2023-08-15T13:51:06-05:00 2022-09-30 621517792 PYA P C 2220 SUTHERLAND AVE KNOXVILLE TN 37919 990 2021-10-01 581954432 NORTHSIDE HOSPITAL INC NORT 4048518000 1000 JOHNSON FERRY ROAD NE ATLANTA GA 303421611 SHANNON A BANNA VP FINANCE / CFO 4048518000 2023-08-15 1 SHANNON BANNA 999009999 DEBORAH O ERNSBERGER P00364912 8656730844 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z ROBERT T QUATTROCCHI 1000 JOHNSON FERRY ROAD NE ATLANTA GA 303421611 6160491167 0 X WWW.NORTHSIDE.COM X 1991 GA TO BE A CENTER OF EXCELLENCE IN PROVIDING HIGH-QUALITY HEALTH CARE. 17 9 30124 716 22654965 2273968 137894469 23595029 5663482589 5963223334 29460447 26859042 71134929 146813762 5901972434 6160491167 3539749 3415425 0 0 2331155760 2771439748 0 0 0 3186048711 3251794277 5520744220 6026649450 381228214 133841717 4670786128 4492033881 1696035748 1302554809 2974750380 3189479072 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 4901152375 3415425 5844661357 AS NOTED IN ITS MISSION, NORTHSIDE IS DEDICATED TO MAINTAINING OUR POSITION AS REGIONAL LEADERS IN SELECT MEDICAL SPECIALTIES. THESE SELECT SPECIALTIES, OR PROGRAM SERVICES, INCLUDE EMERGENCY SERVICES, ONCOLOGY SERVICES, RADIOLOGY SERVICES, SURGICAL SERVICES, AND WOMEN'S SERVICES. IN FURTHERANCE OF ITS CHARITABLE MISSION, NORTHSIDE INVESTED IN THE CONTINUED GROWTH, EXPANSION, AND INCREASED ACCESS TO THESE VITAL PROGRAM SERVICES.SEE SCHEDULE O FOR CONTINUATION 4901152375 1 1 0 1 0 0 0 0 0 1 1 0 0 0 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 1759 0 1 30124 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 BARBARA PARE' CHAIR 1.00 1.00 X 0 0 0 DALE M BEARMAN MD VICE CHAIR 1.00 1.00 X 0 0 0 ANTHONY J SALVATORE TREASURER 1.00 1.00 X 0 0 0 MARK J SWEENEY SECRETARY 1.00 1.00 X 0 0 0 WAYNE L AMBROZE JR MD BOARD MEMBER 40.00 X 457230 0 24872 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 1.00 X 0 0 0 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 1.00 X 493537 0 20568 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 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 4966725 0 40837 SHANNON BANNA VP/CFO NSH, INC./ASST. TREASURER 40.00 1.00 X 860258 0 13976 JORGE J HERNANDEZ VICE PRESIDENT/ASST. SECRETARY 40.00 1.00 X 907438 0 27700 JANIS DUBOW VICE PRESIDENT 40.00 X 622137 0 16418 WILLIAM HAYES CEO, NORTHSIDE HOSPITAL-CHEROKEE 40.00 X 803168 0 36825 DEBORAH MITCHAM BILBRO CEO, NORTHSIDE HOSPITAL GWINNETT 40.00 X 1002357 0 23008 ROBERT PUTNAM VICE PRESIDENT 40.00 X 997304 0 25983 TINA WAKIM VICE PRESIDENT/COO 40.00 X 1035866 0 26293 CHARLES DECOOK MD ORTHOPEDIC SURGEON 40.00 X 1861463 0 40609 RICHARD HARVEY MD CARDIOTHORACIC SURGEON 40.00 X 1239060 0 17053 KENNETH KRESS MD ORTHOPEDIC SURGEON 40.00 X 1288960 0 27200 DAVID A LANGFORD MD THORACIC SURGEON 40.00 X 1276056 0 25462 KEITH OSBORN MD SPINE SURGEON 40.00 X 1371062 0 25308 19182621 0 392112 3245 0 1 0 GEORGIA CANCER SPECIALISTS I PC 1835 SAVOY DRIVE STE 300 ATLANTA GA 30342 SEE SCHEDULE O 37765492 BAKER & HOSTETLER LLP 1170 PEACHTREE STREET NE STE 2400 ATLANTA GA 30309 LEGAL SERVICES 33045946 ATLANTA GASTROENTEROLOGY ASSOCIATES 550 PEACHTREE ST STE 1620 ATLANTA GA 30308 SEE SCHEDULE O 28837525 ATLANTA CANCER CARE PC 1100 JOHNSON FERRY ROAD STE 150 SANDY SPRINGS GA 30342 SEE SCHEDULE O 24643181 MORRISON HEALTHCARE INC 400 NORTHRIDGE RD 600 ATLANTA GA 30350 FOOD SERVICE 17737653 570 2105228 19075886 2413915 23595029 NET PATIENT REVENUE 621990 5911317424 5674338470 12666185 224312769 RENTAL INCOME 531120 30004507 30004507 CAFETERIA & VENDING 722514 7458997 7458997 PARKING REVENUE 812930 6675703 6675703 BILLING REVENUE 561000 6234527 3493398 2741129 1532176 1532176 5963223334 26859042 26859042 MISCELLANEOUS 900003 134800131 130832380 3967751 PASSTHROUGH INVESTMENT 621300 12013631 9486000 2527631 146813762 6160491167 5844661357 22654965 269579816 X 3406255 3406255 9170 9170 12674733 10204679 2470054 2226568339 1792654320 433914019 126132204 101551538 24580666 277720727 223598464 54122263 128343745 103332094 25011651 8653533 8653533 37959872 37959872 1248603 1248603 3261335 3261335 663961199 564851874 99109325 12602511 5434298 7168213 99972003 43108686 56863317 65335802 28173293 37162509 161270008 69540850 91729158 2754159 1187614 1566545 1785881 770085 1015796 872660 872660 237404079 139724969 97679110 81671634 35217428 46454206 SUPPLIES 1413891146 1409317202 4573944 BAD DEBT EXPENSE 285564858 285564858 MINOR EQUIPMENT PURCHAS 25526778 11007340 14519438 RECRUITMENT 8401226 3622672 4778554 139656990 60221153 79435837 6026649450 4901152375 1125497075 0 77106 76953 911966179 571731697 506694849 615088279 0 626381 93678248 108384033 103740694 87972154 4078313084 2069278589 1875171270 2009034495 778943178 658242215 321205534 317282941 79309070 123594733 4670786128 4492033881 837731667 701537139 3622791 4025817 67203542 5601322 787477748 591390531 1696035748 1302554809 X 2974750380 3182854988 0 6624084 2974750380 3189479072 4670786128 4492033881 X 133841717 -143881228 224768203 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 534416 534416 0 PART II-B, LINE 1: NORTHSIDE HOSPITAL, INC. 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 HOSPITAL, INC. 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. 19297796 4285036 -279016 3417160 19886656 10609127 14559204 638990 6509525 19297796 10973195 786795 171961 1322824 10609127 10180369 1829101 286184 1322459 10973195 9083135 2049190 185144 1137100 10180369 0.34784 0.65216 0 1 1 438450540 438450540 2067508058 963493536 1104014522 1373360558 1105785053 267575505 198993928 198993928 2009034495 RESERVE FOR MALPRACTICE 399392731 PERIODIC CAPITAL FINANCING LIABILITY -1021867 REAL ESTATE FINANCING LIABILITY 86573942 RENT/LEASE RELATED LIABILITIES 63209480 OTHER LIABILITIES 43236245 CURRENT PORTION CAPITAL LEASE -6765719 CURRENT PORTION OF LONG TERM DEBT 12367041 CURRENT PORTION OF NOTES PAYABLE -5601322 591390531 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, 2022 AND 2021, 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 325250101 0 325250101 0.05400 462014165 370538231 91475934 0.01520 787264266 370538231 416726035 0.06920 55 232442 2005561 236205 1769356 0.00030 52 3107 17614583 10599763 7014820 0.00120 2 1507 42529932 36414681 6115251 0.00100 1 1116 494794 0 494794 0.00010 6 135 3246916 5996 3240920 0.00050 116 238307 65891786 47256645 18635141 0.00310 116 238307 853156052 417794876 435361176 0.07230 2 51243 51243 0.00000 1 10081 10081 0.00000 4 251702 251702 0.00000 1 2479 2479 0.00000 8 315505 315505 0.00000 1 84333656 537722134 795689038 -257966904 X 1 0 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. AS SET FORTH IN THE FY2022-FY2024 CHNA, NORTHSIDE IS UNABLE TO ADDRESS EACH IDENTIFIED COMMUNITY NEED DUE TO AVAILABILITY OF RESOURCES, MAGNITUDE/SEVERITY OF THE ISSUES IDENTIFIED, AND EXISTING RESOURCES ALREADY AVAILABLE TO MEET SUCH NEEDS. THE NEEDS THAT WILL NOT BE ADDRESSED DIRECTLY FOLLOW: (1) HEALTHY LIFESTYLE BEHAVIORS, (2) RESPIRATORY DISEASE AND SMOKING, AND (3) HIV/AIDSA DETAILED ANALYSIS OF WHY EACH OF THESE NEEDS WILL NOT BE ADDRESSED IS INCLUDED IN NORTHSIDE'S 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 350 1 - NORTHSIDE HOSPITAL CANCER INSTITUTE 308 COLISEUM DRIVE STE 102 MACON GA 31217 PHYSICIAN SERVICES/ OUTPATIENT SERVICES 2 - NHCI SUBURBAN HEMATOLOGY-ONCOLOGY ASSOCIAT 3855 PLEASANT HILL ROAD STE 480 DULUTH GA 30096 PHYSICIAN SERVICES 3 - NHCI SUBURBAN HEMATOLOGY-ONCOLOGY ASSOCIAT 1700 TREE LANE STE 490 SNELLVILLE GA 30078 PHYSICIAN SERVICES 4 - NORTHSIDE HOSPITAL CANCER INSTITUTE 308 DEEP SOUTH FARM ROAD STE 200 BLAIRSVILLE GA 30512 PHYSICIAN SERVICES/ OUTPATIENT SERVICES 5 - NORTHSIDE HOSPITAL CANCER INSTITUTE 101 RIVERSTONE VISTA STE 102 BLUE RIDGE GA 30513 PHYSICIAN SERVICES/ OUTPATIENT SERVICES 6 - NORTHSIDE HOSPITAL CANCER INSTITUTE 747 SOUTH 8TH STREET STE C GRIFFIN GA 30224 PHYSICIAN SERVICES/ OUTPATIENT SERVICES 7 - CARDIOVASCULAR GROUP GRAYSON 1132 ATHENS HIGHWAY STE 207 GRAYSON GA 30017 PHYSICIAN SERVICES 8 - GEORGIA UROLOGY 3790 PLEASANT HILL ROAD STE 150 DULUTH GA 30096 PHYSICIAN SERVICES 9 - NORTHSIDE HOSPITAL CANCER INSTITUTE 820 N COBB STREET MILLEDGEVILLE GA 31061 PHYSICIAN SERVICES/ OUTPATIENT SERVICES 10 - NORTHSIDE HOSPITAL CANCER INSTITUTE 1000 COWLES CLINIC WAY GREENSBORO GA 30642 PHYSICIAN SERVICES/ OUTPATIENT SERVICES 11 - LAUREATE MEDICAL GROUP 6135 BARFIELD ROAD STE 160 ATLANTA GA 30328 PHYSICIAN SERVICES 12 - MEDICAL ASSOCIATES OF NORTH GEORGIA 320 HOSPITAL ROAD STE A CANTON GA 30114 PHYSICIAN SERVICES 13 - LAUREATE MEDICAL GROUP 6135 BARFIELD ROAD STE 200 ATLANTA GA 30328 PHYSICIAN SERVICES 14 - NORTHSIDE HOSPITAL CANCER INSTITUTE 214 PERRY HIGHWAY HAWKINSVILLE GA 31036 PHYSICIAN SERVICES/ OUTPATIENT SERVICES 15 - NORTHSIDE MIDTOWN BREAST CARE IMAGING 1110 WEST PEACHTREE STREET STE 850 ATLANTA GA 30309 PHYSICIAN SERVICES 16 - ARTHRITIS AND TOTAL JOINT SPECIALIST 2000 HOWARD FARM DRIVE STE 200 CUMMING GA 30041 PHYSICIAN SERVICES 17 - NORTHEAST GEORGIA DIAGNOSTIC CLINIC 1240 JESSE JEWELL PKWY BLDG B UNIT 500 GAINESVILLE GA 30501 PHYSICIAN SERVICES 18 - NHCI RADIATION ONCOLOGY - MACON 308 COLISEUM DRIVE STE 100 MACON GA 31217 RADIATION THERAPY CENTER AND PHYSICIAN SERVICES 19 - NORTHSIDE VASCULAR SURGERY 4800 OLDE TOWNE PARKWAY STE 420 MARIETTA GA 30068 PHYSICIAN SERVICES 20 - 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NORTH ATLANTA MEDICAL ASSOC - STONE 1505 LILBURN STONE MOUNTAIN RD STE 100 STONE MOUNTAIN GA 30087 PHYSICIAN SERVICES 200 - LANIER FAMILY PRACTICE 1080 SANDERS ROAD STE 100 CUMMING GA 30041 PHYSICIAN SERVICES 201 - NORTH ATLANTA PULMONARY AND SLEEP 993C JOHNSON FERRY ROAD STE 300 ATLANTA GA 30342 PHYSICIAN SERVICES 202 - GEORGIA COLON & RECTAL ASSOCIATES-DE 2801 N DECATUR ROAD STE 120 DECATUR GA 30033 PHYSICIAN SERVICES 203 - NORTHSIDE CHEROKEE SURGICAL ASSOCIAT 900 TOWNE LAKE PARKWAY STE 412 WOODSTOCK GA 30189 PHYSICIAN SERVICES 204 - NS PRIMARY CARE ASSOCIATES - BRIDGEM 780 CANTON ROAD STE 405 MARIETTA GA 30060 PHYSICIAN SERVICES 205 - ARTHRITIS AND TOTAL JOINT SPECIALIST 1255 FRIENDSHIP ROAD STE 200 BRASELTON GA 30517 PHYSICIAN SERVICES 206 - GEORGIA COLON & RECTAL ASSOCIATES-MI 1110 WEST PEACHTREE STREET STE 1030 ATLANTA GA 30309 PHYSICIAN SERVICES 207 - ARTHRITIS AND TOTAL JOINT SPECIALIST 960 WOODSTOCK PARKWAY STE 200 WOODSTOCK GA 30188 PHYSICIAN SERVICES 208 - SUGARLOAF PRIMARY CARE 1805 HERRINGTON ROAD BUILDING 2 LAWRENCEVILLE GA 30043 PHYSICIAN SERVICES 209 - ATLANTA CARDIAC AND THORACIC SURGICA 1110 W PEACHTREE ST NW STE 1010 ATLANTA GA 30309 PHYSICIAN SERVICES 210 - CHEROKEE LUNG AND SLEEP - KENNESAW 6110 PINE MOUNTAIN ROAD STE 102 KENNESAW GA 30152 PHYSICIAN SERVICES 211 - NORTHSIDE HOSPITAL CARDIOVASCULAR IN 684 SIXES ROAD STE 230 HOLLY SPRINGS GA 30115 PHYSICIAN SERVICES 212 - NORTHSIDE HOSPITAL CARDIOVASCULAR IN 3855 PLEASANT HILL ROAD STE 270B DULUTH GA 30096 PHYSICIAN SERVICES 213 - ATLANTA GYN ONCOLOGY -MARIETTA 780 CANTON ROAD STE 320A MARIETTA GA 30060 PHYSICIAN SERVICES 214 - DULUTH FAMILY AND SPORTS MEDICINE 3855 PLEASANT HILL ROAD STE 100 DULUTH GA 30096 PHYSICIAN SERVICES 215 - EAST COBB FAMILY MEDICINE 1121 JOHNSON FERRY ROAD STE 100 MARIETTA GA 30068 PHYSICIAN SERVICES 216 - NORTHSIDE PRIMARY CARE ASSOCIATES 4450 CALIBRE CROSSING STE 1224 ACWORTH GA 30101 PHYSICIAN SERVICES 217 - NORTHSIDE JOHNS CREEK PRIMARY CARE 4385 JOHNS CREEK PKWY SUWANEE GA 30024 PHYSICIAN SERVICES 218 - NORTHSIDE CARDIOVASCULAR GROUP 2108 TERON TRACE STE 100E DACULA GA 30019 PHYSICIAN SERVICES 219 - SOVEREIGN REHABILITATION LAWRENCEVILLE 575 PROFESSIONAL DR STE 370 LAWRENCEVILLE GA 30045 PHYSICIAN SERVICES 220 - NORTHSIDE HOSPITAL ORTHOPEDIC INSTIT 11685 ALPHARETTA HWY STE 170 ROSWELL GA 30076 PHYSICIAN SERVICES 221 - NORTHSIDE THORACIC SURGERY - MIDTOWN 1110 WEST PEACHTREE STREET STE 1010 ATLANTA GA 30309 PHYSICIAN SERVICES 222 - NORTHSIDE HOSPITAL ORTHOPEDIC INSTIT 3280 PEACHTREE ROAD NE STE 160 ATLANTA GA 30305 PHYSICIAN SERVICES 223 - SOVEREIGN REHABILITATION ATLANTA 5555 PEACHTREE DUNWOODY RD STE 225 ATLANTA GA 30342 PHYSICIAN SERVICES 224 - SOVEREIGN REHABILITATION HAPEVILLE 800 VIRGINIA AVENUE STE 200 HAPEVILLE GA 30354 PHYSICIAN SERVICES 225 - LAUREATE MEDICAL GROUP 470 NORTHSIDE CHEROKEE BLVD STE 490 CANTON GA 30115 PHYSICIAN SERVICES 226 - SOVEREIGN REHABILITATION DECATURE 495 WINN WAY STE 150 DECATUR GA 30030 PHYSICIAN SERVICES 227 - SOVEREIGN REHABILITATION STOCKBRIDGE 125 MEDICAL BOULEVARD STOCKBRIDGE GA 30281 PHYSICIAN SERVICES 228 - SURGICAL SPECIALISTS OF ATLANTA 1110 WEST PEACHTREE STREET STE 1050 ATLANTA GA 30309 PHYSICIAN SERVICES 229 - MEDICAL ASSOCIATES OF NORTH GEORGIA ELIJ 433 HIGHLAND PARKWAY STE 101 EAST ELIJAY GA 30540 PHYSICIAN SERVICES 230 - SOVEREIGN REHABILITATION CHAMBLEE 5553 PEACHTREE ROAD STE 105 CHAMBLEE GA 30341 PHYSICIAN SERVICES 231 - NORTHSIDE DACULA PRIMARY CARE 720 DACULA ROAD STE 2B DACULA GA 30019 PHYSICIAN SERVICES 232 - GWINNETT PHYSICIAN GROUP CONCUSSION 3855 PLEASANT HILL ROAD STE 130 DULUTH GA 30096 PHYSICIAN SERVICES 233 - NORTHSIDE CHEROKEE SURGICAL ASSOCIATES - 4450 CALIBRE CROSSING STES 1106 1110 ACWORTH GA 30101 PHYSICIAN SERVICES 234 - SOVEREIGN REHABILITATION SUWANEE 1220 SATELLITE BOULEVARD SUWANEE GA 30024 PHYSICIAN SERVICES 235 - HEALTH AND WELLNESS CENTER 100 MEDICAL CENTER BOULEVARD LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 236 - NORTHSIDE URGENT CARE 7386 FRIENDSHIP SPRINGS BOULEVARD STE 125 FLOWERY BRANCH GA 30542 PHYSICIAN SERVICES 237 - INTERNAL MEDICINE PRACTICE OF NORTHS 10745 WESTSIDE WAY STE 125 150 ALPHARETTA GA 30009 PHYSICIAN SERVICES 238 - ROSWELL URGENT CARE CENTER 660 WEST CROSSVILLE ROAD STE 110 ROSWELL GA 30075 PHYSICIAN SERVICES 239 - MASON PRIMARY CARE 3500 MCCLURE BRIDGE ROAD DULUTH GA 30096 PHYSICIAN SERVICES 240 - NORTHSIDE HOSPITAL ORTHOPEDIC INSTIT 2000 HOWARD FARM DRIVE STE 300 CUMMING GA 30041 PHYSICIAN SERVICES 241 - NORTHSIDE PULMONARY AND SLEEP MEDICI 4700 NELSON BROGDON BLVD NE STE 125A BUFORD GA 30019 PHYSICIAN SERVICES 242 - GWINNETT PHYSICIANS GROUP OBGYN 1942 ATKINSON ROAD STE 100-400 LAWRENCEVILLE GA 30043 PHYSICIAN SERVICES 243 - NORTHSIDE ORTHOPEDIC SPECIALISTS 2220 WISTERIA DRIVE SW STE 202 SNELLVILLE GA 30078 PHYSICIAN SERVICES 244 - CARDIOVASCULAR GROUP SNELLVILLE 1608 TREE LANE STE C SNELLVILLE GA 30078 PHYSICIAN SERVICES 245 - MELANOMA AND SARCOMA SPECIALISTS OF GEORGI 980 JOHNSON FERRY ROAD STE 940 ATLANTA GA 30342 PHYSICIAN SERVICES 246 - ADULT PRIMARY CARE 575 PROFESSIONAL DR STE 510 520 550 LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 247 - GWINNETT EAR NOSE AND THROAT 3855 PLEASANT HILL ROAD STE 280 DULUTH GA 30096 PHYSICIAN SERVICES 248 - GEORGIA COLON & RECTAL ASSOCIATES-AL 3400 OLD MILTON PKWY BLDG A STE 440 ALPHARETTA GA 30005 PHYSICIAN SERVICES 249 - NORTHSIDE THORACIC SURGERY 1270 FRIENDSHIP ROAD STE 100J BRASELTON GA 30517 PHYSICIAN SERVICES 250 - CUMMING FAMILY MEDICINE 765 LENIER 400 PKWY STE 200 CUMMING GA 30040 PHYSICIAN SERVICES 251 - GWINNETT EXTENDED CARE CENTER 650 PROFESSIONAL DRIVE LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 252 - NORTHSIDE HEART GRAYSON 1132 ATHENS HIGHWAY STE 207 GRAYSON GA 30017 PHYSICIAN SERVICES 253 - GEORGIA ORTHOPEDIC SPECIALISTS 460 NORTHSIDE CHEROKEE BLVD STE 430 CANTON GA 30115 PHYSICIAN SERVICES 254 - ACADEMIC INTERNAL MED - STAFF 665 DULUTH HIGHWAY STE 401 LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 255 - ADVANCED NEUROSURGERY ASSOCIATES INC 3855 PLEASANT HILL ROAD STE 270A DULUTH GA 30096 PHYSICIAN SERVICES 256 - ADVANCED NEUROSURGERY ASSOCIATES INC 631 PROFESSIONAL DRIVE STE 360 LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 257 - ALPHARETTA FOOT AND ANKLE SPECIALIST 3400 OLD MILTON PKWY BLDG A STE 50 ALPHARETTA GA 30005 PHYSICIAN SERVICES 258 - ANKLE AND FOOT CENTERS OF NORTH GEOR 81 NORTHSIDE DAWSON DRIVE STE 204 DAWSONVILLE GA 30534 PHYSICIAN SERVICES 259 - ARTHRITIS AND TOTAL JOINT SPECIALIST 4800 OLDE TOWNE PARKWAY STE 430A MARIETTA GA 30068 PHYSICIAN SERVICES 260 - ARTHRITIS AND TOTAL JOINT SPECIALIST 5670 PEACHTREE DUNWOODY RD STE 1230 ATLANTA GA 30342 PHYSICIAN SERVICES 261 - NORTHEAST GEORGIA DIAGNOSTIC CLINIC 1485 JESSE JEWELL PKWY NE STE 330 GAINESVILLE GA 30501 PHYSICIAN SERVICES 262 - ARTHRITIS AND TOTAL JOINT SPECIALIST 2000 HOWARD FARM DRIVE STE T110 CUMMING GA 30041 PHYSICIAN SERVICES 263 - ATLANTA CARDIAC AND THORACIC SURGICA 780 CANTON ROAD STE 320C MARIETTA GA 30060 PHYSICIAN SERVICES 264 - ATLANTA CARDIAC AND THORACIC SURGICA 308 DEEP SOUTH FARM ROAD STE 200 BLAIRSVILLE GA 30512 PHYSICIAN SERVICES 265 - ATLANTA CARDIAC AND THORACIC SURGICA 460 NORTHSIDE CHEROKEE BLVD STE 140 CANTON GA 30115 PHYSICIAN SERVICES 266 - ATLANTA CARDIAC AND THORACIC SURGICA 980 JOHNSON FERRY ROAD STE 800 ATLANTA GA 30342 PHYSICIAN SERVICES 267 - ATLANTA COLON & RECTAL SURGERY-EAST 780 CANTON ROAD STE 315 MARIETTA GA 30060 PHYSICIAN SERVICES 268 - ATLANTA COLON AND RECTAL SURGERY 1505 NORTHSIDE BOULEVARD STE 1900 CUMMING GA 30041 PHYSICIAN SERVICES 269 - ATLANTA GYNECOLOGIC ONCOLOGY 980 JOHNSON FERRY ROAD STE 900 ATLANTA GA 30342 PHYSICIAN SERVICES 270 - ATLANTA GYNECOLOGIC ONCOLOGY 470 NORTHSIDE CHEROKEE BLVD STE 475 CANTON GA 30115 PHYSICIAN SERVICES 271 - BARIATRIC INNOVATIONS OF ATLANTA 6135 BARFIELD ROAD STE 150 ATLANTA GA 30328 PHYSICIAN SERVICES 272 - CARDIOVASCULAR GROUP BUFORD 535 JESSE JEWELL PARKWAY STE C GAINESVILLE GA 30501 PHYSICIAN SERVICES 273 - CARDIOVASCULAR GROUP LAWRENCEVILLE 755 WALTHER ROAD LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 274 - CHATTAHOOCHEE SURGICAL GROUP 81 NORTHSIDE DAWSON DRIVE STE 305D DAWSONVILLE GA 30534 PHYSICIAN SERVICES 275 - CHATTAHOOCHEE SURGICAL GROUP 980 SANDERS ROAD STE 100 CUMMING GA 30042 PHYSICIAN SERVICES 276 - CHATTAHOOCHEE SURGICAL GROUP 4700 NELSON BROGDON BLVD NE STE 125B BUFORD GA 30019 PHYSICIAN SERVICES 277 - CHATTAHOOCHEE SURGICAL GROUP 70 MOUNTAIN DRIVE DAHLONEGA GA 30533 PHYSICIAN SERVICES 278 - GENERAL SURGEONS OF GWINNETT 3890 JOHNS CREEK PARKWAY STE 240D SUWANEE GA 30024 PHYSICIAN SERVICES 279 - GENERAL SURGEONS OF GWINNETT 631 PROFESSIONAL DRIVE STE 470 LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 280 - GEORGIA GYNECOLOGIC ONCOLOGY 771 OLD NORCROSS ROAD STE 165 LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 281 - GWINNETT INTERNAL MEDICINE ASSOCIATE 601 OLD NORCROSS ROAD STE A LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 282 - GYN SURGICAL SPECIALISTS 900 TOWNE LAKE PARKWAY STE 302 WOODSTOCK GA 30189 PHYSICIAN SERVICES 283 - GYN SURGICAL SPECIALISTS 980 JOHNSON FERRY ROAD STE 910 ATLANTA GA 30342 PHYSICIAN SERVICES 284 - HEALTH AND WELLNESS CENTER DULUTH 3620 HOWELL FERRY ROAD DULUTH GA 30096 PHYSICIAN SERVICES 285 - LAUREATE MEDICAL GROUP 6135 BARFIELD ROAD STE 130B ATLANTA GA 30328 PHYSICIAN SERVICES 286 - LAUREATE MEDICAL GROUP 6600 PEACHTREE DUNWOODY RD STE 310 ATLANTA GA 30328 PHYSICIAN SERVICES 287 - LAUREATE MEDICAL GROUP 6600 PEACHTREE DUNWOODY RD STE 325 ATLANTA GA 30328 PHYSICIAN SERVICES 288 - NORTHSIDE FAMILY MEDICINE AND URGENT 81 NORTHSIDE DAWSON DRIVE STE 100 DAWSONVILLE GA 30534 PHYSICIAN SERVICES 289 - NORTH ATLANTA BREAST CARE 1400 NORTHSIDE FORSYTH DR STE 290 CUMMING GA 30041 PHYSICIAN SERVICES 290 - NORTH ATLANTA MEDICAL ASSOCIATES 2545 LAWRENCEVILLE HIGHWAY STE 200 DECATUR GA 30033 PHYSICIAN SERVICES 291 - NORTH GEORGIA DIABETES AND ENDOCRINO 1505 NORTHSIDE BOULEVARD STE 2850 CUMMING GA 30041 PHYSICIAN SERVICES 292 - NORTH GEORGIA DIABETES AND ENDOCRINO 3350 PADDOCKS PARKWAY STE 100 SUWANEE GA 30024 PHYSICIAN SERVICES 293 - NORTH POINT PULMONARY ASSOCIATES 3400 OLD MILTON PKWY BLDG C STE 425 ALPHARETTA GA 30005 PHYSICIAN SERVICES 294 - NORTHEAST GEORGIA DIAGNOSTIC CLINIC 1250 JESSE JEWELL PKWY BLDG A STE 500 GAINESVILLE GA 30501 PHYSICIAN SERVICES 295 - NORTHEAST GEORGIA DIAGNOSTIC CLINIC 1255 FRIENDSHIP ROAD STE 230 BRASELTON GA 30517 PHYSICIAN SERVICES 296 - NORTHSIDE CENTER FOR UROGYNECOLOGY 960 JOHNSON FERRY ROAD STE 336A ATLANTA GA 30342 PHYSICIAN SERVICES 297 - NORTHSIDE CHEROKEE SURGICAL ASSOCIAT 780 CANTON ROAD STE 320B MARIETTA GA 30060 PHYSICIAN SERVICES 298 - NORTHSIDE HOSPITAL CARDIOVASCULAR IN 575 PROFESSIONAL DRIVE STE 400 LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 299 - NORTHSIDE HOSPITAL CARDIOVASCULAR IN 1255 FRIENDSHIP ROAD STE 240 BRASELTON GA 30517 PHYSICIAN SERVICES 300 - NORTHSIDE HOSPITAL CARDIOVASCULAR IN 684 SIXES ROAD STE 230 HOLLY SPRINGS GA 30115 PHYSICIAN SERVICES 301 - NORTHSIDE HOSPITAL ORTHOPEDIC INSTIT 11685 ALPHARETTA HWY STE 250 ROSWELL GA 30076 PHYSICIAN SERVICES 302 - NORTHSIDE NEUROLOGY 1400 NORTHSIDE FORSYTH DR STE 220 CUMMING GA 30041 PHYSICIAN SERVICES 303 - NORTHSIDE RADIATION ONCOLOGY ALPHA 3330 PRESTON RIDGE RD STE 100 ALPHARETTA GA 30005 PHYSICIAN SERVICES 304 - NORTHSIDE RADIATION ONCOLOGY CHERO 460 NORTHSIDE CHEROKEE BLVD STE T10 CANTON GA 30115 PHYSICIAN SERVICES 305 - NORTHSIDE RADIATION ONCOLOGY - FORSY 1100 NORTHSIDE FORSYTH DR STE 140 CUMMING GA 30041 PHYSICIAN SERVICES 306 - NORTHSIDE RADIATION ONCOLOGY - MIDTO 1110 WEST PEACHTREE STREET STE P100 ATLANTA GA 30309 PHYSICIAN SERVICES 307 - NORTHSIDE VASCULAR SURGERY 460 NORTHSIDE CHEROKEE BLVD STE 100 CANTON GA 30115 PHYSICIAN SERVICES 308 - NORTHSIDE VASCULAR SURGERY 1505 NORTHSIDE BOULEVARD STE 2400 CUMMING GA 30041 PHYSICIAN SERVICES 309 - PERIMETER ADVANCED SURGERY CENTER 1100 JOHNSON FERRY ROAD STE 300 ATLANTA GA 30342 PHYSICIAN SERVICES 310 - PERIMETER ADVANCED SURGERY CENTER 460 NORTHSIDE CHEROKEE BLVD STE 200 CANTON GA 30115 PHYSICIAN SERVICES 311 - PERIMETER ADVANCED SURGERY CENTER 1055 HAW CREEK PARKWAY STE 1 CUMMING GA 30041 PHYSICIAN SERVICES 312 - PERIMETER ADVANCED SURGERY CENTER 2131 FOUNTAIN DRIVE STE 100 SNELLVILLE GA 30078 PHYSICIAN SERVICES 313 - PERIMETER ADVANCED SURGERY CENTER 1110 WEST PEACHTREE STREET STE 1200 ATLANTA GA 30309 PHYSICIAN SERVICES 314 - PERIMETER ADVANCED SURGERY CENTER 1110 WEST PEACHTREE STREET STE 1200 ATLANTA GA 30309 PHYSICIAN SERVICES 315 - PERIMETER ADVANCED SURGERY CENTER 2000 HOWARD FARM DRIVE STE T100 CUMMING GA 30041 PHYSICIAN SERVICES 316 - PERIMETER ADVANCED SURGERY CENTER 5505 PEACHTREE DUNWOODY RD STE 150 ATLANTA GA 30342 PHYSICIAN SERVICES 317 - PERIMETER NORTH MEDICAL ASSOCIATES - 900 TOWNE LAKE PARKWAY STE 302B WOODSTOCK GA 30189 PHYSICIAN SERVICES 318 - SOUTHEASTERN NEURO SPECIALISTS - MAR 900 TOWNE LAKE PARKWAY STE 375 WOODSTOCK GA 30189 PHYSICIAN SERVICES 319 - SOUTHEASTERN NEUROSURGICAL SPECIALIS 980 JOHNSON FERRY ROAD STE 490 ATLANTA GA 30342 PHYSICIAN SERVICES 320 - SOUTHEASTERN PRIMARY CARE SPECIALIST 105 CARNEGIE PLACE STE 103 FAYETTEVILLE GA 30214 PHYSICIAN SERVICES 321 - SOUTHEASTERN PRIMARY CARE SPECIALIST 105 CARNEGIE PLACE STE 111 FAYETTEVILLE GA 30214 PHYSICIAN SERVICES 322 - SPECTRUM NEUROSURGICAL SPECIALISTS 470 NORTHSIDE CHEROKEE BLVD STE 460 CANTON GA 30115 PHYSICIAN SERVICES 323 - SURGICAL SPECIALISTS OF ATLANTA 1110 WEST PEACHTREE ST STE 1010A ATLANTA GA 30309 PHYSICIAN SERVICES 324 - SURGICAL SPECIALISTS OF ATLANTA 4800 OLDE TOWNE PARKWAY STE 110C MARIETTA GA 30068 PHYSICIAN SERVICES 325 - SURGICAL SPECIALISTS OF ATLANTA - JO 7823 SPIVEY STATION BLVD STE 310 JONESBORO GA 30236 PHYSICIAN SERVICES 326 - SURGICAL SPECIALISTS OF ATLANTA - MA 4800 OLDE TOWNE PARKWAY STE 110 MARIETTA GA 30068 PHYSICIAN SERVICES 327 - TOWN LAKE PRIMARY CARE 900 TOWNE LAKE PARKWAY STE 410 WOODSTOCK GA 30189 PHYSICIAN SERVICES 328 - TOWN LAKE PRIMARY CARE 900 TOWNE LAKE PARKWAY STE 410B WOODSTOCK GA 30189 PHYSICIAN SERVICES 329 - UNIVERSITY GYNECOLOGIC ONCOLOGY 1110 WEST PEACHTREE STREET STE 810C ATLANTA GA 30309 PHYSICIAN SERVICES 330 - UNIVERSITY GYNECOLOGIC ONCOLOGY 960 JOHNSON FERRY ROAD STE 130 ATLANTA GA 30342 PHYSICIAN SERVICES 331 - UROLOGY SPECIALISTS OF ATLANTA 5673 PEACHTREE DUNWOODY RD STE 910 ATLANTA GA 30342 PHYSICIAN SERVICES 332 - WINDERMERE MEDICAL CLINIC 3850 WINDERMERE PARKWAY STE 105 CUMMING GA 30041 PHYSICIAN SERVICES 333 - GEORGIA COLON & RECTAL SURGICAL ASSOCIATES 684 SIXES ROAD STE 220 HOLLY SPRINGS GA 30115 PHYSICIAN SERVICES 334 - ELLIJAY SPORTS MEDICINE 433 HIGHLAND PARKWAY STE 102 EAST ELIJAY GA 30540 PHYSICIAN SERVICES 335 - ADVANCED JOINT SURGERY SPECIALISTS 433 HIGHLAND PARKWAY STE 102A EAST ELIJAY GA 30540 PHYSICIAN SERVICES 336 - NSC CARDIOLOGY INC 1100 NORTHSIDE FORSYTH DRIVE STE 345 CUMMING GA 30041 PHYSICIAN SERVICES 337 - COMPREHENSIVE NEUROLOGY SPECIALISTS PC 6300 HOSPITAL PARKWAY STE 260 JOHNS CREEK GA 30097 PHYSICIAN SERVICES 338 - GWINNETT NEUROLOGY ASSOCIATES LAWRENCEVIL 771 OLD NORCROSS ROAD STE 355 LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 339 - NORTHSIDE TRAUMA SURGICAL SPECIALISTS 500 MEDICAL CENTER BOULEVARD STE 190 LAWRENCEVILLE GA 30043 PHYSICIAN SERVICES 340 - GMC SPECIALTY CENTER-HAMILTON MILL 2108 TERON TRACE STE 100 DACULA GA 30019 PHYSICIAN SERVICES 341 - NORTHSIDE VASCULAR SURGERY 2220 WISTERIA DRIVE SW STE 209 SNELLVILLE GA 30078 PHYSICIAN SERVICES 342 - HEALTH CHOICE URGENT CARE - SUGAR HILL 5910 SUWANEE DAM ROAD STE 100 SUGAR HILL GA 30518 PHYSICIAN SERVICES 343 - HEALTHCHOICE URGENT CARE 2050 SCENIC HIGHWAY STE F SNELLVILLE GA 30078 PHYSICIAN SERVICES 344 - NORTHSIDE FAMILY MEDICINE PARTNERS 7376 SPOUT SPRINGS ROAD STE 125 FLOWERY BRANCH GA 30542 PHYSICIAN SERVICES 345 - NORTHSIDE ACUTE CARE SURGERY 980 JOHNSON FERRY ROAD STE 880 ATLANTA GA 30342 PHYSICIAN SERVICES 346 - NORTHSIDENORTHPOINT OB-GYN LLC 5780 PEACHTREE DUNWOODY ROAD STE 295 ATLANTA GA 30342 PHYSICIAN SERVICES 347 - ASTRA PLASTIC SURGERY LLC 1110 WEST PEACHTREE STREET STE 1050A ATLANTA GA 30309 PHYSICIAN SERVICES 348 - KIDNEY CARE CENTER GWINNETT LLC 1110 WEST PEACHTREE STREET STE 1050C ATLANTA GA 30309 PHYSICIAN SERVICES 349 - NORTHSIDE HOSPITAL PHARMACY 1110 WEST PEACHTREE STREET STE 340 ATLANTA GA 30309 PHYSICIAN SERVICES 350 - NORTHSIDE DECATUR PRIMARY CARE 1462 MONTREAL ROAD STE 316 TUCKER GA 30084 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 $285,564,858 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, 2022, NORTHSIDE INCURRED TOTAL RESEARCH COSTS OF $9.4 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 2022, NORTHSIDE SUPPORTED THREE (3) DIFFERENT COMMUNITY BUILDING ACTIVITIES INCLUDING ECONOMIC DEVELOPMENT, COMMUNITY SUPPORT AND PHYSICAL IMPROVEMENTS/HOUSING, PROVIDING $313,000 IN COMMUNITY BUILDING FUNDING TO 20 NON-PROFIT ORGANIZATIONS. FOR EXAMPLE, NORTHSIDE CONTRIBUTED TO THE NON-PROFIT, ELACHEE NATURE SCIENCE CENTER. ELACHEE NATURE SCIENCE CENTER PROMOTES ENVIRONMENTAL UNDERSTANDING THROUGH EDUCATION AND CONSERVATION. FOUNDED IN 1978, ELACHEE SITS IN ONE OF GEORGIA'S LARGEST PROTECTED GREENSPACES, THE 1,440-ACRE CHICOPEE WOODS NATURE PRESERVE. ELACHEE IS AN URBAN WOODLAND REFUGE, OUTDOOR CLASSROOM AND EXHIBIT CENTER DESIGNED TO INVOLVE, ENGAGE AND EDUCATE. AS THE ONLY SACS/COGNIA-ACCREDITED NATURE CENTER IN THE SOUTHEASTERN UNITED STATES, ELACHEE LEADS THE WAY IN TEACHING SCHOOLCHILDREN AND NATURE LOVERS HOW NATURE WORKS. ELACHEE IS BUSY YEAR-ROUND, HISTORICALLY WELCOMING SOME 70,000 ANNUAL VISITORS TO HIKE THE TRAILS IN THE CHICOPEE WOODS, VISIT ON SCHOOL FIELD TRIPS AND TO EXPERIENCE CAMP ELACHEE SUMMER DAY CAMPS. ELACHEE ALSO OFFERS FAMILY-FRIENDLY SEASONAL PUBLIC NATURE ENCOUNTERS AND ADULT LEARNING PROGRAMS, AS WELL AS SELF-GUIDED INTERPRETIVE ECOLOGY AND LIVE ANIMAL EXHIBITS. A ROBUST VOLUNTEER CORPS AND OTHER COMMUNITY PARTNERS ASSIST ELACHEE'S PRESERVE MANAGEMENT TEAM IN CONSERVATION AND PRESERVATION INITIATIVES WITHIN THE CHICOPEE WOODS CONSERVATION AREA. AMONG THESE ARE ACTIVITIES THAT SUPPORT AND MAINTAIN THE CHICOPEE WOODS 8-MILE HIKING TRAIL SYSTEM. OF NOTE, THIS TRAIL SYSTEM PROMOTES HEALTHY LIVING CHOICES FOR THE NORTH GEORGIA REGION; OPEN DAILY TO THE VISITING PUBLIC AT NO CHARGE TO ACCESS THESE TRAILS. THE NATURE CENTER CAMPUS IS ALSO HOME TO ELACHEE NATURE ACADEMY, AN ACCREDITED AND LICENSED SCHOOL WITH NATURE-BASED PRESCHOOL TO 3RD GRADE CLASSES. ELACHEE RELIES ON SPONSORSHIPS TO OFFER INNOVATIVE PROGRAMMING, ACCESS TO EXHIBITS AND THE CHICOPEE WOODS HIKING TRAILS. FURTHERMORE, ELACHEE NATURE ACADEMY IS CATEGORIZED AS COMMUNITY BUILDING PHYSICAL IMPROVEMENTS SINCE IT ADDRESSES MULTIPLE DOMAINS WITHIN SDOH, INCLUDING NEIGHBORHOOD AND BUILT ENVIRONMENT AND EDUCATION ACCESS AND QUALITY. 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.IN ADDITION TO THE WORKFORCE DEVELOPMENT ACTIVITIES NOTED ABOVE, NORTHSIDE ALSO PARTICIPATED IN OTHER COMMUNITY BUILDING ACTIVITIES SUCH AS THE GEORGIA MATERNAL MORTALITY REVIEW COMMITTEE. 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, 2022 AND 2021 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 2022 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: THE COLLECTION POLICY IS SPECIFIC TO THE TIMING AND PROTOCOLS FOLLOWED IN THE DEBT COLLECTION PROCESS. HOWEVER, THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY SUPERSEDES THE DEBT COLLECTION POLICY IN ANY SITUATION WHERE A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE. 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 2022, NORTHSIDE HOSPITAL, INC. SUBMITTED THIRTY-SEVEN 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 OVER $632 MILLION OVER THE NEXT SEVERAL YEARS. PROJECTS INCLUDE: 1) $450 MILLION TO EXPAND INPATIENT BED CAPACITY AT NORTHSIDE HOSPITAL GWINNETT; 2) $122 MILLION IN SEVERAL FACILITY EXPANSION PROJECTS SUCH AS TO MODERNIZE AN INPATIENT REHABILITATION FACILITY, TO CONSTRUCT THREE (3) NEW OUTPATIENT IMAGING CENTERS AND TWO (2) NEW AMBULATORY SURGERY CENTERS, AND TO ESTABLISH A NEW RADIATION THERAPY CENTER; 3) $31 MILLION TO ACQUIRE THREE (3) STATE-OF-THE-ART SURGICAL ROBOTS, NUMEROUS IMAGING EQUIPMENT UPGRADES ACROSS THE SYSTEM'S PORTFOLIO AND TO ACQUIRE STATE-OF-THE-ART CARDIAC PET/CT IMAGING EQUIPMENT; AND 4) $29 MILLION TO DEVELOPED A NEW, OFF-CAMPUS MEDICAL OFFICE BUILDING LOCATED IN COBB COUNTY, GEORGIA. THESE PROJECTS ARE LOCATED THROUGHOUT NORTHSIDE HOSPITAL, INC.'S SERVICE AREA IN CHEROKEE, COBB, FORSYTH, FULTON, AND GWINNETT COUNTIES 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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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 441754 0 10000 0 5476 0 1962 0 22910 0 482102 0 0 0 IQBAL GARCHA MD BOARD MEMBER 339152 0 144633 0 9752 0 4412 0 16156 0 514105 0 0 0 ROBERT T QUATTROCCHI PRESIDENT & CEO NSH, INC. 1494540 0 3450000 0 22185 0 6747 0 34090 0 5007562 0 0 0 SHANNON BANNA VP/CFO NSH, INC./ASST. TREASURER 593734 0 234600 0 31924 0 4054 0 9922 0 874234 0 0 0 JORGE J HERNANDEZ VICE PRESIDENT/ASST. SECRETARY 565637 0 313088 0 28713 0 4379 0 23321 0 935138 0 0 0 JANIS DUBOW VICE PRESIDENT 403439 0 201668 0 17030 0 4964 0 11454 0 638555 0 0 0 WILLIAM HAYES CEO, NORTHSIDE HOSPITAL-CHEROKEE 548764 0 220867 0 33537 0 6564 0 30261 0 839993 0 0 0 DEBORAH MITCHAM BILBRO CEO, NORTHSIDE HOSPITAL GWINNETT 686490 0 257250 0 58617 0 6640 0 16368 0 1025365 0 0 0 ROBERT PUTNAM VICE PRESIDENT 688118 0 275140 0 34046 0 5583 0 20400 0 1023287 0 0 0 TINA WAKIM VICE PRESIDENT/COO 734489 0 258487 0 42890 0 3977 0 22316 0 1062159 0 0 0 CHARLES DECOOK MD ORTHOPEDIC SURGEON 1495120 0 358987 0 7356 0 6923 0 33686 0 1902072 0 0 0 RICHARD HARVEY MD CARDIOTHORACIC SURGEON 993092 0 244268 0 1700 0 6539 0 10514 0 1256113 0 0 0 KENNETH KRESS MD ORTHOPEDIC SURGEON 1044363 0 235493 0 9104 0 7327 0 19873 0 1316160 0 0 0 DAVID A LANGFORD MD THORACIC SURGEON 993836 0 100000 0 182220 0 6673 0 18789 0 1301518 0 0 0 KEITH OSBORN MD SPINE SURGEON 693782 0 565059 0 112221 0 6519 0 18789 0 1396370 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 NINETEEN 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. RACHEL BEARMAN DALE M. BEARMAN, M.D., BOARD MEMBER & RACHEL BEARMAN FAMILY MEMBER 109096 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 2021 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 796921 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 2021 TO GARY LEVENGOOD, M.D. FOR SERVICES RENDERED TO THE ORGANIZATION. 0 ALLIE BUCHANAN CARL BUCHANAN, M.D., BOARD MEMBER & ALLIE BUCHANAN FAMILY MEMBER 70943 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 2021 TO ALLIE BUCHANAN FOR SERVICES RENDERED TO THE ORGANIZATION. 0 DALE BEARMAN MD BOARD MEMBER 1451151 THE BOARD MEMBER WAS INVOLVED IN SEPARATE JOINT VENTURES WITH THE ORGANIZATION INVOLVING BUSINESS TRANSACTIONS SPECIFIC TO REAL ESTATE SALES CONTRACTS FOR AMOUNTS AS DETERMINED BY AN INDEPENDENT THIRD PARTY TO BE FAIR MARKET VALUE. 0 GENEVIEVE FAIRBROTHER MD BOARD MEMBER 1261922 THE BOARD MEMBER WAS INVOLVED IN SEPARATE JOINT VENTURES WITH THE ORGANIZATION INVOLVING BUSINESS TRANSACTIONS SPECIFIC TO REAL ESTATE SALES CONTRACTS FOR AMOUNTS AS DETERMINED BY AN INDEPENDENT THIRD PARTY TO BE FAIR MARKET VALUE. 0 STEPHANIE GROGAN MD IQBAL GARCHA, M.D., BOARD MEMBER & STEPHANIE GROGAN, M.D. FAMILY MEMBER 2594763 IQBAL GARCHA, M.D., MEMBER OF THE NORTHSIDE HOSPITAL, INC. BOARD OF DIRECTORS, HAS A FAMILY RELATIONSHIP WITH STEPHANIE GROGAN, M.D., AN EMPLOYEE OF NORTHSIDE HOSPITAL, INC. STEPHANIE GROGAN, M.D. WAS INVOLVED IN SEPARATE JOINT VENTURES WITH THE ORGANIZATION INVOLVING BUSINESS TRANSACTIONS SPECIFIC TO REAL ESTATE SALES CONTRACTS FOR AMOUNTS AS DETERMINED BY AN INDEPENDENT THIRD PARTY TO BE FAIR MARKET VALUE. 0 FORM 990 TO OUR PATIENTS IN THEIR JOURNEYS TOWARD HEALTH OF BODY AND MIND. TO ENSURE INNOVATIVE AND UNSURPASSED CARE FOR OUR PATIENTS, WE ARE DEDICATED TO MAINTAINING OUR POSITION AS REGIONAL LEADERS IN SELECT MEDICAL SPECIALTIES. TO ENHANCE THE WELLNESS OF OUR COMMUNITY, WE COMMIT OURSELVES TO PROVIDING A DIVERSE ARRAY OF EDUCATIONAL AND OUTREACH PROGRAMS. PART III, LINE 4A: PROGRAM SERVICE ACCOMPLISHMENTS (CONT'D) PROVIDING A BROAD ARRAY OF COMMUNITY BENEFIT PROGRAM ACTIVITIES. 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 238,000 PERSONS, SPENDING OVER 138,000 STAFF HOURS, AND PROVIDING $18.95 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 $6.1 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. AS ONE OF ONLY SEVEN LEVEL II TRAUMA CENTERS IN GEORGIA, NORTHSIDE RECOGNIZED THE NEED TO EXPAND ED CAPACITY AND IN AUGUST 2020, NORTHSIDE INITIATED A 37,000 SQUARE FOOT EXPANSION OF NORTHSIDE HOSPITAL GWINNETT'S EMERGENCY ROOM THAT ADDED 27 MULTI-PURPOSE EXAM ROOMS, A 30-BED ED OBSERVATION UNIT AND ENLARGED THE 66 EXISTING ED ROOMS. AS A RESULT, ED VOLUME AT NORTHSIDE HOSPITAL GWINNETT INCREASED 9% FROM FY2021 TO FY2022 WITH OVER 89,000 TOTAL ED VISITS IN FY2022 INCLUDING OVER 2,100 TOTAL TRAUMA VISITS. THE GROWTH IN ED VOLUME RESULTED IN A NET COMMUNITY BENEFIT IMPACT OF JUST OVER 1,500 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 $7.01 MILLION IN NET COMMUNITY BENEFIT AND SERVING 3,107 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 FY2022, 442 PHYSICIANS/MEDICAL STUDENTS RECEIVED CME ON TOPICS SUCH AS MEDICAL ETHICS, 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 FY2022 NORTHSIDE'S GME PROGRAM HAD 72 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 FY2022, NORTHSIDE'S CPE PROGRAM EDUCATED 48 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 FY2022, NORTHSIDE PROVIDED $3.2 MILLION IN CASH AND IN-KIND DONATIONS TO 210 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 COVENANT HOUSE GEORGIA ("CHGA") AND CENTER FOR BLACK WOMEN'S WELLNESS ("CBWW"). NORTHSIDE SELECTED CHGA AS A FUNDING RECIPIENT BECAUSE IT ADDRESSES AN IMPORTANT SDOH: HOUSING/HOMELESSNESS. CHGA SERVES YOUTH AGES 16 TO 24 WHO ARE EXPERIENCING HOMELESSNESS AND ESCAPING TRAFFICKING IN THE METRO ATLANTA AREA. THEY PROVIDE WRAP-AROUND SERVICES DESIGNED TO HELP YOUTH REALIZE LASTING STABILITY. CHGA'S TWO OVERARCHING GOALS ARE 1) TO PROVIDE SAFE, ACCESSIBLE HOUSING TO YOUTH FORMERLY LIVING ON THE STREETS AND 2) TO OFFER THEM SERVICES THAT EMPOWER THEM TO ACHIEVE SELF-SUFFICIENCY. LAST YEAR CHGA SERVED OVER 1,300 YOUNG PEOPLE. ANOTHER EXAMPLE OF A SELECTED FUNDS RECIPIENT IS THE CENTER FOR BLACK WOMEN'S WELLNESS. NORTHSIDE PROVIDED FINANCIAL SUPPORT TO CBWW BECAUSE IT ADDRESSES ONE OF NORTHSIDE'S PRIORITIZED HEALTH NEEDS: MATERNAL AND INFANT HEALTH. CBWW OFFERS LOW COST/NO COST HEALTHCARE SERVICES (WOMEN'S HEALTH, PRIMARY HEALTHCARE, AND BEHAVIORAL HEALTH); PROGRAMS TO IMPROVE HEALTHY BEHAVIORS; CASE MANAGEMENT FOR PREGNANT WOMEN AND THEIR INFANTS; AND FINANCIAL LITERACY AND MICRO-BUSINESS TRAINING TO IMPROVE ECONOMIC SELF-SUFFICIENCY. 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 ACITIVITIES INCLUDING COMMUNITY HEALTH EDUCATION; COMMUNITY BASED CLINICAL SERVICES; HEALTH CARE SUPPORT SERVICES; AND SOCIAL AND ENVIRONMENTAL IMPROVEMENT ACTIVITIES. IN FY2022, NORTHSIDE PROVIDED OVER $1.8 MILLION IN COMMUNITY HEALTH IMPROVEMENT SERVICES ACROSS 54 DIFFERENT PROGRAMS THAT REACHED NEARLY 284,000 PEOPLE AND SERVED OVER 232,000 PEOPLE. 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. 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 967 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 UNRELATED AND INDEPENDENT ACCOUNTANT USING DETAILED FINANCIAL STATEMENTS SUPPORTED BY A CONSOLIDATED AUDIT (ALSO PREPARED BY OUTSIDE, INDEPENDENT AUDITORS). NORTHSIDE FINANCIAL LEADERSHIP, INCLUDING THE SYSTEM CONTROLLER AND CFO, PERFORM A DETAILED REVIEW OF THE 990 AND APPROVAL OF THE RETURNS BEFORE THEY ARE 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 GEORGIA CANCER SPECIALISTS I, P.C. ("GCS") 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. GCS 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, GCS REMAINS A PRIVATELY HELD ORGANIZATION WITHOUT OWNERSHIP OR MANAGEMENT BY NORTHSIDE. GCS MAINTAINS RESPONSIBILITY FOR PROVIDING ALL ADMINISTRATIVE OPERATIONS OF THE PRACTICE (E.G., STAFF BENEFITS, MALPRACTICE INSURANCE, ETC.). NORTHSIDE MAKES PAYMENTS TO GCS AT FAIR MARKET VALUE RATES FOR 1) PERSONALLY PERFORMED AND MODIFIER ADJUSTED PROFESSIONAL SERVICES 2) MANAGEMENT OVERSIGHT RESPONSIBILITIES AND 3) BILLING ARRANGEMENTS. GCS EMPLOYS APPROXIMATELY 100 CLINICIANS AND 480 STAFF TO MAINTAIN ONCOLOGY, HEMATOLOGY, MANAGEMENT AND BILLING SERVICES AT NORTHSIDE'S FACILITIES AND THROUGHOUT THE COMMUNITIES SERVED BY NORTHSIDE. 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 165 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. 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 36 CLINICIANS AND 170 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 564,851,874. MANAGEMENT AND GENERAL EXPENSES 99,109,325. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 663,961,199. FORM 990, PART XI, LINE 9: INCOME FROM JOINT VENTURES NOT ON BOOKS -9,116,506. OTHER CHANGES IN NET ASSETS 1,794. CHANGE IN PENSION 236,172,923. EQUITY TRANSFER -1,543,699. INTERCOMPANY REVENUE 109,195. 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