCIAL ASSISTANCE. BECAUSE NORTHSIDE'S FINANCIAL ASSISTANCE POLICY SUPERSEDES THE DEBT COLLECTION POLICY IN ANY SITUATION WHERE A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, COLLECTION PRACTICES ARE NOT PURSUED AGAINST ANY PATIENT WHO HAS QUALIFIED FOR FINANCIAL ASSISTANCE. IN THE EVENT THAT A PATIENT APPLIES FOR FINANCIAL ASSISTANCE AFTER A DEBT COLLECTION PROCESS HAS BEGUN, THE DEBT COLLECTION PROCESS CEASES AND ONLY RESUMES, IF AT ALL, ONCE THE PATIENT'S ELIGIBILITY FOR FULL OR PARTIAL FINANCIAL ASSISTANCE IS DETERMINED. PART VI, LINE 2: NORTHSIDE DEVELOPED A STANDARDIZED PROCESS FOR CONDUCTING ITS COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA"). IN SHORT, NORTHSIDE'S CHNA PROCESS INCLUDED: - DEFINING THE NORTHSIDE COMMUNITY. - REVIEWING NORTHSIDE INTERNAL DATA. - REVIEWING PUBLICLY AVAILABLE HEALTH DATA. - REVIEWING PROPRIETARY QUANTITATIVE CONSUMER RESEARCH DATA. - PERFORMING STAKEHOLDER INTERVIEWS. - SUMMARIZING AND PRIORITIZING THE HEALTH NEEDS IDENTIFIED WITHIN NORTHSIDE'S COMMUNITY. - DEVELOPING AN IMPLEMENTATION STRATEGY TO ADDRESS THE IDENTIFIED NEEDS. - PRESENTING THE FINALIZED CHNA REPORT AND IMPLEMENTATION STRATEGY TO THE BOARD OF DIRECTORS OF NORTHSIDE HOSPITAL, INC. FOR ADOPTION. - PROVIDING CONTINUED PUBLIC ACCESS TO NORTHSIDE'S CHNA REPORT VIA WWW.NORTHSIDE.COM/COMMUNITY-WELLNESS/IN-THE-COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENT AND PROVIDING AN OPPORTUNITY FOR PUBLIC FEEDBACK VIA NORTHSIDE.CHNA@NORTHSIDE.COM.NORTHSIDE UTILIZED AN EVIDENCE-BASED MODEL OF POPULATION HEALTH ADAPTED FROM THE WISCONSIN POPULATION HEALTH INSTITUTE AND ALSO UTILIZED BY COUNTY HEALTH RANKINGS AND ROADMAPS. THIS MODEL ILLUSTRATES THE COMPLEXITY OF ASSESSING A COMMUNITY'S HEALTH STATUS BY OUTLINING THE FACTORS THAT ACT IN COMBINATION TO DETERMINE THE CURRENT STATUS OF A COMMUNITY'S HEALTH. THE EVIDENCE-BASED MODEL OUTLINES THE HEALTH DETERMINANTS (DEMOGRAPHICS AND SOCIAL ENVIRONMENT, HEALTHCARE ACCESS AND QUALITY, HEALTH BEHAVIORS, AND THE PHYSICAL ENVIRONMENT) THAT LEAD TO THE HEALTH OUTCOMES IN A COMMUNITY (MORBIDITY AND MORTALITY).THE CENTERS FOR DISEASE CONTROL AND PREVENTION ("CDC") PERFORMED A SYSTEMATIC LITERATURE REVIEW TO DETERMINE A COMMON SET OF HEALTH METRICS THAT SHOULD BE USED TO MEASURE BOTH THE HEALTH DETERMINANTS AND HEALTH OUTCOMES. NORTHSIDE USED THE CDC'S LIST OF "MOST FREQUENTLY RECOMMENDED HEALTH METRICS" TO DETERMINE WHAT VARIABLES TO CONSIDER FOR NORTHSIDE'S CURRENT CHNA. NORTHSIDE UTILIZED THE CDC'S RECOMMENDED VARIABLES AND METRIC WHEN THEY WERE READILY AVAILABLE AT THE COUNTY LEVEL. PART VI, LINE 3: NORTHSIDE INFORMS AND EDUCATES PATIENTS AND PERSONS WHO ARE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE AND NORTHSIDE'S FINANCIAL ASSISTANCE PROGRAM IN NUMEROUS WAYS.NORTHSIDE CONSPICUOUSLY POSTS NOTICE OF ITS FINANCIAL ASSISTANCE PROGRAM AND HOW TO ACCESS ITS FINANCIAL ASSISTANCE POLICY AND FINANCIAL ASSISTANCE APPLICATION AT ALL MAJOR POINTS OF ACCESS TO ITS INPATIENT AND OUTPATIENT FACILITIES, THESE POINTS OF ACCESS INCLUDE THE HOSPITALS' PATIENT WAITING ROOMS AND EMERGENCY DEPARTMENTS. FOR PATIENTS THAT PRE-REGISTER OVER THE PHONE FOR HOSPITAL SERVICES, NORTHSIDE VERBALLY INFORMS PATIENTS OF ITS FINANCIAL ASSISTANCE PROGRAM AND PROVIDES PATIENTS WITH INFORMATION ON HOW TO OBTAIN A COPY OF NORTHSIDE'S FINANCIAL ASSISTANCE POLICY AND FINANCIAL ASSISTANCE APPLICATION VIA NORTHSIDE'S WEBSITE OR VIA MAIL. ADDITIONALLY, UPON ADMISSION TO ONE OF ITS HOSPITALS FOR SERVICES, NORTHSIDE PROVIDES EACH PATIENT A REGISTRATION PACKET THAT INCLUDES INFORMATION ON ITS FINANCIAL ASSISTANCE PROGRAM. FURTHER, A FINANCIAL COUNSELOR WILL SPEAK WITH ALL PATIENTS DURING EITHER THE PRE-REGISTRATION PROCESS OR UPON ADMISSION AND EXPLAIN NORTHSIDE'S FINANCIAL ASSISTANCE PROGRAM. IF A PATIENT INDICATES A NEED OR REQUESTS MORE INFORMATION REGARDING FINANCIAL ASSISTANCE, NORTHSIDE WILL REFER THE PATIENT TO A FINANCIAL ASSISTANCE COUNSELOR WHO WILL WORK DIRECTLY WITH THE PATIENT TO ASSIST THE PATIENT IN APPLYING FOR FINANCIAL ASSISTANCE.IN ORDER TO EXPEDITE THE FINANCIAL ASSISTANCE PROCESS, NORTHSIDE USES THIRD PARTY SOFTWARE TO HELP IDENTIFY PATIENTS THAT QUALIFY FOR FINANCIAL ASSISTANCE BASED ON PUBLICLY AVAILABLE INFORMATION (E.G., PARTICIPATION IN STATE FUNDED PRESCRIPTION PROGRAMS, PARTICIPATION IN THE WOMEN, INFANTS AND CHILDREN (WIC) PROGRAM, PARTICIPATION IN THE SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP, FORMERLY FOOD STAMPS), SUBSIDIZED SCHOOL LUNCH PROGRAM ELIGIBILITY, OR ELIGIBILITY FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS). PATIENTS THAT ARE IDENTIFIED BY SUCH THIRD-PARTY SOFTWARE AS ELIGIBLE TO RECEIVE FINANCIAL ASSISTANCE WILL NOT BE REQUIRED TO COMPLETE THE FINANCIAL ASSISTANCE APPLICATION AND INSTEAD WILL AUTOMATICALLY BE DEEMED TO QUALIFY FOR FINANCIAL ASSISTANCE. FURTHER, NORTHSIDE'S FINANCIAL COUNSELORS WILL ASSIST PATIENTS WITH APPLYING TO PROGRAMS THAT THEY ARE ELIGIBLE FOR, BUT NOT CURRENTLY ENROLLED IN, SUCH AS STATE OR FEDERAL HEALTHCARE PROGRAMS OR DRUG DISCOUNT PROGRAMS.NORTHSIDE ALSO INCLUDES A SUMMARY OF ITS FINANCIAL ASSISTANCE PROGRAM, INCLUDING HOW TO OBTAIN MORE INFORMATION AND APPLY FOR FINANCIAL ASSISTANCE, ON ALL PATIENT BILLS.LASTLY, NORTHSIDE WORKS WITH MANY COMMUNITY OUTREACH PROGRAMS TO PROVIDE FINANCIAL ASSISTANCE TO PATIENTS WHO QUALIFY FOR FREE OR DISCOUNTED SERVICES THROUGH THESE PROGRAMS. TO EXPEDITE THE FINANCIAL ASSISTANCE PROCESS FOR SUCH PATIENTS, NORTHSIDE PROVIDES A PRE-APPROVAL PROCESS FOR ALL PATIENTS WHO ARE REFERRED FOR MEDICALLY NECESSARY SERVICES VIA A COMMUNITY OUTREACH PROGRAM. THIS PROCESS ALLOWS PATIENTS TO QUALITY FOR FINANCIAL ASSISTANCE PRIOR TO RECEIVING HOSPITAL SERVICES, THEREBY RELIEVING THE PATIENTS OF THE STRESS AND BURDEN OF THE FINANCIAL ASPECT OF THEIR CARE, AND ALLOWING THEM TO FOCUS ON THEIR HEALTH, WELL-BEING AND RECOVERY. PART VI, LINE 4: NORTHSIDE BEGAN THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS BY DEFINING EACH HOSPITAL'S COMMUNITY, WHICH INCLUDED (I) DEFINING EACH FACILITY'S PRIMARY PATIENT CATCHMENT AREA; (II) MAPPING THE MEDICALLY UNDERSERVED AREAS AROUND EACH FACILITY TO ENSURE THAT NO MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS WERE EXCLUDED WITHIN OR NEAR THE PRIMARY CATCHMENT AREAS; AND (III) MAPPING EACH FACILITY'S DISTRIBUTION OF OUTPATIENT SERVICES ACROSS THE REGION. THE RESULTS OF THIS PROCESS REVEALED SIGNIFICANT OVERLAP BETWEEN THE COMMUNITIES SERVED BY EACH NORTHSIDE HOSPITAL FACILITY. THUS, NORTHSIDE HOSPITAL-ATLANTA, NORTHSIDE HOSPITAL-CHEROKEE, NORTHSIDE HOSPITAL-DULUTH, NORTHSIDE HOSPITAL-FORSYTH, AND NORTHSIDE HOSPITAL-GWINNETT DEVELOPED A SINGLE COMMUNITY DEFINITION IN COMPLIANCE WITH IRS SECTION 501(R) FINAL RULE. THE NORTHSIDE COMMUNITY CONSISTS OF BARROW, CHEROKEE, COBB, DAWSON, DEKALB, FORSYTH, FULTON, GWINNETT, PICKENS, AND WALTON COUNTIES.IN 2020, THE ESTIMATED 4.3 MILLION RESIDENTS OF THE NORTHSIDE COMMUNITY ACCOUNTED FOR 40% OF GEORGIA'S TOTAL POPULATION. THE NORTHSIDE COMMUNITY IS SLIGHTLY YOUNGER THAN GEORGIA OVERALL, WITH A MEDIAN AGE OF 36.3 COMPARED TO GEORGIA'S 36.9. OVERALL, THE 2020 NORTHSIDE COMMUNITY WAS COMPRISED OF A DIVERSE POPULATION. INDIVIDUAL COUNTIES, HOWEVER, HAVE VARYING RACIAL COMPOSITIONS, INCLUDING TWO COUNTIES THAT HAVE 90 PERCENT OF THEIR POPULATIONS BELONGING TO JUST ONE RACIAL GROUP. ALMOST HALF OF GEORGIA'S HISPANIC POPULATION LIVES IN THE COMMUNITY AND 25% LIVES IN GWINNETT COUNTY.OVERALL, THE NORTHSIDE COMMUNITY HAS A HIGH LEVEL OF EDUCATIONAL ATTAINMENT AND AFFLUENCE WHEN COMPARED TO GEORGIA AS A WHOLE. THE MEDIAN DISPOSABLE INCOME, HOUSEHOLD INCOME, HOUSEHOLD NET WORTH, AND HOUSING UNIT VALUE IN THE NORTHSIDE COMMUNITY ARE ALL HIGHER THAN GEORGIA'S AVERAGES. DESPITE THIS GENERAL PICTURE OF AFFLUENCE, HOWEVER, DISPARITIES DO EXIST, ESPECIALLY ALONG RACIAL AND ETHNIC LINES AND BETWEEN COUNTIES THAT NORTHSIDE'S COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY AIM TO ADDRESS. PART VI, LINE 5: NORTHSIDE HOSPITAL, INC. IS A CHARITABLE ORGANIZATION AND AS SUCH IS ENGAGED IN NUMEROUS ACTIVITIES TO PROVIDE RELIEF TO THE POOR, THE DISTRESSED, OR THE UNDERPRIVILEGED. NORTHSIDE ROUTINELY PROVIDES FINANCIAL ASSISTANCE, HEALTH PROFESSIONS EDUCATION, CASH AND IN-KIND DONATIONS, COMMUNITY HEALTH IMPROVEMENT SERVICES, RESEARCH, AND COMMUNITY-BUILDING ACTIVITIES. MANY OF THESE EFFORTS HAVE BEEN REPORTED THROUGHOUT THIS RETURN.IN ADDITION TO THE NUMEROUS COMMUNITY BENEFIT ACTIVITIES NORTHSIDE ENGAGES IN THROUGHOUT THE YEAR, NORTHSIDE ALSO INVESTS SURPLUS FUNDS BACK INTO EXPANDING ACCESS TO SERVICES FOR ALL PEOPLE THROUGHOUT ITS COMMUNITY. OVER THE COURSE OF FY 2023, NORTHSIDE HOSPITAL, INC. SUBMITTED FIFTY THREE APPLICATIONS TO THE GEORGIA DEPARTMENT OF COMMUNITY HEALTH TO EXPAND OR RENOVATE FACILITIES, EXPAND SERVICES, ACQUIRE STATE-OF-THE-ART EQUIPMENT, CONTINUE CRITICAL CARDIAC-RELATED SERVICES (I.E., THERAPEUTIC CARDIAC CATHETERIZATION), AND EXPAND OUTPATIENT LOCATIONS. THESE APPLICATIONS REPRESENT A LONG-TERM FINANCIAL COMMITMENT TOTALING NEARLY $130 MILLION OVER THE NEXT SEVERAL YEARS. PROJECTS INCLUDE: 1) $72 MILLION FOR ADDING FIVE (5) NEW OUTPATIENT IMAGING CENTERS, EXPANDING THIRTEEN EXISTING IMAGING CENTERS AS WELL AS UPGRADING EXISTING IMAGING EQUIPMENT ACROSS THE SYSTEM'S PORTFOLIO ; 2) $28 MILLION IN SEVERAL PROJECTS TO RENOVATE OR EXPAND INPATIENT DEPARTMENTS SUCH AS CLINICAL LAB, DIALYSIS, PHARMACY, AND GI; 3) $21 MILLION TO EXPAND INPATIENT CAPACITY AT NORTHSIDE HOSPITAL CHEROKEE (131 BEDS) AND NORTHSIDE HOSPITAL FORSYTH (18 BEDS); 4) $10 MILLION TO EXPAND THE NEONATAL INTERMEDIATE CARE UNITS AT NORTHSIDE HOSPITAL CHEROKEE (3 BEDS) AND NORTHSIDE HOSPITAL GWINNETT (7 BEDS); 5) $3 MILLION IN ACQUIRING TWO (2) STATE-OF-THE-ART SURGICAL ROBOTS; AND 6) $2.5 MILLION IN UPGRADING CT-SIMULATORS AND BRACHYTHERAPY EQUIPMENT AT SEVERAL RADIATION THERAPY CENTERS ACROSS THE SYSTEM.. THESE PROJECTS ARE LOCATED THROUGHOUT NORTHSIDE HOSPITAL, INC.'S SERVICE AREA AND WILL HELP IMPROVE THE COMMUNITY'S ACCESS TO INPATIENT CARE, SPECIALISTS AND OUTPATIENT HOSPITAL SERVICES. PART VI, LINE 6: THE NORTHSIDE HOSPITAL SYSTEM PROVIDES A NUMBER OF COMMUNITY-BASED SERVICES, DESIGNED TO IMPROVE THE HEALTH OF AREA RESIDENTS. WORKING WITH VARIOUS ORGANIZATIONS, HOSPITAL EMPLOYEES AND MEDICAL STAFF, THE NORTHSIDE HOSPITAL SYSTEM PARTICIPATES IN HEALTH EDUCATION AND SCREENINGS, AS WELL AS PROVIDES SUPPORT ACTIVITIES FOR INDIVIDUALS IN THE COMMUNITY LIVING WITH A SERIOUS OR CHRONIC HEALTH CONDITION.IN ADDITION TO THE EXCELLENT MEDICAL CARE AND EDUCATIONAL PROGRAMS WE PROVIDE TO THE COMMUNITY, NORTHSIDE ALSO PROVIDES FINANCIAL SUPPORT TO A NUMBER OF OTHER NON-PROFIT, COMMUNITY AND CIVIC CAUSES WHOSE MISSIONS AND OBJECTIVES COMPLEMENT NORTHSIDE HOSPITAL'S MISSION AND VALUES.NORTHSIDE HOSPITAL GIVES BACK A SIGNIFICANT AMOUNT TO THE COMMUNITY. WE MEASURE THE SUCCESS OF OUR EFFORTS BY THE NUMBER OF RESIDENTS WE REACH WITH OUR MESSAGES RELATED TO HEALTH AND WELLNESS. OUR MISSION IS TO WORK TO POSITIVELY IMPACT THE OVERALL HEALTH OF THE COMMUNITIES WE SERVE. CLEARLY, EDUCATION, OUTREACH AND COMMUNITY SERVICE ALLOW US TO BROADEN OUR IMPACT BEYOND THE WALLS OF OUR FACILITIES. PART VI, LINE 7 NORTHSIDE HOSPITAL, INC. 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G KOMEN BREAST CANCER FOUNDATION PO BOX 934048 ATLANTA GA 31193 581959763 501(C)(3) 50000 0 GENERAL SUPPORT THE ATLANTA WOMENS FOUNDATION 3355 LENOX ROAD SUITE 850 ATLANTA GA 30326 582389721 501(C)(3) 25000 0 GENERAL SUPPORT THE MUSEUM OF CONTEMPORARY ART OF GEORGIA INC 75 BENNETT ST A-2 ATLANTA GA 30309 582562811 501(C)(3) 25000 0 GENERAL SUPPORT THE PARTNERSHIP AGAINST DOMESTIC VIOLENCE PO BOX 361969 DECATUR GA 30036 823295945 501(C)(3) 137500 0 GENERAL SUPPORT TRAVELERS AID OF METROPOLITAN ATLANTA INC DBA HOPE ATLANTA 458 PONCE DE LEON AVE NE TER LEVEL ATLANTA GA 30308 580566247 501(C)(3) 100000 0 GENERAL SUPPORT WOMENS CLUB OF SUGARLOAF COUNTY 6555 SUGARLOAF PKWY STE 307 DULUTH GA 30097 261140144 501(C)(3) 25000 0 GENERAL SUPPORT ZOO ATLANTA 800 CHEROKEE AVE SE ATLANTA GA 30315 541655184 501(C)(3) 50000 0 GENERAL SUPPORT 64 17 SCHOLARSHIP / EDUCATIONAL ASSISTANCE 3 14363 PART I, LINE 2: THE ORGANIZATION HAS GUIDELINES IN PLACE THAT ARE TO BE USED IN REVIEWING THE ELIGIBILITY OF GRANTEES. ALL GRANTS REQUIRE WRITTEN DOCUMENTATION AND APPROPRIATE LEVELS OF APPROVAL. X 1 1 X X X X X X 0 1 0 0 0 0 0 1 0 WAYNE L AMBROZE JR MD BOARD MEMBER 439354 0 10000 0 9988 0 0 0 22597 0 481939 0 0 0 KEITH CARNES MD BOARD MEMBER 441049 0 0 0 12895 0 0 0 19149 0 473093 0 0 0 IQBAL GARCHA MD BOARD MEMBER 535943 0 41000 0 8034 0 0 0 16509 0 601486 0 0 0 ROBERT T QUATTROCCHI PRESIDENT & CEO NSH, INC. 1487319 0 3450000 0 29224 0 0 0 33658 0 5000201 0 0 0 SHANNON BANNA VP/CFO NSH, INC./ASST. TREASURER 647234 0 258060 0 35315 0 0 0 9967 0 950576 0 0 0 JORGE J HERNANDEZ VICE PRESIDENT/ASST. SECRETARY 595133 0 331873 0 33213 0 0 0 22992 0 983211 0 0 0 JANIS DUBOW VICE PRESIDENT 422287 0 213768 0 10873 0 0 0 11205 0 658133 0 0 0 WILLIAM HAYES CEO, NORTHSIDE HOSPITAL-CHEROKEE 566950 0 227493 0 55283 0 0 0 18267 0 867993 0 0 0 DEBORAH MITCHAM BILBRO CEO, NORTHSIDE HOSPITAL GWINNETT 753207 0 264968 0 14396 0 0 0 13063 0 1045634 0 0 0 ROBERT PUTNAM VICE PRESIDENT 702940 0 283394 0 59600 0 0 0 20066 0 1066000 0 0 0 TINA WAKIM VICE PRESIDENT/COO 750499 0 0 0 9737 0 0 0 22133 0 782369 0 0 0 CHARLES DECOOK MD ORTHOPEDIC SURGEON 1258843 0 571430 0 9393 0 0 0 30448 0 1870114 0 0 0 JIMMY J JIANG MD ORTHOPEDIC HAND SURGEON 483402 0 2098646 0 9210 0 0 0 33460 0 2624718 0 0 0 KENNETH KRESS MD ORTHOPEDIC SURGEON 876997 0 493961 0 15409 0 0 0 17464 0 1403831 0 0 0 DAVID A LANGFORD MD THORACIC SURGEON 986259 0 175000 0 150628 0 0 0 19668 0 1331555 0 0 0 CHRISTOPHER A POTTS MD ORTHOPEDIC SURGEON 716610 0 962782 0 18642 0 0 0 20491 0 1718525 0 0 0 PART I, LINE 1A ON OCCASION, CERTAIN BENEFITS, SUCH AS LONG TERM DISABILITY PREMIUMS, ARE GROSSED UP FOR SELECTED EMPLOYEES. PART I, LINE 4B MR. QUATTROCCHI HAS LED THE ORGANIZATION FOR MORE THAN TWENTY YEARS AS CEO AND FOR SEVENTEEN YEARS AS A SENIOR EXECUTIVE PRIOR TO BECOMING CEO. IN RECOGNITION OF HIS SUCCESSFUL LEADERSHIP AND EXTENDED TENURE, AND TO ENCOURAGE CONTINUATION OF THIS RELATIONSHIP, THE BOARD OF DIRECTORS HAS PROVIDED A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") DESIGNED TO PROVIDE THE CEO WITH A SOURCE OF RETIREMENT INCOME. NORTHSIDE DOES NOT CONSIDER SERP PAYMENTS TO BE DEFERRED COMPENSATION FOR TAX REPORTING PURPOSES. THE SERP PAYMENTS ARE BASED ON A MATHEMATICAL FORMULA, PURSUANT TO A SIGNED CONTRACT, AND ARE REVIEWED AND ASSESSED PERIODICALLY FOR REASONABLENESS BY AN OUTSIDE CONSULTANT. THE COMPENSATION COMMITTEE AND FULL BOARD OF DIRECTORS APPROVE EACH PAYMENT BEFORE PAYMENT IS MADE. HOWEVER, NO FURTHER FUNDING OF THE SERP IS EXPECTED BASED ON ACTUARIAL PROJECTIONS. AS A RESULT, IN ORDER TO ASSIST FURTHER IN THE CEO'S RETENTION, THE COMPANY HAS ESTABLISHED AN ANNUAL RETENTION PROGRAM FOR THE CEO, PROVIDING FOR AN ANNUAL RETENTION INCENTIVE, BUT ONLY IF HE CONTINUES TO BE EMPLOYED ON THE LAST DAY OF EACH FISCAL YEAR, BEGINNING WITH THE FISCAL YEAR ENDING SEPTEMBER 30, 2021. NORTHSIDE DOES NOT CONSIDER THE RETENTION PAYMENTS TO BE DEFERRED COMPENSATION FOR TAX REPORTING PURPOSES. AS AN ADDITIONAL RETENTION INCENTIVE, THE BOARD OF DIRECTORS MAY DEFER A PORTION OF ANY ANNUAL BONUS PAYABLE TO THE CEO CONDITIONING PAYMENT OF THE DEFERRED PORTION ON THE CEO'S CONTINUED EMPLOYMENT AND SATISFACTION OF CERTAIN SPECIFIED ORGANIZATION METRICS. PART II CERTAIN AMOUNTS REPORTED ON SCHEDULE J, PART II, COLUMN (B) MAY INCLUDE AMOUNTS FOR SERVICES PERFORMED IN A PRIOR CALENDAR YEAR BUT NOT DUE AND PAYABLE UNTIL THE ORGANIZATION'S CURRENT TAX YEAR. RACHEL BEARMAN DALE M. BEARMAN, M.D., BOARD MEMBER & RACHEL BEARMAN FAMILY MEMBER 120635 DALE M. BEARMAN, M.D., MEMBER OF THE NORTHSIDE HOSPITAL, INC. BOARD OF DIRECTORS, HAS A FAMILY RELATIONSHIP WITH RACHEL BEARMAN, AN EMPLOYEE OF NORTHSIDE HOSPITAL, INC. AMOUNT REPRESENTS FAIR MARKET VALUE COMPENSATION PAID DURING CALENDAR YEAR 2022 TO RACHEL BEARMAN FOR SERVICES RENDERED TO THE ORGANIZATION. 0 GARY LEVENGOOD MD MICHAEL LEVENGOOD, M.D., BOARD MEMBER & GARY LEVENGOOD, M.D. FAMILY MEMBER 815401 MICHAEL LEVENGOOD, M.D., MEMBER OF THE NORTHSIDE HOSPITAL, INC. BOARD OF DIRECTORS, HAS A FAMILY RELATIONSHIP WITH GARY LEVENGOOD, M.D., AN EMPLOYEE OF NORTHSIDE HOSPITAL, INC. AMOUNT REPRESENTS FAIR MARKET VALUE COMPENSATION PAID DURING CALENDAR YEAR 2022 TO GARY LEVENGOOD, M.D. FOR SERVICES RENDERED TO THE ORGANIZATION. 0 ALLIE BUCHANAN CARL BUCHANAN, M.D., BOARD MEMBER & ALLIE BUCHANAN FAMILY MEMBER 91569 CARL BUCHANAN, M.D., MEMBER OF THE NORTHSIDE HOSPITAL, INC. BOARD OF DIRECTORS, HAS A FAMILY RELATIONSHIP WITH ALLIE BUCHANAN, AN EMPLOYEE OF NORTHSIDE HOSPITAL, INC. AMOUNT REPRESENTS FAIR MARKET VALUE COMPENSATION PAID DURING CALENDAR YEAR 2022 TO ALLIE BUCHANAN FOR SERVICES RENDERED TO THE ORGANIZATION. 0 PART III, LINE 4A: PROGRAM SERVICE ACCOMPLISHMENTS (CONT'D) REINVESTING TO ENHANCE CAPACITY AND TO DELIVER HIGH-QUALITY HEALTH CARE TO THE COMMUNITIES WE SERVE. BECAUSE NORTHSIDE HOSPITAL INC. IS NOT-FOR-PROFIT AND IS NOT REQUIRED TO RETURN PROFITS TO SHAREHOLDERS LIKE TAXABLE ORGANIZATIONS, WE ROUTINELY REINVEST OUR CASH RESERVES IN ORDER TO ENHANCE OUR CAPACITY AND ABILITY TO DELIVER HIGH-QUALITY HEALTH CARE TO THE COMMUNITIES WE SERVE. IN FY2023, NORTHSIDE HOSPITAL, INC. WAS IN THE POSITION TO DEPLOY OVER $425 MILLION IN CASH INVESTMENTS ACROSS THE SYSTEM FOR IMPORTANT PROGRAM SERVICES AND INITIATIVES. WHILE THE $425 MILLION WAS ALLOCATED OVER A DOZEN CATEGORIES, A MAJORITY OF THE CASH INVESTMENTS WERE TO PROGRAM SERVICES AND INITIATIVES THAT OVERLAP WITH NORTHSIDE'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT. NORTHSIDE MADE CASH INVESTMENTS TO NUMEROUS PROGRAM SERVICES INCLUDING CARDIOLOGY, ONCOLOGY AND WOMEN'S SERVICES; DETAILS OF THESE COMMITMENTS ARE AS FOLLOWS. $18 MILLION FOR CARDIOLOGY PRIMARILY TO UPGRADE EQUIPMENT IN FOUR (4) CARDIAC CATH LABS ACROSS THE SYSTEM. $24 MILLION FOR ONCOLOGY PRIMARILY TO OPEN A NEW, 14,000 SQUARE FOOT RADIATION THERAPY CENTER IN SOUTH ATLANTA FOR IMPROVED GEOGRAPHIC ACCESS. IN ADDITION, NORTHSIDE INVESTED $8 MILLION IN WOMEN'S SERVICES PRIMARILY FOR STATE-OF-THE-ART INCUBATORS DESIGNED TO CREATE A CONTROLLED, PROTECTED MIRCOENVIRONMENT FOR PEACEFUL, FAST HEALING. NORTHSIDE ALSO MADE SUBSTANTIAL CASH INVESTMENTS IN OTHER VITAL PROGRAM SERVICES AND INITIATIVES TO EXPAND CAPACITY, IMPROVE QUALITY AND INCREASE ACCESS TO CARE; THE LATTER OF WHICH ALSO IS IN NORTHSIDE'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT. DETAILS OF THESE COMMITMENTS ARE AS FOLLOWS. $57 MILLION FOR SURGERY PRIMARILY TO EXPAND INPATIENT SURGICAL CAPACITY AT TWO (2) NORTHSIDE HOSPITALS, EXPAND OUTPATIENT SURGICAL CAPACITY THROUGH THE CONSRUCTION OF THREE (3) AMBULATORY SURGERY CENTERS AND TO ACQUIRE NUMEROUS STATE-OF-THE-ART ROBOTIC SURGICAL SYSTEMS WHICH HAVE THE DEMONSTRATED BENEFITS OF IMPROVING QUALITY OUTCOMES THROUGH FASTER RECOVERY TIMES AND LOWERING COSTS. $70 MILLION TO BEGIN DEVELOPING AND/OR COMPLETE THE DEVELOPMENT OF FOUR (4) NEW MEDICAL OFFICE BUILDINGS LOCATED THROUGHOUT THE NORTHSIDE SYSTEM SERVICE AREA IN COBB COUNTY, GWINNETT COUNTY (2) AND HALL COUNTY. $35 MILLION TO UPGRADE EQUIPMENT AND ESTABLISH NEW COMMUNITY-BASED OUTPATIENT IMAGING CENTERS ACROSS THE NORTHSIDE SYSTEM PORTFOLIO. LAST BUT CERTIANLY NOT LEAST, NORTHSIDE INVESTED $83 MILLION IN CASH RESERVES TO FINALIZE TWO INPATIENT BED EXPANSION PROJECTS AT NORTHSIDE CHEROKEE AND FORSYTH AND TO MAKE SIGNIFICANT CONSTRUCTION PROGRESS ON THE NEW INPATIENT BED TOWER AT NORTHSIDE GWINNETT. IN FURTHERANCE OF ITS CHARITABLE MISSION AND TO MEET THE COMMUNITY'S TOP IDENTIFIED HEALTH NEEDS, NORTHSIDE HOSPITAL ENGAGES IN NUMEROUS OUTREACH AND COMMUNITY BENEFIT ACTIVITIES THROUGHOUT THE YEAR. THE CULMINATION OF THESE EFFORTS RESULTED IN NORTHSIDE HOSPITAL SERVING OVER 341,600 PERSONS, SPENDING OVER 155,700 STAFF HOURS, AND PROVIDING $33.37 MILLION IN NET COMMUNITY BENEFIT PROGRAM ACTIVITIES. THE HIGHEST DOLLAR IMPACT CATEGORIES (I.E., BENEFIT IN EXCESS OF $1 MILLION) INCLUDE 1) SUBSIDIZED HEALTH SERVICES, 2) HEALTH PROFESSIONS EDUCATION, 3) CASH AND IN-KIND DONATIONS, AND 4) COMMUNITY HEALTH IMPROVEMENT SERVICES. 1) THROUGH SUBSIDIZED HEALTH SERVICES, NORTHSIDE PROVIDED OVER $17.8 MILLION IN COMMUNITY BENEFIT. SUBSIDIZED HEALTH SERVICES ARE CLINICAL SERVICES PROVIDED DESPITE A FINANCIAL LOSS SO SIGNIFICANT THAT NEGATIVE MARGINS REMAIN AFTER REMOVING THE EFFECTS OF FINANCIAL ASSISTANCE, MEDICIAD SHORTFALLS AND BAD DEBT. A MAJORITY OF NORTHSIDE HOSPITAL'S SUBSIDIZED HEALTH SERVICES COMMUNITY BENEFIT WAS FROM THE LEVEL II TRAUMA CENTER LOCATED AT NORTHSIDE HOSPITAL GWINNETT. ED VOLUME AT NORTHSIDE HOSPITAL GWINNETT INCREASED 7% FROM FY2022 TO FY2023 WITH OVER 95,000 TOTAL ED VISITS IN FY2023 INCLUDING OVER 4,952 TOTAL TRAUMA VISITS. THE GROWTH IN ED VOLUME RESULTED IN A NET COMMUNITY BENEFIT IMPACT OF JUST OVER 3,074 LEVEL II TRAUMA VISITS. 2) HEALTH PROFESSIONS EDUCATION INCLUDES EDUCATIONAL PROGRAMS FOR PHYSICIANS, INTERNS, RESIDENTS, MEDICAL STUDENTS, NURSES AND NURSING STUDENTS, PASTORAL CARE FELLOWS AND INTERNS, AND OTHER HEALTH PROFESSIONALS WHEN THAT EDUCATION IS NECESSARY TO RETAIN STATE LICENSURE OR CERTIFICATION BY A BOARD IN THE INDIVIDUAL'S HEALTH PROFESSIONAL SPECIALTY. NORTHSIDE PROVIDED CONTINUING MEDICAL EDUCATION ("CME"), GRADUATE MEDICAL EDUCATION AND VARIOUS HEALTH PROFESSIONS EDUCATION FOR NURSING STUDENTS, PASTORAL STUDENTS, AND OTHER ALLIED HEALTH STUDENTS, TOTALING $7.6 MILLION IN NET COMMUNITY BENEFIT AND SERVING 4,708 STUDENTS. NORTHSIDE'S CME ACTIVITIES PROVIDE PHYSICIANS AND HEALTH CARE PROFESSIONALS WITH COORDINATED, BALANCED EDUCATIONAL OPPORTUNITIES THAT WILL HELP TO ADVANCE THEIR PROFESSIONAL LEARNING, INCREASE THEIR COMPETENCE IN PRACTICE AND IMPROVE THEIR PRACTICE PERFORMANCE. IN FY2023, 1,094 PHYSICIANS/MEDICAL STUDENTS RECEIVED CME ON TOPICS SUCH AS MEDICAL ETHICS, MATERNAL AND INFANT, ONCOLOGY, PRIMARY CARE, NEUROSCIENCES AND GERIATRIC MEDICINE. A SEPTEMBER 2022 ANALYSIS BY THE KAISER FAMILY FOUNDATION INDICATED THAT GEORGIA NEEDS NEARLY 700 PRIMARY CARE PHYSICIANS TO FILL CURRENT PRIMARY CARE HEALTH PROFESSIONAL SHORTAGE AREAS. TO HELP DEVELOP A FUTURE SUPPLY OF PRIMARY CARE PROFESSIONALS, NORTHSIDE HOSPITAL GWINNETT OFFERS THE FOLLOWING ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION ("ACGME") APPROVED POSTGRADUATE RESIDENCY AND FELLOWSHIP PROGRAMS: FAMILY MEDICINE RESIDENCY, INTERNAL MEDICINE RESIDENCY, TRANSITIONAL YEAR RESIDENCY, AND SPORTS MEDICINE FELLOWSHIP. IN FY2023 NORTHSIDE'S GME PROGRAM HAD 75 RESIDENTS ENROLLED IN ITS ACGME APPROVED PROGRAMS. LAST, NORTHSIDE'S CPE PROGRAM IS A GRADUATE-LEVEL PROFESSIONAL EDUCATION PROGRAM WHEREIN CLERGY INTEGRATE THEIR MASTER'S OR DOCTORAL LEVEL THEOLOGICAL EDUCATION AND MINISTRY EXPERIENCE WITH THE REAL CHALLENGES OF OFFERING PROFESSIONAL INTERFAITH SPIRITUAL AND PASTORAL CARE TO PERSONS IN CRISIS. IN FY2023, NORTHSIDE'S CPE PROGRAM EDUCATED 56 FUTURE SPIRITUAL COUNSELORS. 3) THROUGH CASH AND IN-KIND DONATIONS, NORTHSIDE HOSPITAL SUPPORTS COMMUNITY ORGANIZATIONS WHOSE MISSIONS COMPLEMENT THE HOSPITAL'S MISSION AND WHOSE INITIATIVES EITHER ALIGN WITH THE PRIORITIZED HEALTH NEEDS IDENTIFIED IN NORTHSIDE'S CURRENT COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") OR ADDRESS SOCIAL DETERMINANTS OF HEALTH ("SDOH") SUCH AS HOUSING/HOMELESSNESS, FOOD INSECURITY, EDUCATION, ETC. IN FY2023, NORTHSIDE PROVIDED $4.7 MILLION IN CASH AND IN-KIND DONATIONS TO 417 COMMUNITY ORGANIZATIONS. WHILE SOME OF THE RECIPIENT ORGANIZATIONS ARE WELL-KNOWN COMMUNITY GROUPS, SUCH AS THE AMERICAN CANCER SOCIETY AND THE AMERICAN HEART ASSOCIATION, NORTHSIDE ALSO SUPPORTED SMALLER, ORGANIZATIONS SUCH AS COMMUNITY ASSISTANCE CENTER ("CAC") AND SUMMIT COUNSELING CENTER. NORTHSIDE SELECTED COMMUNITY ASSISTANCE CENTER AS A FUNDING RECIPIENT BECAUSE IT ADDRESSES IMPORTANT SDOHS: HOUSING/HOMELESSNESS, FOOD INSECURITY, AND HELPING INDIVIDUALS FIND EMPLOYMENT. CAC IS COMMIMTTED TO STRENGHTHENING LIVES AND STABILIZING FAMILIES IN DUWNOODY AND SANDY SPRINGS AREA BY PREVENTING HOMELESSNESS, ALLEVIATING HUNGER AND WORKING WITH NEIGHBORS TO ACHIEVE GREATER SELF-SUFFICIENCY. ON AN ANNUAL BASIS, CAC SERVED OVER 6,500 INDIVIDUALS AND 2,500 HOUSEHOLDS. ANOTHER EXAMPLE OF A SELECTED FUNDS RECIPIENT IS THE SUMMIT COUNSELING CENTER. NORTHSIDE PROVIDED FINANCIAL SUPPORT TO SUMMIT COUNSELING CENTER BECAUSE IT ADDRESSES ONE OF NORTHSIDE'S PRIORITIZED HEALTH NEEDS: BEHAVIORAL HEALTH AND SUBSTANCE USE. SUMMIT COUNSELING CENTER OFFERS PROFESSIONAL COUNSELING, PSYCHOLOGICAL SERVICES, SCHOOL-BASED MENTAL HEALTH, AND COMMUNITY EDUCATION SERVICES UTILIZING AN INTEGRATED APPROACH TO CARE FOR THE WHOLE PERSON-BODY, MIND, SPIRIT AND COMMUNITY. THE SUMMIT COUNSELING CENTER ENVISIONS A COMMUNITY WHERE EVERY PERSON, WITHOUT EXCEPTION, HAS FULL ACCESS TO INTEGRATED BEHAVIORAL HEALTH SERVICES. IN PARTNERSHIP WITH LOCAL SCHOOLS, BUSINESSES, CHURCHES AND THE COMMUNITY, THE CENTER WILL MOVE THE MOUNTAINS OF STIGMA, ACCESSIBILITY, AFFORDABILITY AND GROWING NEED WHICH ARE THE REAL BARRIERS TO COMPREHENSIVE BEHAVIORAL HEALTH CARE SERVICES. 4) COMMUNITY HEALTH IMPROVEMENT SERVICES ARE ACTIVITIES OR PROGRAMS SUBSIDIZED BY NORTHSIDE HOSPITAL AND CARRIED OUT OR SUPPORTED FOR THE EXPRESS PURPOSE OF IMPROVING HEALTH. NORTHSIDE EMPLOYS A VARIETY OF COMMUNITY HEALTH IMPROVEMENT ACTIVITIES INCLUDING COMMUNITY HEALTH EDUCATION; COMMUNITY BASED CLINICAL SERVICES; HEALTH CARE SUPPORT SERVICES; AND SOCIAL AND ENVIRONMENTAL IMPROVEMENT ACTIVITIES. IN FY2023, NORTHSIDE PROVIDED OVER $2.01 MILLION IN COMMUNITY HEALTH IMPROVEMENT SERVICES ACROSS 81 DIFFERENT PROGRAMS THAT REACHED 323,946 PEOPLE. PART III, LINE 4A: PROGRAM SERVICE ACCOMPLISHMENTS (CONT'D) MUCH OF NORTHSIDE'S COMMUNITY HEALTH IMPROVEMENT ACTIVITIES INCLUDES COMMUNITY AND CORPORATE HEALTH SCREENINGS, COMMUNITY HEALTH EDUCATION EVENTS AND COMMUNITY-BASED CANCER SCREENINGS. HOWEVER, THERE ALSO ARE A COUPLE OF UNIQUE PROGRAMS THAT MAY APPEAR SMALLER IN TERMS OF OCCURRENCES BUT HAVE A MEANINGFUL IMPACT ON THE COMMUNITY'S DISPARATE POPULATION. ONE SUCH PROGRAM IS THE FINANCIAL ACCESS SURGERY PROGRAM OR "FASP". NORTHSIDE'S FASP WAS DESIGNED SPECIFICALLY TO ADDRESS AN UNMET COMMUNITY-BASED NEED FOR HIGH QUALITY, FINANCIALLY ACCESSIBLE, OUTPATIENT SURGICAL AND ENDOSCOPY SERVICES FOR THE UNINSURED OR UNDERINSURED POPULATION. MORE SPECIFICALLY, VARIOUS CHARITY ORGANIZATIONS AND FREE CLINICS SERVING THE METROPOLITAN ATLANTA AREA HAVE CONFIRMED DIFFICULTY SECURING ACCESS TO NEEDED OUTPATIENT SURGICAL SERVICES FOR THE POPULATIONS THEY SERVE. NORTHSIDE RECEIVED REFERRALS FROM 17 CHARITABLE ORGANIZATIONS, INCLUDING SAFETY NET CLINICS AND FEDERALLY QUALIFIED HEALTH CENTERS, FOR PATIENTS WHO WOULD NOT OTHERWISE BE ABLE TO AFFORD OR OBTAIN MEDICALLY NECESSARY OUTPATIENT SURGERY AND ENDOSCOPY SERVICES. PATIENTS ARE PRE-SCREENED BASED ON FINANCIAL STATUS AND MEDICAL NECESSITY, AMONG OTHER FACTORS. THE FASP COVERS THE ENTIRE SURGICAL EPISODE OF CARE INCLUDING PRE- AND POST-OPERATIVE SERVICES AND, AS NEEDED, RELATED SERVICES SUCH AS ANESTHESIA, RADIOLOGY, PHARMACY, AND LABORATORY. THE FASP BEGAN IN 2012 WITH ONE (1) LOCATION AND HAS GROWN TO FOUR (4) LOCATIONS BASED ON COMMUNITY DEMAND. THE FASP PROVIDED FREE OUTPATIENT SURGICAL AND ENDOSCOPY SERVICES TO OVER 500 FINANCIALLY INDIGENT PATIENTS WHOSE CONDITIONS WOULD HAVE GONE UNTREATED UNTIL THE CONDITION WORSENED LEAVING THE PATIENT NO CHOICE BUT TO SEEK CARE IN A LOCAL HOSPITAL'S EMERGENCY DEPARTMENT. IN FY2023 FASP SERVED 528 PERSONS. ANOTHER UNIQUE COMMUNITY HEALTH IMPROVEMENT PROGRAM IS NORTHSIDE'S IMAGING OUTREACH PROGRAM. THROUGH THIS PROGRAM, NORTHSIDE PROVIDES A COMPREHENSIVE RANGE OF IMAGING SERVICES TO LOW INCOME, UNINSURED OR UNDERINSURED PATIENTS. A DEDICATED IMAGING CHARITY COORDINATOR RECEIVES REFERRALS FROM COMMUNITY SAFETY NET CLINICS AND ASSISTS PATIENTS WITH COMPLETING NORTHSIDE'S FINANCIAL ASSISTANCE POLICY APPLICATION. APPROXIMATELY 727 INDIGENT AND CHARITY PATIENTS RECEIVED MUCH-NEEDED MEDICAL IMAGING THROUGH THIS IMPORTANT SAFETY-NET PROGRAM. IN ESSENCE, NORTHSIDE HAS ESTABLISHED A SUCCESSFUL MEDICAL HOME NETWORK MODEL OF CARE THAT IS DEDICATED TO SERVING THE COMMUNITY'S MOST VULNERABLE POPULATION. THESE ARE JUST A FEW EXAMPLES OF HOW NORTHSIDE HOSPITAL IS FULFILLING ITS CHARITABLE MISSION AND PROVIDING MEANINGFUL BENEFITS TO ITS COMMUNITY. FORM 990, PART VI, SECTION A, LINE 7A NORTHSIDE HEALTH SERVICES ELECTS ALL THE MEMBERS OF THE GOVERNING BODY FOR NORTHSIDE HOSPITAL, INC. FORM 990, PART VI, SECTION A, LINE 7B NORTHSIDE HEALTH SERVICES MUST APPROVE BYLAW REVISIONS AND REVISIONS OF THE ARTICLES OF INCORPORATION FOR NORTHSIDE HOSPITAL, INC. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS PREPARED BY AN OUTSIDE, INDEPENDENT ACCOUNTING FIRM USING DETAILED FINANCIAL STATEMENTS SUPPORTED BY A CONSOLIDATED AUDIT (ALSO PREPARED BY OUTSIDE, INDEPENDENT AUDITORS). NORTHSIDE FINANCIAL LEADERSHIP, INCLUDING THE SENIOR DIRECTOR OF CORPORATE FINANCE AND CFO, PERFORM A DETAILED REVIEW OF THE FORM 990 AND APPROVAL OF THE RETURN BEFORE IT IS FILED. ADDITIONALLY, OUTSIDE COUNSEL REVIEWS SEVERAL SECTIONS OF THE FORM AT NORTHSIDE'S REQUEST. FORM 990, PART VI, SECTION B, LINE 12C OFFICERS, DIRECTORS AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE AND SIGN A DISCLOSURE QUESTIONNAIRE ANNUALLY, IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY. NORTHSIDE'S LEGAL SERVICES DEPARTMENT REVIEWS CONTRACTS WITH OTHER CARE PROVIDERS, EDUCATIONAL INSTITUTIONS, MANUFACTURERS AND PAYORS TO DETERMINE WHETHER CONFLICTS OF INTEREST EXIST AND WHETHER THEY ARE IN COMPLIANCE WITH SPECIFIC LAWS AND REGULATIONS. FORM 990, PART VI, SECTION B, LINE 15 TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S CEO AND KEY EMPLOYEES, A COMPENSATION STUDY, INCLUDING PEER ORGANIZATIONS, IS COMPLETED BY AN INDEPENDENT COMPENSATION CONSULTANT. THIS INFORMATION IS SHARED WITH THE COMPENSATION COMMITTEE. INDEPENDENT MEMBERS OF THE COMPENSATION COMMITTEE DELIBERATE AND DETERMINE THE COMPENSATION OF THE CEO AND APPROVE THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES. RECORDS ARE RETAINED OF THESE DECISIONS. THE CEO'S FINAL WRITTEN EMPLOYMENT CONTRACT MUST BE APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 THE CORPORATE GOVERNANCE DOCUMENTS (SPECIFICALLY ALL ARTICLES OF INCORPORATION DOCUMENTS) ARE MADE AVAILABLE ON THE GEORGIA SECRETARY OF STATE WEBSITE. OUR CONFLICT OF INTEREST POLICY IS MADE AVAILABLE ON OUR INTRANET TO NORTHSIDE EMPLOYEES. OUR AUDITED FINANCIAL STATEMENTS AND OUR CONFLICT OF INTEREST POLICY ARE AVAILABLE IN ACCORDANCE WITH STATE REQUIREMENTS. WHEN AND IF APPROPRIATE REQUESTS ARE MADE BY THE PUBLIC, WE EVALUATE DISCLOSURE ON A CASE BY CASE BASIS. FORM 990, PART VI, LINE 16B IN LIEU OF ADOPTING A WRITTEN POLICY CONCERNING JOINT VENTURE ARRANGEMENTS, THE ORGANIZATION REQUIRES AND UNDERTAKES A RIGOROUS CASE-BY-CASE EVALUATION OF ITS PARTICIPATION IN ANY PROPOSED JOINT VENTURE ARRANGEMENT UNDER APPLICABLE TAX AND OTHER LAWS AND REGULATIONS. EACH PROPOSED JOINT VENTURE WITH A TAXABLE ENTITY IS REVIEWED UNDER APPLICABLE TAX LAWS, REGULATIONS, AND GUIDELINES BY OUTSIDE LEGAL COUNSEL AND ORGANIZATION PERSONNEL TO CONFIRM THAT THE JOINT VENTURE WOULD BE FORMED, OPERATED AND MANAGED IN A MANNER THAT FURTHERS THE COMMUNITY BENEFIT AND CHARITABLE PURPOSES OF THE ORGANIZATION. JOINT VENTURES WITH TAXABLE ENTITIES ARE REQUIRED TO BE STRUCTURED, INCLUDING THROUGH FINANCIAL AND GOVERNANCE PROVISIONS AND RESERVED POWERS, IN A MANNER TO SAFEGUARD THE ORGANIZATION'S EXEMPT STATUS AND ENSURE THAT THE ORGANIZATION CONTROLS ALL ASPECTS OF THE JOINT VENTURE RELATED TO ITS EXEMPT PURPOSE. FORM 990, PART VII, SECTION B: TO SERVE THE PATIENTS WITHIN NORTHSIDE'S GEOGRAPHIC REGION, NORTHSIDE ENTERED INTO A PROFESSIONAL SERVICES AGREEMENT ("PSA") BASED UPON PERSONALLY PERFORMED AND MODIFIER ADJUSTED PRODUCTIVITY WITH AGA, LLC TO ENSURE GASTROENTEROLOGY ("GI") SERVICES ARE PROVIDED TO ALL PATIENTS WITHIN THE COMMUNITY, REGARDLESS OF THE PATIENTS' ABILITY TO PAY. AS SUCH, THIS ARRANGEMENT ALLOWS NORTHSIDE TO ESTABLISH CENTERS OF EXCELLENCE IN GI SERVICES, ESPECIALLY RELATED TO ENDOSCOPIC ULTRASOUND AND ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY. GI SERVICES ALSO HAVE A SIGNIFICANT TIE-IN TO ONCOLOGY SERVICES FOR WHICH NORTHSIDE IS A LEADER IN THE ATLANTA SERVICE AREA IN TERMS OF DIAGNOSIS AND TREATMENT. AGA, LLC HAS A LARGE COMPLEMENT OF CLINICIANS THAT PROVIDE GI SERVICES INCLUDING GI ONCOLOGY. IN ACCORDANCE WITH THE PSA, AGA, LLC REMAINS A PRIVATELY HELD ORGANIZATION WITHOUT OWNERSHIP OR MANAGEMENT BY NORTHSIDE. AGA, LLC MAINTAINS RESPONSIBILITY FOR ALL EXPENSES TYPICALLY FOUND IN A GI CLINICIANS' PRACTICE (E.G., STAFF, BILLING, MEDICAL SUPPLIES, MEDICAL RECORDS, OCCUPANCY, MALPRACTICE INSURANCE, ETC.). UNDER THE PSA, NORTHSIDE PAYS AGA A FAIR MARKET VALUE RATE BASED ON PERSONALLY PERFORMED AND MODIFIER ADJUSTED WRVUS. AGA, LLC PROVIDES APPROXIMATELY 184 CLINICIANS TO ENSURE GI SERVICES AT NORTHSIDE'S FACILITIES AND THROUGHOUT THE COMMUNITIES SERVED BY NORTHSIDE. THE COMPENSATION REFLECTED ON FORM 990, PART VII, SECTION B, COLUMN (C), REPRESENTS PROFESSIONAL SERVICES UNDER THE PSA TO INCLUDE RELATED COMPENSATION AND BENEFITS. FORM 990, PART VII, SECTION B: TO SERVE THE PATIENTS WITHIN NORTHSIDE'S GEOGRAPHIC REGION, NORTHSIDE ENTERED INTO A PROFESSIONAL SERVICES AGREEMENT ("PSA") BASED UPON PERSONALLY PERFORMED AND MODIFIER ADJUSTED PRODUCTIVITY WITH ATLANTA CANCER CARE ("ACC") TO ENSURE ONCOLOGY AND HEMATOLOGY SERVICES ARE PROVIDED TO ALL PATIENTS WITHIN THE COMMUNITY REGARDLESS OF THE PATIENTS' ABILITY TO PAY. NORTHSIDE HAS PROVIDED A BROAD RANGE OF CANCER CARE SERVICES THROUGH ITS CANCER CARE PROGRAM AT THE NORTHSIDE HOSPITAL CANCER INSTITUTE ("NHCI"). THE NHCI, WHICH IS RECOGNIZED NATIONALLY AS A LEADER IN ONCOLOGY DIAGNOSIS, TREATMENT AND RESEARCH, OFFERS CLINICAL EXCELLENCE ON PAR WITH ACADEMIC-BASED PROGRAMS ALONG WITH THE PERSONALIZED AND ATTENTIVE CARE TYPICALLY ASSOCIATED WITH A COMMUNITY HOSPITAL. NORTHSIDE HAS COMMITTED TO BECOMING A REGIONAL AND NATIONAL LEADER THAT REDEFINES CANCER CARE, WHICH IN PART REQUIRES THE EXPANSION OF ITS GEOGRAPHIC FOOTPRINT THROUGH DEVELOPMENT OF AN AFFILIATION WITH ADDITIONAL LOCATIONS, AS WELL AS HAVING AN INTEGRATED CANCER CARE PROGRAM THAT FACILITATES COLLABORATION BETWEEN NORTHSIDE AND CLINICIANS SPECIALIZING IN ONCOLOGY SERVICES. ACC HAS A LARGE COMPLEMENT OF CLINICIANS TO ASSIST NORTHSIDE IN DEVELOPING AN OUTPATIENT ONCOLOGY SERVICES PROGRAM, SPECIALIZING IN MEDICAL ONCOLOGY AND HEMATOLOGY AND THE PROVISION OF INFUSION THERAPY SERVICES AND MEDICAL AND CLINICAL RESEARCH SERVICES. IN ACCORDANCE WITH THE PSA, ACC REMAINS A PRIVATELY HELD ORGANIZATION WITHOUT OWNERSHIP BY NORTHSIDE. ACC MAINTAINS RESPONSIBILITY FOR PROVIDING ALL ADMINISTRATIVE OPERATIONS OF THE PRACTICE (E.G., STAFF BENEFITS, MALPRACTICE INSURANCE, ETC.). NORTHSIDE MAKES PAYMENTS TO ACC AT FAIR MARKET VALUE RATES FOR 1) PERSONALLY PERFORMED AND MODIFIER ADJUSTED PROFESSIONAL SERVICES 2) MANAGEMENT OVERSIGHT RESPONSIBILITIES AND 3) BILLING ARRANGEMENTS. ACC EMPLOYS APPROXIMATELY 39 CLINICIANS AND 191 STAFF TO MAINTAIN ONCOLOGY, HEMATOLOGY, MANAGEMENT AND BILLING SERVICES AT NORTHSIDE'S FACILITIES AND THROUGHOUT THE COMMUNITIES SERVED BY NORTHSIDE. FORM 990, PART IX, LINE 11G OTHER FEES: PROGRAM SERVICE EXPENSES 623,424,699. MANAGEMENT AND GENERAL EXPENSES 109,746,800. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 733,171,499. FORM 990, PART XI, LINE 9: INCOME FROM JOINT VENTURES NOT ON BOOKS -9,889,632. OTHER CHANGES IN NET ASSETS 301. CHANGE IN PENSION 115,440,807. EQUITY TRANSFER -35,927,800. ADOPTION OF NEW LEASE GUIDANCE 8,380,088. 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