2020-06-02T07:48:09-05:00 2019-09-30 621517792 PYA P C 2220 SUTHERLAND AVE KNOXVILLE TN 37919 990 2018-10-01 581954432 NORTHSIDE HOSPITAL INC NORT 4048518000 1000 JOHNSON FERRY ROAD NE ATLANTA GA 303421611 SHANNON A BANNA CFO 4048518000 2020-06-01 1 DEBORAH O ERNSBERGER P00364912 8656730844 174.135.176.2 2020-06-02 07:48:00 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 AF23F2A68CFF53983216DF8908F842EE3670BFA3 2018 2021-01-29 14:40:06Z ROBERT T QUATTROCCHI 1000 JOHNSON FERRY ROAD NE ATLANTA GA 303421611 3759629362 0 X WWW.NORTHSIDE.COM X 1991 GA TO BE A CENTER OF EXCELLENCE IN PROVIDING HIGH-QUALITY HEALTH CARE. 12 8 15311 940 17374287 0 1020392 794925 3252869985 3707807833 21815756 11579713 42106668 39446891 3317812801 3759629362 3075702 2763605 0 0 1283592604 1447690596 0 0 0 1868926366 2194614728 3155594672 3645068929 162218129 114560433 2726110697 3566126908 917238461 1418189612 1808872236 2147937296 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 2933534628 2763605 3739775922 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 2933534628 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 1571 0 1 15311 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 12 8 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 1 GA X SHANNON A BANNA 4048518000 1000 JOHNSON FERRY ROAD ATLANTA GA 30342 X ANTHONY J SALVATORE BOARD MEMBER 1.00 1.00 X 0 0 0 WILLIAM G HASTY JR BOARD MEMBER 1.00 X 0 0 0 WAYNE L AMBROZE MD BOARD MEMBER 1.00 X 0 0 0 ROBERT E WHITLEY ESQ BOARD MEMBER 1.00 1.00 X 0 0 0 K DOUGLAS SMITH MD BOARD MEMBER 1.00 1.00 X 0 0 0 MARK J SWEENEY BOARD MEMBER 1.00 1.00 X 0 0 0 DALE M BEARMAN MD BOARD MEMBER 1.00 1.00 X 0 0 0 BARBARA PARE' BOARD MEMBER 1.00 1.00 X 0 0 0 GENEVIEVE FAIRBROTHER MD BOARD MEMBER 1.00 X 0 0 0 THURBERT BAKER BOARD MEMBER 1.00 1.00 X 0 0 0 IQBAL GARCHA MD BOARD MEMBER 1.00 X 0 0 0 ROBERT T QUATTROCCHI PRESIDENT & CEO NSH, INC. 40.00 1.00 X X 4702123 0 38888 SHANNON BANNA VP/CFO NSH, INC. 40.00 1.00 X 487667 0 12182 JORGE J HERNANDEZ VICE PRESIDENT/ASST. SECRE 40.00 X 669078 0 16700 JANIS DUBOW VICE PRESIDENT 40.00 X 536267 0 15015 WILLIAM HAYES CEO, NORTHSIDE HOSPITAL-CH 40.00 X 559504 0 36916 ROBERT PUTNAM VICE PRESIDENT 40.00 X 906086 0 24028 TINA WAKIM VICE PRESIDENT/COO 40.00 X 972323 0 13867 CHARLES DECOOK MD ORTHOPEDIC SURGEON 40.00 X 1832612 0 36045 WILLIAM EARLY MD GASTROENTEROLOGY/INTERNAL 40.00 X 821994 0 21425 GERALD FEUER MD GYNECOLOGIST/SURGEON 40.00 X 922889 0 37471 JIMMY JIANG MD ORTHOPEDIC SURGEON 40.00 X 866076 0 15061 KENNETH KRESS MD ORTHOPEDIC SURGEON 40.00 X 1193455 0 23031 DEBORAH S MITCHAM FORMER VP/CFO NSH, INC. 40.00 1.00 X 497372 0 0 14967446 0 290629 1939 1 1 0 GEORGIA CANCER SPECIALISTS I PC 1835 SAVOY DRIVE STE 300 ATLANTA GA 30342 SEE SCHEDULE O 45544161 BAKER & HOSTETLER LLP 1170 PEACHTREE STREET NE STE 2400 ATLANTA GA 30309 LEGAL SERVICES 30133262 AGA LLC 550 PEACHTREE ST STE 1620 ATLANTA GA 30308 SEE SCHEDULE O 26107215 ATLANTA CANCER CARE PC 1100 JOHNSON FERRY ROAD STE 150 SANDY SPRINGS GA 30342 SEE SCHEDULE O 19581575 GE HEALTHCARE INC 1575 NORTHSIDE DR NW 305 ATLANTA GA 30318 BIOMEDICAL SERVICES 14829429 366 388245 134881 271799 794925 NET PATIENT REVENUE 621990 3669845339 3526184057 6275097 137386185 RENTAL INCOME 531120 17343499 17343499 BILLING REVENUE 561000 7103293 3620388 3482905 PARKING REVENUE 812930 6597016 6597016 CAFETERIA & VENDING 722210 5795179 5795179 1123507 1123507 3707807833 11579713 11579713 MISCELLANEOUS 900099 35742405 30833065 4909340 PASSTHROUGH INVESTMENT 621300 3704486 1135024 2569462 39446891 3759629362 3575495645 17374287 165964505 X 2751045 2751045 12560 12560 13772365 10545627 3226738 1152288873 882318211 269970662 48626932 37234090 11392842 154953805 118649557 36304248 78048621 59762549 18286072 18018969 18018969 39343072 39343072 1557449 1557449 1943493 1943493 528369961 451085876 77284085 14637767 6930225 7707542 63930516 30267790 33662726 34272500 16226255 18046245 95525854 45226547 50299307 2483312 1175720 1307592 1778309 841937 936372 10334693 10334693 171546646 101786806 69759840 36234422 17155123 19079299 SUPPLIES 912771668 905512874 7258794 BAD DEBT EXPENSE 197611769 197611769 MINOR EQUIPMENT PURCHAS 16977050 8037754 8939296 RECRUITMENT 4060440 1922408 2138032 43216838 20460936 22755902 3645068929 2933534628 711534301 0 61314 82399 473740545 358235119 309315 1330748 218774559 353006270 159474 239265 53149179 70193814 36074069 66664152 3175760155 1434296743 1264857785 1741463412 324565957 610655791 282050766 295418364 72367734 68837574 2726110697 3566126908 488148491 582082338 1986595 3043724 89491897 60011697 337611478 773051853 917238461 1418189612 X 1808872236 2147937296 1808872236 2147937296 2726110697 3566126908 X 114560433 13106241 211398386 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 528480 528480 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. 10180369 1829101 286184 1322459 10973195 9083135 2049190 185144 1137100 10180369 8616383 1701861 150580 1385689 9083135 7742074 1758394 128084 1012169 8616383 7079636 1525651 114920 978133 7742074 0.28760 0.71240 0 1 1 381190549 381190549 1695154906 675060478 1020094428 1042116508 759236265 282880243 57298192 57298192 1741463412 FAS 106 ACCRUAL 1490532 RESERVE FOR MALPRACTICE 254272274 RETIREMENT PLAN OBLIGATIONS 290505079 PERIODIC CAPITAL FINANCING LIABILITY 2857949 REAL ESTATE FINANCING LIABILITY 115913245 RENT/LEASE RELATED LIABILITIES 60952853 OTHER LIABILITIES 47059921 773051853 X PART V, LINE 4: NORTHSIDE HOSPITAL, INC. AND NORTHSIDE HOSPITAL FOUNDATION, INC. HAVE ENDOWMENT FUNDS THAT CONSIST OF 40 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, 2019 AND 2018, 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 125.000000000000 1 X 1 1 1 0 1 1 0 0 185684988 0 185684988 0.05100 0 0 259528510 155126419 104402091 0.02860 445213498 155126419 290087079 0.07960 77 290183 2498305 206361 2291944 0.00060 15 1206 2425296 307877 2117419 0.00060 6 0 5353864 4032485 1321379 0.00040 1 711 715311 0 715311 0.00020 8 37995 3402911 19685 3383226 0.00090 107 330095 14395687 4566408 9829279 0.00270 107 330095 459609185 159692827 299916358 0.08230 2 0 134083 100 133983 0.00000 1 0 83286 0 83286 0.00000 1 0 197550 900 196650 0.00010 1 0 585 0 585 0.00000 1 98 236368 0 236368 0.00010 6 98 651872 1000 650872 0.00020 1 52166586 384088103 498931046 -114842943 X 1 0 1 GWINNETT ENDOSCOPY CENTER PC OUTPATIENT CENTER 0.15000 0.85000 2 MIDTOWN ENDOSCOPY CENTER LLC OUTPATIENT CENTER 0.15000 0.85000 3 NORTHERN CRESCENT ENDOSCOPY SUITE LLC OUTPATIENT CENTER 0.70000 0.30000 4 NORTHWEST ENDOSCOPY CENTER LLC OUTPATIENT CENTER 0.15000 0.85000 5 SOUTHERN CRESCENT ENDOSCOPY CENTER SUITE PC OUTPATIENT CENTER 0.15000 0.85000 6 WOODSTOCK ENDOSCOPY CENTER LLC OUTPATIENT CENTER 0.70000 0.30000 7 WEST METRO ENDOSCOPY CENTER LLC OUTPATIENT CENTER 0.15000 0.85000 8 ENT SURGERY CENTER OF ATLANTA LLC AMBULATORY SURGERY 0.64330 0.35670 9 PEACHTREE ORTHOPAEDIC SURGERY CENTER AT PERIMETER LLC AMBULATORY SURGERY 0.15000 0.71260 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 0.19000 12 NASA SURGERY CENTER LLC AMBULATORY SURGERY 0.70000 0.30000 13 SOVEREIGN REHABILITATION OF GEORGIA LLC REHABILITATION CENTER 0.88000 0.12000 14 PANOLA ENDOSCOPY CENTER LLC OUTPATIENT CENTER 0.15000 0.85000 15 AOA AMC LLC ONCOLOGY CLINIC 0.49000 0.51000 16 ADVANCED CENTER FOR JOINT SURGERY LLC ORTHOPEDIC SURGERY 0.51000 0.49000 17 THOMAS EYE SURGERY CENTER LLC EYE SURGERY 0.49000 0.51000 18 NORTHSIDE ATLANTA ORTHOPEDICS & SPORTS MEDICINE HOLDINGS LLC ORTHOPEDIC & SPORTS MEDICINE 0.10000 0.90000 19 GWINNETT SURGERY CENTER LLC SURGERY CENTER 0.51000 0.49000 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 B 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 B FACILITY REPORTING GROUP - A 0 0 1 X X X X X X X X X 18 1 1 0 1 X HTTP://WWW.NORTHSIDE.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENT X 1 18 0 1 0 1 X 125.000000000000 300.000000000000 X X X X X X X 1 1 X X X 1 X WWW.NORTHSIDE.COM X WWW.NORTHSIDE.COM X WWW.NORTHSIDE.COM X X X X 1 X 0 X X X X 1 X 0 0 FACILITY REPORTING GROUP - B 0 1 1 X X X X X X X X X 18 1 1 1 1 X WWW.GWINNETTMEDICALCENTER.ORG/ABOUTUS X 1 18 1 WWW.GWINNETTMEDICALCENTER.ORG/ABOUTUS 0 1 X 125.000000000000 300.000000000000 X X X X X X X 1 1 X X X 1 X WWW.GWINNETTMEDICALCENTER.ORG X WWW.GWINNETTMEDICALCENTER.ORG X WWW.GWINNETTMEDICALCENTER.ORG X X X X 1 X 0 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 GROUP A-FACILITY 1 -- HOSPITALS - ATLANTA, CHEROKEE, FORSYTH PART V, SECTION B, LINE 3J: NORTHSIDE HOSPITAL, INC. ("NORTHSIDE") COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") FOR EACH OF ITS HOSPITAL FACILITIES IDENTIFIED IN REPORTING GROUP A. IN COMPLETING THE CHNAS FOR ITS HOSPITAL FACILITIES, NORTHSIDE DID NOT ENCOUNTER ANY INFORMATION GAPS THAT LIMITED ITS ABILITY TO ASSESS EACH HOSPITAL FACILITY'S COMMUNITY NEED. IN ADDITION TO THE INFORMATION LISTED ABOVE, NORTHSIDE DESCRIBES IN THE CHNAS EACH COMMUNITY'S ACCESS TO HEALTH CARE AND PROVIDES AN OVERVIEW OF EACH HOSPITAL FACILITY'S IMPLEMENTATION STRATEGY. GROUP A-FACILITY 1 -- HOSPITALS - ATLANTA, CHEROKEE, FORSYTH PART V, SECTION B, LINE 5: NORTHSIDE IDENTIFIED AND REACHED OUT TO A TOTAL OF 44 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 IN-PERSON AND TELEPHONE INTERVIEWS WITH A QUALIFIED REPRESENTATIVE OF EACH IDENTIFIED STAKEHOLDER. IN TOTAL, NORTHSIDE COMPLETED INTERVIEWS WITH THE FOLLOWING 19 OF THE 44 STAKEHOLDERS IDENTIFIED: (1) CHEROKEE COUNTY HEALTH DEPARTMENT, (2) COBB/DOUGLAS HEALTH DEPARTMENT, (3) PICKENS COUNTY HEALTH DEPARTMENT, (4) BETHESDA COMMUNITY CLINIC, (5) GOOD SAMARITAN ATLANTA, (6) GOOD SAMARITAN COBB, (7) GOOD SAMARITAN GWINNETT, (8) CENTER FOR BLACK WOMEN'S WELLNESS,(9) COMMUNITY ADVANCED PRACTICE NURSES,(10) URBAN HEALTH AND WELLNESS, (11) GOOD SHEPHERD OF DAWSON COUNTY, (12) NORTH FULTON COMMUNITY CHARITIES, (13) UNITED WAY - FORSYTH, (14) LIFELINK, (15) CHEROKEE COUNTY SCHOOLS, (16) LA AMISTAD,(17) HEALTHY MOTHERS HEALTHY BABIES COALITION OF GEORGIA,(18) CHEROKEE COUNTY CHAMBER OF COMMERCE, AND (19) CUMMING/FORSYTH CHAMBER OF COMMERCE. GROUP A-FACILITY 1 -- HOSPITALS - ATLANTA, CHEROKEE, FORSYTH PART V, SECTION B, LINE 6A: THE NORTHSIDE HOSPITAL, INC. SYSTEM COMPRISES THREE HOSPITAL FACILITIES: (1) NORTHSIDE HOSPITAL-ATLANTA, (2) NORTHSIDE HOSPITAL-CHEROKEE AND (3) NORTHSIDE HOSPITAL-FORSYTH. GIVEN THE SIGNIFICANT OVERLAP IN SERVICE AREAS AMONG ITS THREE FACILITIES, NORTHSIDE CONDUCTED A JOINT CHNA (OR SYSTEM-LEVEL CHNA). GROUP A-FACILITY 1 -- HOSPITALS - ATLANTA, CHEROKEE, FORSYTH PART V, SECTION B, LINE 11: BASED ON THE RESULTS OF NORTHSIDE'S 2019 CHNA, NORTHSIDE HOSPITAL, INC. ADOPTED AN IMPLEMENTATION STRATEGY WHICH OUTLINED SEVERAL INITIATIVES TO HELP ADDRESS THE SIGNIFICANT NEEDS IDENTIFIED IN THE COMMUNITY. AS SET FORTH IN THE 2019 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) RESPIRATORY DISEASE & SMOKING, (2) TRANSPORTATION, (3) HIV/AIDS, (4) AFFORDABLE/ADEQUATE HOUSING/HOMELESSNESS, AND (5) CULTURALLY COMPETENT SERVICES.A DETAILED ANALYSIS OF WHY EACH OF THESE NEEDS WILL NOT BE ADDRESSED IS INCLUDED IN NORTHSIDE'S CHNA. GROUP A-FACILITY 1 -- HOSPITALS - ATLANTA, CHEROKEE, FORSYTH 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 -- HOSPITALS - ATLANTA, CHEROKEE, FORSYTH 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. PART V, SECTION B FACILITY REPORTING GROUP B FACILITY REPORTING GROUP B CONSISTS OF: - FACILITY 2: NORTHSIDE HOSPITAL GWINNETT, - FACILITY 5: NORTHSIDE HOSPITAL DULUTH GROUP B-FACILITY 2 -- HOSPITALS - GWINNETT AND DULUTH PART V, SECTION B, LINE 2: IN AUGUST 2019, NORTHSIDE AND GWINNETT HEALTH SYSTEM, INC. ("GWINNETT") EXECUTED AN AFFILIATION AND MERGER AGREEMENT WHEREBY GWINNETT AND CERTAIN SUBSIDIARIES AND AFFILIATES WERE MERGED INTO NORTHSIDE, AND NORTHSIDE WAS THE SURVIVING ENTITY. THE GWINNETT HEALTH SYSTEM COMPRISED OF TWO LICENSED HOSPITAL FACILITIES IN LAWRENCEVILLE AND DULUTH, GEORGIA. GWINNETT COMPLETED A COMBINED CHNA IN AUGUST 2018, FOR ITS TWO HOSPITAL FACILITIES DURING ITS YEAR ENDING JUNE 30, 2019. A CHNA WAS NOT REQUIRED FOR THE PERIOD ENDING SEPTEMBER 30, 2019 FOR THE GWINNETT HOSPITAL FACILITIES POST-MERGER. GROUP B-FACILITY 2 -- HOSPITALS - GWINNETT AND DULUTH PART V, SECTION B, LINE 3J: GWINNETT HEALTH SYSTEM COMPLETED A COMBINED CHNA FOR ITS TWO HOSPITAL FACILITIES DURING ITS FISCAL YEAR ENDING JUNE 30, 2019. IN ADDITION TO THE INFORMATION LISTED ABOVE, THE CHNA DESCRIBES THE GWINNETT COMMUNITY'S ACCESS TO HEALTH CARE AND PROVIDES AN OVERVIEW OF THE TWO HOSPITALS' COMBINED IMPLEMENTATION STRATEGIES AND HEALTH IMPROVEMENT PLAN GOALS. GROUP B-FACILITY 2 -- HOSPITALS - GWINNETT AND DULUTH PART V, SECTION B, LINE 5: GWINNETT COMPLETED A COMBINED CHNA IN AUGUST 2018, FOR ITS TWO HOSPITAL FACILITIES DURING ITS YEAR ENDING JUNE 30, 2019. A CHNA WAS NOT REQUIRED FOR THE PERIOD ENDING SEPTEMBER 30, 2019 FOR THE GWINNETT HOSPITAL FACILITIES POST-MERGER. DURING THIS TIME, THE GWINNETT HEALTH SYSTEM COLLABORATED WITH THE GWINNETT COALITION FOR HEALTH AND HUMAN SERVICES AND THE GWINNETT COUNTY HEALTH DEPARTMENT TO COORDINATE VARIOUS FOCUS GROUP MEETINGS INVOLVING THE DEMOGRAPHICS REPRESENTATIVE OF THE COMMUNITY TO DISCUSS COMMUNITY RELATIONS AND ENGAGEMENT, ECONOMIC AND FINANCIAL STABILITY, EDUCATION, SAFETY, AGE FOCUS, AND HEALTH AND WELLNESS. ADDITIONAL INFORMATION IS PROVIDED WITHIN GWINNETT HEALTH SYSTEM'S 2018 FORM 990 FOR THE YEAR ENDED JUNE 30, 2019. GROUP B-FACILITY 2 -- HOSPITALS - GWINNETT AND DULUTH PART V, SECTION B, LINE 6A: NORTHSIDE HOSPITAL GWINNETT (FORMERLY GWINNETT MEDICAL CENTER - LAWRENCEVILLE) AND NORTHSIDE HOSPITAL DULUTH (FORMERLY GWINNETT MEDICAL CENTER - DULUTH) ARE NORTHSIDE HOSPITAL FACILITIES BOTH LOCATED IN GWINNETT COUNTY. AS THE TWO HOSPITAL FACILITIES ARE LOCATED WITHIN 10 MILES OF EACH OTHER, THE CHNA REPRESENTS THE COMBINED RESULTS OF EACH FACILITY. GROUP B-FACILITY 2 -- HOSPITALS - GWINNETT AND DULUTH PART V, SECTION B, LINE 6B: THE CHNA WAS CONDUCTED THROUGH COLLABORATIONS WITH THE GWINNETT COALITION FOR HEALTH AND HUMAN SERVICES AND THE GWINNETT COUNTY HEALTH DEPARTMENT. GROUP B-FACILITY 2 -- HOSPITALS - GWINNETT AND DULUTH PART V, SECTION B, LINE 11: BASED ON THE RESULTS OF THE 2019 CHNA THE TOP OPPORTUNITIES LIE IN THE FOLLOWING AREAS:-MANAGING HEALTH CONDITIONS AND CHRONIC DISEASE TREATMENTS-IMPROVING ACCESS TO CARE-PREVENTING CHRONIC DISEASES AND INCREASING WELLNESSIMPLEMENTATION STRATEGIES IN 2019 WERE UPDATED TO ADDRESS HEART DISEASE, STROKE, CANCER, EMERGENCY AND TRAUMA SERVICES, CHRONIC LOWER RESPIRATORY DISEASE, DIABETES, MATERNAL/INFANT HEALTH, INJURY PREVENTION AND WELLNESS PROGRAMS. COMMUNITY NEEDS OUTSIDE THE HOSPITAL'S SCOPE AS A HEALTHCARE PROVIDER WERE NOT ADDRESSED SUCH AS TRANSPORTATION, COMMUNITY COMMUNICATION AND ENGAGEMENT, HOMELESSNESS/UNEMPLOYMENT, CRIME, LACK OF DIVERSITY IN COMMUNITY LEADERSHIP AND RESIDENTS WITHOUT ADEQUATE HEALTH INSURANCE.ADDITIONAL INFORMATION IS PROVIDED WITHIN GWINNETT HEALTH SYSTEM'S 2018 FORM 990 FOR THE YEAR ENDED JUNE 30, 2019. GROUP B-FACILITY 2 -- HOSPITALS - GWINNETT AND DULUTH 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 B-FACILITY 2 -- HOSPITALS - GWINNETT AND DULUTH 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. 236 1 - NORTHSIDE HOSPITAL CANCER INSTITUTE -MACON 308 COLISEUM DRIVE STE 120 MACON GA 31217 PHYSICIAN SERVICES/ OUTPATIENT SERVICES 2 - NORTHSIDE HOSPITAL CANCER INSTITUTE -MILLE 624 MARTIN LUTHER KING JR DRIVE MILLEDGEVILLE GA 31061 PHYSICIAN SERVICES/ OUTPATIENT SERVICES 3 - NORTHEAST GEORGIA DIAGNOSTIC CLINIC -GAINE 1250 JESSE JEWELL PARKWAY STE 400 GAINESVILLE GA 30501 PHYSICIAN SERVICES 4 - NORTHSIDE HOSPITAL CANCER INSTITUTE -BLUE 101 RIVERSTONE VISTA STE 102 BLUE RIDGE GA 30513 PHYSICIAN SERVICES/ OUTPATIENT SERVICES 5 - NORTHSIDE HOSPITAL CANCER INSTITUTE -BLAIR 308 DEEP SOUTH FARM ROAD STE 200 BLAIRSVILLE GA 30512 PHYSICIAN SERVICES/ OUTPATIENT SERVICES 6 - NORTHSIDE HOSPITAL CANCER INSTITUTE -GRIFF 747 SOUTH 8TH STREET STE C GRIFFIN GA 30224 PHYSICIAN SERVICES/ OUTPATIENT SERVICES 7 - LAUREATE MEDICAL GROUP -ATLANTA 6135 BARFIELD ROAD STE 110 ATLANTA GA 30328 PHYSICIAN SERVICES 8 - NORTHSIDE HOSPITAL CANCER INSTITUTE -GREEN 1000 COWLES CLINIC WAY STE 102 GREENSBORO GA 30642 PHYSICIAN SERVICES/ OUTPATIENT SERVICES 9 - MEDICAL ASSOCIATES OF NORTH GEORGIA -CANTO 320 HOSPITAL ROAD STE A CANTON GA 30114 PHYSICIAN SERVICES 10 - ARTHRITIS AND TOTAL JOINT SPECIALIST -CUMM 3400 OLD MILTON PARKWAY SUITE 290 CUMMING GA 30041 PHYSICIAN SERVICES 11 - NORTHSIDE HEART -ATLANTA 1110 WEST PEACHTREE STREET STE 920C ATLANTA GA 30309 PHYSICIAN SERVICES 12 - NORTHEAST GEORGIA DIAGNOSTIC CLINIC -BRASE 1515 RIVER PLACE STE 150 BRASELTON GA 30517 PHYSICIAN SERVICES 13 - NORTHSIDE HOSPITAL CANCER INSTITUTE -HAWKI 214 PERRY HIGHWAY HAWKINSVILLE GA 31036 PHYSICIAN SERVICES/ OUTPATIENT SERVICES 14 - NORTHSIDE VASCULAR SURGERY -ATLANTA 980 JOHNSON FERRY ROAD SUITE 1040 ATLANTA GA 30342 PHYSICIAN SERVICES 15 - ATLANTA CLINICAL CARE 5673 PEACHTREE DUNWOODY RD STE 330 ATLANTA GA 30342 PHYSICIAN SERVICES 16 - NORTHSIDE HEART -BLUE RIDGE 2855 OLD HIGHWAY 5 STE 103 BLUE RIDGE GA 30513 PHYSICIAN SERVICES 17 - SOUTHEASTERN PRIMARY CARE SPECIALISTS -STO 1035 SOUTHCREST DRIVE STE 200 STOCKBRIDGE GA 30281 PHYSICIAN SERVICES 18 - NHCI RADIATION ONCOLOGY - MACON 308 COLISEUM DRIVE STE 100 MACON GA 31217 RADIATION THERAPY CENTER AND PHYSICIAN SERVICES 19 - THE IMAGING CENTER OF WARNER ROBINS 2706 WATSON BOULEVARD STE D WARNER ROBINS GA 31093 OUTPATIENT CENTER 20 - NORTH GEORGIA OBGYN SPECIALISTS -WOODSTOC 900 TOWNE LAKE PARKWAY STE 404 WOODSTOCK GA 30189 PHYSICIAN SERVICES 21 - GWINNETT ADVANCED SURGERY CENTER 2131 FOUNTAIN DRIVE STE 100 SNELLVILLE GA 30078 AMBULATORY SURGERY 22 - UROLOGY SPECIALISTS OF ATLANTA -ATLANTA 5673 PEACHTREE DUNWOODY RD STE 905 ATLANTA GA 30342 PHYSICIAN SERVICES 23 - LAUREATE MEDICAL GROUP -ATLANTA 1110 WEST PEACHTREE STREET STE 1100 ATLANTA GA 30309 PHYSICIAN SERVICES 24 - SOUTHEASTERN NEUROSURGICAL SPECIALISTS -CU 980 JOHNSON FERRY ROAD SUITE 490 ATLANTA GA 30342 PHYSICIAN SERVICES 25 - PERIMETER ADVANCED SURGERY CENTER 1100 JOHNSON FERRY ROAD STE 300 ATLANTA GA 30342 AMBULATORY SURGERY 26 - PREMIER CARE FOR WOMEN 960 JOHNSON FERRY ROAD STE 400 ATLANTA GA 30342 PHYSICIAN SERVICES 27 - CHEROKEE LUNG AND SLEEP -BLAIRSVILLE 308 DEEP SOUTH FARM ROAD STE 102 BLAIRSVILLE GA 30512 PHYSICIAN SERVICES 28 - ENDOCRINE SPECIALISTS OF ATLANTA 975 JOHNSON FERRY ROAD STE 400 ATLANTA GA 30342 PHYSICIAN SERVICES 29 - WINDERMERE MEDICAL CLINIC -CANTON 3850 WINDERMERE PARKWAY SUITE 105 CUMMING GA 30041 PHYSICIAN SERVICES 30 - MEDICAL ASSOCIATES OF NORTH GEORGIA -CANTO 460 NORTHSIDE CHEROKEE BLVD STE 300 CANTON GA 30115 PHYSICIAN SERVICES 31 - NORTHSIDE HOSPITAL SPORTS MEDICINE NETWORK 470 NORTHSIDE CHEROKEE BLVD STE 160 CANTON GA 30115 PHYSICIAN SERVICES 32 - MOUNT VERNON INTERNAL MEDICINE -ATLANTA 755 MT VERNON HIGHWAY STE 400 ATLANTA GA 30328 PHYSICIAN SERVICES 33 - NORTHSIDE FAMILY MEDICINE AND URGENT CARE 5610 BETHELVIEW ROAD STE 500 CUMMING GA 30040 PHYSICIAN SERVICES 34 - INTERNAL MEDICINE ASSOCIATES OF JOHNS CREE 3380 PADDOCKS PARKWAY STE 100 SUWANEE GA 30024 PHYSICIAN SERVICES 35 - NORTH POINT PULMONARY ASSOCIATES 1400 NORTHSIDE FORSYTH DR STE 240 CUMMING GA 30041 PHYSICIAN SERVICES 36 - CHATTAHOOCHEE SURGICAL GROUP -ALPHARETTA 3400 OLD MILTON PARKWAY STE 210A ALPHARETTA GA 30005 PHYSICIAN SERVICES 37 - UNIVERSITY GYNECOLOGIC ONCOLOGY -CUMMING 960 JOHNSON FERRY ROAD SUITE 130 ATLANTA GA 30342 PHYSICIAN SERVICES 38 - NORTHSIDE PULMONARY AND SLEEP MEDICINE -CU 1400 NORTHSIDE FORSYTH DR STE 210 CUMMING GA 30041 PHYSICIAN SERVICES 39 - CUMMING FAMILY MEDICINE -CUMMING 765 LANIER 400 PARKWAY STE A CUMMING GA 30040 PHYSICIAN SERVICES 40 - PEACHTREE DUNWOODY MEDICAL ASSOCIATES 875 JOHNSON FERRY ROAD STE 200 ATLANTA GA 30342 PHYSICIAN SERVICES 41 - MRI & IMAGING OF ATHENS 845 PRINCE AVENUE ATHENS GA 30606 OUTPATIENT CENTER 42 - JOHNS CREEK SPECIALIST CENTER 3340 PADDOCKS PARKWAY STE 100 SUWANEE GA 30024 PHYSICIAN SERVICES 43 - ATLANTA COLON AND RECTAL SURGERY -ATLANTA 5667 PEACHTREE DUNWOODY RD STE 330 ATLANTA GA 30342 PHYSICIAN SERVICES 44 - NORTHSIDE HOSPITAL SPORTS MEDICINE NETWORK 960 JOHNSON FERRY ROAD STE 415 ATLANTA GA 30342 PHYSICIAN SERVICES 45 - NORTHSIDE HEART -CUMMING 1505 NORTHSIDE FORSYTH DR STE 3600 CUMMING GA 30041 PHYSICIAN SERVICES 46 - PERIMETER NORTH MEDICAL ASSOCIATES 900 TOWNE LAKE PARKWAY STE 210 WOODSTOCK GA 30189 PHYSICIAN SERVICES 47 - NORTHSIDE NEUROLOGY -CUMMING 1400 NORTHSIDE FORSYTH DR STE 220 CUMMING GA 30041 PHYSICIAN SERVICES 48 - SOUTHEASTERN NEUROSURGICAL SPECIALISTS -JA 49 GORDON ROAD STE 100 JASPER GA 30143 PHYSICIAN SERVICES 49 - NORTHSIDE FAMILY PRACTICE 960 WOODSTOCK PARKWAY STE 300 WOODSTOCK GA 30188 PHYSICIAN SERVICES 50 - NORTHSIDE HOSPITAL CARDIOVASCULAR CARE 980 JOHNSON FERRY ROAD STE 520 ATLANTA GA 30342 PHYSICIAN SERVICES 51 - NORTHSIDE HOSPITAL SPORTS MEDICINE NETWORK 3400 OLD MILTON PARKWAY SUITE 190 CUMMING GA 30041 PHYSICIAN SERVICES 52 - NORTHSIDE FAMILY MEDICINE AND URGENT CARE 684 SIXES ROAD STE 125 CANTON GA 30115 PHYSICIAN SERVICES 53 - PERIMETER NORTH MEDICAL ASSOCIATES 3400 OLD MILTON PARKWAY STE 130 ALPHARETTA GA 30005 PHYSICIAN SERVICES 54 - ATLANTA CARDIAC AND THORACIC SURGICAL ASSO 960 JOHNSON FERRY ROAD SUITE 100 ATLANTA GA 30342 PHYSICIAN SERVICES 55 - NORTHSIDE FAMILY MEDICINE AND URGENT CARE 4800 OLDE TOWNE PARKWAY STE 150 MARIETTA GA 30068 PHYSICIAN SERVICES 56 - CUMMING FAMILY MEDICINE -CUMMING 303 PIRKLE FERRY ROAD STE A CUMMING GA 30040 PHYSICIAN SERVICES 57 - PERIMETER NORTH MEDICAL ASSOCIATES 960 JOHNSON FERRY ROAD STE 300 ATLANTA GA 30342 PHYSICIAN SERVICES 58 - NORTHSIDE HOSPITAL SPORTS MEDICINE NETWORK 5277 PEACHTREE PARKWAY NORCROSS GA 30092 PHYSICIAN SERVICES 59 - NORTHSIDE CHEROKEE PEDIATRICS -CANTON 684 SIXES ROAD STE 130 CANTON GA 30115 PHYSICIAN SERVICES 60 - ATLANTA COLON AND RECTAL SURGERY -CANTON 460 NORTHSIDE CHEROKEE BLVD STE 140A CANTON GA 30115 PHYSICIAN SERVICES 61 - ATLANTA GYNECOLOGIC ONCOLOGY -ATLANTA 980 JOHNSON FERRY ROAD STE 900 ATLANTA GA 30342 PHYSICIAN SERVICES 62 - GEORGIA COLON AND RECTAL SURGICAL ASSOCIAT 5445 MERIDIAN MARK ROAD STE 180 ATLANTA GA 30342 PHYSICIAN SERVICES 63 - LAUREATE MEDICAL GROUP -ALPHARETTA 3400 OLD MILTON PARKWAY STE 500 ALPHARETTA GA 30005 PHYSICIAN SERVICES 64 - NORTH GEORGIA DIABETES AND ENDOCRINOLOGY - 1505 NORTHSIDE FORSYTH DR STE 2800 CUMMING GA 30041 PHYSICIAN SERVICES 65 - GENERAL SURGEONS OF GWINNETT -SUWANEE 3890 JOHNS CREEK PARKWAY STE 240D SUWANEE GA 30024 PHYSICIAN SERVICES 66 - LAUREATE MEDICAL GROUP -JONESBORO 7823 SPIVEY STATION BLVD STE 310 JONESBORO GA 30236 PHYSICIAN SERVICES 67 - PERIMETER NORTH MEDICAL ASSOCIATES -CUMMIN 1505 NORTHSIDE FORSYTH DR STE 4400 CUMMING GA 30041 PHYSICIAN SERVICES 68 - MRI & IMAGING OF HABERSHAM 638 HISTORIC HIGHWAY 441 N STE D DEMOREST GA 30535 OUTPATIENT CENTER 69 - MIDTOWN MEDICAL ASSOCIATES 1110 WEST PEACHTREE STREET STE 1040 ATLANTA GA 30309 PHYSICIAN SERVICES 70 - NEUROSURGERY ANSWER 1100 NORTHSIDE FORSYTH DR STE 310 CUMMING GA 30041 PHYSICIAN SERVICES 71 - PERIMETER NORTH MEDICAL ASSOCIATES 3890 JOHNS CREEK PARKWAY STE 230 SUWANEE GA 30024 PHYSICIAN SERVICES 72 - GEORGIA GYNECOLOGIC ONCOLOGY -LAWRENCEVILL 759 OLD NORCROSS ROAD STE 100 LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 73 - NORTHSIDE CHEROKEE SURGICAL ASSOCIATES -CA 470 NORTHSIDE CHEROKEE BLVD STE 230 CANTON GA 30115 PHYSICIAN SERVICES 74 - GEORGIA COLON AND RECTAL SURGICAL ASSOCIAT 1260 HIGHWAY 54 WEST STE 100 FAYETTEVILLE GA 30214 PHYSICIAN SERVICES 75 - NORTH GEORGIA DIABETES AND ENDOCRINOLOGY - 3350 PADDOCKS PARKWAY STE 100 SUWANEE GA 30024 PHYSICIAN SERVICES 76 - GOYCO INTERNAL MEDICINE 900 SANDERS ROAD STE B CUMMING GA 30041 PHYSICIAN SERVICES 77 - NORTH ATLANTA PULMONARY AND SLEEP 993C JOHNSON FERRY ROAD STE 300 ATLANTA GA 30342 PHYSICIAN SERVICES 78 - NORTHSIDE CHEROKEE PEDIATRICS -WOODSTOCK 900 TOWNE LAKE PARKWAY STE 306 WOODSTOCK GA 30189 PHYSICIAN SERVICES 79 - MARTHA M BOONE MD 3400 OLD MILTON PARKWAY STE 560 ALPHARETTA GA 30005 PHYSICIAN SERVICES 80 - ATLANTA LIVER AND PANCREAS SURGICAL SPECIA 980 JOHNSON FERRY ROAD STE 170 ATLANTA GA 30342 PHYSICIAN SERVICES 81 - GEORGIA COLON AND RECTAL SURGICAL ASSOCIAT 721 WELLNESS WAY STE 200 LAWRENCEVILLE GA 30045 PHYSICIAN SERVICES 82 - ALPHARETTA FOOT AND ANKLE SPECIALISTS -CUM 2000 HOWARD FARM DRIVE STE 340A CUMMING GA 30041 PHYSICIAN SERVICES 83 - LAUREATE MEDICAL GROUP -MARIETTA 4800 OLDE TOWNE PARKWAY STE 400 MARIETTA GA 30068 PHYSICIAN SERVICES 84 - BARIATRIC INNOVATIONS OF ATLANTA -ATLANTA 1110 WEST PEACHTREE ST STE 1050A ATLANTA GA 30309 PHYSICIAN SERVICES 85 - TOWN LAKE PRIMARY CARE -WOODSTOCK 900 TOWNE LAKE PARKWAY STE 408 WOODSTOCK GA 30189 PHYSICIAN SERVICES 86 - MEDICAL ASSOCIATES OF NORTH GEORGIA -BALL 470 VALLEY STREET STE 200 BALL GROUND GA 30107 PHYSICIAN SERVICES 87 - NORTH ATLANTA BREAST CARE -CUMMING 1400 NORTHSIDE FORSYTH DR STE 280 CUMMING GA 30041 PHYSICIAN SERVICES 88 - ATLANTA COLON AND RECTAL SURGERY -ROSWELL 1380 UPPER HEMBREE ROAD STE A ROSWELL GA 30076 PHYSICIAN SERVICES 89 - MELANOMA AND SARCOMA SPECIALISTS OF GEORGI 980 JOHNSON FERRY ROAD STE 940 ATLANTA GA 30342 PHYSICIAN SERVICES 90 - GEORGIA COLON AND RECTAL SURGICAL ASSOCIAT 1505 NORTHSIDE FORSYTH DR STE 2900 CUMMING GA 30041 PHYSICIAN SERVICES 91 - ANKLE AND FOOT CENTERS OF NORTH GEORGIA -B 1255 FRIENDSHIP ROAD STE 200 BRASELTON GA 30517 PHYSICIAN SERVICES 92 - INTERNAL MEDICINE PRACTICE OF NORTHSIDE -A 10745 WESTSIDE WAY STE 125 ALPHARETTA GA 30009 PHYSICIAN SERVICES 93 - LAUREATE MEDICAL GROUP -CANTON 684 SIXES ROAD STE 250 CANTON GA 30115 PHYSICIAN SERVICES 94 - RAVRY MEDICAL GROUP 5505 PEACHTREE DUNWOODY RD STE 650 ATLANTA GA 30342 PHYSICIAN SERVICES 95 - EAST COBB FAMILY MEDICINE -MARIETTA 1121 JOHNSON FERRY ROAD STE 305 MARIETTA GA 30068 PHYSICIAN SERVICES 96 - ROSWELL INTERNAL MEDICINE SPECIALISTS 1357 HEMBREE ROAD STE 130 ROSWELL GA 30076 PHYSICIAN SERVICES 97 - NORTHSIDE FAMILY MEDICINE AND URGENT CARE 1110 WEST PEACHTREE STREET STE P200 ATLANTA GA 30309 PHYSICIAN SERVICES 98 - CUMMING FAMILY MEDICINE -DAWSONVILLE 133 PROMINENCE COURT STE 230 DAWSONVILLE GA 30534 PHYSICIAN SERVICES 99 - NORTHSIDE HOSPITAL SPORTS MEDICINE NETWORK 4800 OLDE TOWNE PARKWAY STE 430 MARIETTA GA 30068 PHYSICIAN SERVICES 100 - SURGICAL SPECIALISTS OF ATLANTA -ATLANTA 1110 WEST PEACHTREE STREET STE 1010 ATLANTA GA 30309 PHYSICIAN SERVICES 101 - REPRODUCTIVE SURGICAL SPECIALISTS 1800 NORTHSIDE FORSYTH DR STE 380 CUMMING GA 30041 PHYSICIAN SERVICES 102 - CUMMING FAMILY MEDICINE -MARBLE HILL 25 FOOTHILLS PARKWAY STE 108 MARBLE HILL GA 30148 PHYSICIAN SERVICES 103 - NORTHSIDE HOSPITAL SPORTS MEDICINE NETWORK 1110 WEST PEACHTREE STREET STE 950 ATLANTA GA 30309 PHYSICIAN SERVICES 104 - NORTH POINT PRIMARY CARE 3180 NORTH POINT PARKWAY STE 201 ALPHARETTA GA 30005 PHYSICIAN SERVICES 105 - NEUROSURGERY AND SPINE ASSOCIATES 631 PROFESSIONAL DRIVE STE 360 LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 106 - ANDERSON FAMILY MEDICINE 81 NORTHSIDE DAWSON DRIVE STE 205 DAWSONVILLE GA 30534 PHYSICIAN SERVICES 107 - NORTHSIDE FAMILY MEDICINE AND URGENT CARE 11685 ALPHARETTA HWY STE 150 ROSWELL GA 30076 PHYSICIAN SERVICES 108 - NEWTOWN MEDICAL 3400 OLD MILTON PARKWAY STE 200 ALPHARETTA GA 30005 PHYSICIAN SERVICES 109 - NORTHSIDE HOSPITAL SPORTS MEDICINE NETWORK 1839 BUFORD HIGHWAY NE STE 100 BUFORD GA 30518 PHYSICIAN SERVICES 110 - KENNESAW FAMILY MEDICINE 6110 PINE MOUNTAIN ROAD KENNESAW GA 30152 PHYSICIAN SERVICES 111 - GEORGIA ORTHOPEDIC SPECIALISTS -CANTON 460 NORTHSIDE CHEROKEE BLVD STE 430C CANTON GA 30115 PHYSICIAN SERVICES 112 - NORTHSIDE MEDICAL SPECIALISTS 145 RIVERSTONE TERRACE STE 100 CANTON GA 30114 PHYSICIAN SERVICES 113 - GEORGIA GYNECOLOGIC ONCOLOGY -ATLANTA 1110 WEST PEACHTREE ST STE 1050B ATLANTA GA 30309 PHYSICIAN SERVICES 114 - PRIMARY CARE OF BROOKHAVEN -ATLANTA 4062 PEACHTREE ROAD STE C ATLANTA GA 30319 PHYSICIAN SERVICES 115 - NORTHSIDE HOSPITAL SPORTS MEDICINE NETWORK 5555 PEACHTREE DUNWOODY RD STE 101 ATLANTA GA 30342 PHYSICIAN SERVICES 116 - LANIER FAMILY PRACTICE 1080 SANDERS ROAD STE 100 CUMMING GA 30041 PHYSICIAN SERVICES 117 - CHEROKEE LUNG AND SLEEP -WOODSTOCK 900 TOWNE LAKE PARKWAY STE 206 WOODSTOCK GA 30189 PHYSICIAN SERVICES 118 - SLEEP DISORDERS CENTER OF GEORGIA 993C JOHNSON FERRY ROAD STE 301 ATLANTA GA 30342 PHYSICIAN SERVICES 119 - NORTHSIDE HOSPITAL SPORTS MEDICINE NETWORK 11685 ALPHARETTA HWY STE 170 ROSWELL GA 30076 PHYSICIAN SERVICES 120 - GEORGIA COLON AND RECTAL SURGICAL ASSOCIAT 1110 WEST PEACHTREE STREET STE 1030 ATLANTA GA 30309 PHYSICIAN SERVICES 121 - GEORGIA COLON AND RECTAL SURGICAL ASSOCIAT 3400 OLD MILTON PARKWAY STE 440 ALPHARETTA GA 30005 PHYSICIAN SERVICES 122 - VASCULAR MEDICINE AND SURGERY SPECIALISTS 2675 N DECATUR ROAD STE 701 DECATUR GA 30033 PHYSICIAN SERVICES 123 - NORTH GEORGIA OBGYN SPECIALISTS -BLUE RID 2855 OLD HIGHWAY 5 STE 110 BLUE RIDGE GA 30513 PHYSICIAN SERVICES 124 - LAUREATE MEDICAL GROUP -CANTON 460 NORTHSIDE CHEROKEE BLVD STE 170 CANTON GA 30115 PHYSICIAN SERVICES 125 - COMPLETE CARDIOLOGY 1100 JOHNSON FERRY ROAD STE 450 ATLANTA GA 30342 PHYSICIAN SERVICES 126 - NORTH GEORGIA OBGYN SPECIALISTS -EAST ELL 433 HIGHLAND CROSSING STE 203 EAST ELLIJAY GA 30540 PHYSICIAN SERVICES 127 - GEORGIA COLON AND RECTAL SURGICAL ASSOCIAT 2801 N DECATUR ROAD STE 120 DECATUR GA 30033 PHYSICIAN SERVICES 128 - CHEROKEE BREAST CARE -CANTON 460 NORTHSIDE CHEROKEE BLVD STE 420 CANTON GA 30115 PHYSICIAN SERVICES/ OUTPATIENT SERVICES 129 - NORTHEAST GEORGIA DIAGNOSTIC CLINIC -BRASE 1270 FRIENDSHIP ROAD STE 100C BRASELTON GA 30517 PHYSICIAN SERVICES 130 - INTERNAL MEDICINE SPECIALIST OF ROSWELL 11685 ALPHARETTA HWY STE 270 ROSWELL GA 30076 PHYSICIAN SERVICES/ OUTPATIENT SERVICES 131 - MASON PEDIATRICS 665 DULUTH HIGHWAY STE 920 LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 132 - NORTHSIDE CARDIAC SURGERY 631 PROFESSIONAL DRIVE STE 200 LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 133 - JOHN ATTOKAREN MD 11600 ATLANTIS PLACE STE B ALPHARETTA GA 30022 PHYSICIAN SERVICES 134 - GWINNETT PHYSICIANS GROUP OBGYN 1942 ATKINSON ROAD STE 100 LAWRENCEVILLE GA 30043 PHYSICIAN SERVICES 135 - PRIMARY CARE OF MILTON 980 BIRMINGHAM ROAD STE 304 MILTON GA 30004 PHYSICIAN SERVICES 136 - PERIMETER NORTH MEDICAL ASSOCIATES 10515 BELLS FERRY ROAD STE 200 CANTON GA 30114 PHYSICIAN SERVICES 137 - NORTHSIDE CHEROKEE SURGICAL ASSOCIATES -CA 460 NORTHSIDE CHEROKEE BLVD STE 140D CANTON GA 30115 PHYSICIAN SERVICES 138 - ATLANTA GYNECOLOGIC ONCOLOGY -MARIETTA 780 CANTON ROAD STE 405 MARIETTA GA 30060 PHYSICIAN SERVICES 139 - WINDERMERE MEDICAL CLINIC -BALDWIN 386 HIGHWAY 441 BYPASS BALDWIN GA 30551 PHYSICIAN SERVICES 140 - HARPER AND ASSOC FAMILY MEDICINE 6000 HILLANDALE DRIVE STE 100 LITHONIA GA 30058 PHYSICIAN SERVICES 141 - GWINNETT CONSULTANTS IN CARDIOLOGY 755 WALTHER ROAD LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 142 - GEORGIA PULMONARY AND CRITICAL CARE CONSUL 1505 NORTHSIDE BOULEVARD STE 3000 CUMMING GA 30041 PHYSICIAN SERVICES 143 - GWINNETT INTERNAL MEDICINE ASSOCIATES -BUF 2850 HOG MOUNTAIN ROAD STE 101 BUFORD GA 30019 PHYSICIAN SERVICES 144 - GROFF FAMILY MEDICINE 115 LEE BYRD ROAD LOGANVILLE GA 30052 PHYSICIAN SERVICES 145 - ADULT PRIMARY CARE 575 PROFESSIONAL DRIVE STE 510 LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 146 - MEDICAL ASSOCIATES OF NORTH GEORGIA -CANTO 470 NORTHSIDE CHEROKEE BLVD STE 380 CANTON GA 30115 PHYSICIAN SERVICES 147 - GWINNETT SURGERY CENTER 631 PROFESSIONAL DRIVE STE 360 LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 148 - SURGICAL SPECIALISTS OF ATLANTA -ALPHARETT 3400 OLD MILTON PARKWAY STE 440 ALPHARETTA GA 30005 PHYSICIAN SERVICES 149 - GWINNETT FAMILY MEDICAL CARE 2835 CENTERVILLE HIGHWAY BUILDNG ONE SNELLVILLE GA 30078 PHYSICIAN SERVICES 150 - COVENANT FAMILY MEDICINE 2069 TERON TRACE STE 100 BUFORD GA 30019 PHYSICIAN SERVICES 151 - CHEROKEE LUNG AND SLEEP -EAST ELLIJAY 433 HIGHLAND CROSSING STE 203B EAST ELLIJAY GA 30540 PHYSICIAN SERVICES 152 - BOSTOCK FAMILY MEDICINE 771 OLD NORCROSS ROAD STE 255 LAWRENCEVILLE GA 30045 PHYSICIAN SERVICES 153 - GWINNETT EAR NOSE AND THROAT 3855 PLEASANT HILL ROAD STE 280 DULUTH GA 30096 PHYSICIAN SERVICES 154 - ACADEMIC INTERNAL MEDICINE 500 MEDICAL CENTER BLVD STE 310 LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 155 - DACULA FAMILY MEDICINE 2850 HOG MOUNTAIN ROAD STE 102 BUFORD GA 30019 PHYSICIAN SERVICES 156 - SUWANEE PRIMARY CARE -SUWANEE 1120 PEACHTREE INDUSTRIAL BLVD STE 208 SUWANEE GA 30024 PHYSICIAN SERVICES 157 - NORTH ATLANTA MEDICAL ASSOCIATES -JOHNS CR 10700 MEDLOCK BRIDGE ROAD STE 201 JOHNS CREEK GA 30097 PHYSICIAN SERVICES 158 - GORDON J AZAR SR MD INTERNAL MEDICINE 960 JOHNSON FERRY ROAD STE 235 ATLANTA GA 30342 PHYSICIAN SERVICES 159 - NORTH FULTON RHEUMATOLOGY 1300 UPPER HEMBREE ROAD BUILDING 100 STE ROSWELL GA 30076 PHYSICIAN SERVICES 160 - NORTHSIDE HOSPITAL SPORTS MEDICINE NETWORK 3280 PEACHTREE ROAD NE STE 160 ATLANTA GA 30305 PHYSICIAN SERVICES 161 - GWINNETT PHYSICIAN GROUP CONCUSSION 3855 PLEASANT HILL ROAD STE 130 DULUTH GA 30096 PHYSICIAN SERVICES 162 - NORTH ATLANTA MEDICAL ASSOCIATES -STONE MO 809 MAIN STREET STONE MOUNTAIN GA 30083 PHYSICIAN SERVICES 163 - PEACHTREE CORNERS INTERNAL MEDICINE 5277 PEACHTREE PARKWAY NORCROSS GA 30092 PHYSICIAN SERVICES 164 - ATLANTA CARDIAC AND THORACIC SURGICAL ASSO 1110 WEST PEACHTREE STREET STE 1010 ATLANTA GA 30309 PHYSICIAN SERVICES 165 - STRICKLAND FAMILY MEDICINE 655 DULUTH HIGHWAY STE 501 LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 166 - WOUND TREATMENT CENTER 100 MEDICAL CENTER BLVD STE 165 LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 167 - GLANCY REHABILITATION CENTER 3215 MCCLURE BRIDGE ROAD DULUTH GA 30096 PHYSICIAN SERVICES 168 - GWINNETT EXTENDED CARE CENTER -LAWRENCEVI 650 PROFESSIONAL DRIVE LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 169 - GWINNETT EXTENDED CARE CENTER -LAWRENCEVIL 650 PROFESSIONAL DRIVE LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 170 - ARTHRITIS AND TOTAL JOINT SPECIALIST -CUMM 2000 HOWARD FARM DRIVE STE T110 CUMMING GA 30041 PHYSICIAN SERVICES 171 - NORTHEAST GEORGIA DIAGNOSTIC CLINIC -GAINE 1276 JESSE JEWELL PARKWAY STE B-C2 GAINESVILLE GA 30501 PHYSICIAN SERVICES 172 - ATLANTA CARDIAC AND THORACIC SURGICAL ASSO 1366 WELLBROOK COURT NE STE B CONYERS GA 30012 PHYSICIAN SERVICES 173 - GWINNETT INTERNAL MEDICINE ASSOCIATES -LAW 601 OLD NORCROSS ROAD STE A LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 174 - UNIVERSITY GYNECOLOGIC ONCOLOGY -ATLANTA 1110 WEST PEACHTREE STREET STE 810C ATLANTA GA 30309 PHYSICIAN SERVICES 175 - ARTHRITIS AND TOTAL JOINT SPECIALIST -MARI 4800 OLDE TOWNE PARKWAY STE 430A MARIETTA GA 30068 PHYSICIAN SERVICES 176 - GEORGIA GYNECOLOGIC ONCOLOGY -CUMMING 1505 NORTHSIDE FORSYTH DR STE 3800B CUMMING GA 30041 PHYSICIAN SERVICES 177 - NORTHSIDE HEART -ALPHARETTA 3400 OLD MILTON PARKWAY STE 360B ALPHARETTA GA 30005 PHYSICIAN SERVICES 178 - ANKLE AND FOOT CENTERS OF NORTH GEORGIA -C 2000 HOWARD FARM DRIVE STE 340B CUMMING GA 30041 PHYSICIAN SERVICES 179 - NORTHSIDE PULMONARY AND SLEEP MEDICINE -DA 81 NORTHSIDE DAWSON DRIVE STE 315B DAWSONVILLE GA 30534 PHYSICIAN SERVICES 180 - CHATTAHOOCHEE SURGICAL GROUP -DAWSONVILLE 81 NORTHSIDE DAWSON DRIVE STE 305D DAWSONVILLE GA 30534 PHYSICIAN SERVICES 181 - GEORGIA GYNECOLOGIC ONCOLOGY -WOODSTOCK 900 TOWNE LAKE PARKWAY STE 302F WOODSTOCK GA 30189 PHYSICIAN SERVICES 182 - SOUTHEASTERN NEUROSURGICAL SPECIALISTS -AL 3400 OLD MILTON PARKWAY STE 210D ALPHARETTA GA 30005 PHYSICIAN SERVICES 183 - CHEROKEE LUNG AND SLEEP -EAST ELLIJAY 433 HIGHLAND CROSSING STE 203A EAST ELLIJAY GA 30540 PHYSICIAN SERVICES 184 - SOUTHEASTERN NEUROSURGICAL SPECIALISTS -WO 900 TOWNE LAKE PARKWAY STE 202B WOODSTOCK GA 30189 PHYSICIAN SERVICES 185 - ATLANTA CARDIAC AND THORACIC SURGICAL ASSO 460 NORTHSIDE CHEROKEE BLVD STE 140B CANTON GA 30115 PHYSICIAN SERVICES 186 - ARTHRITIS AND TOTAL JOINT SPECIALIST -ATLA 5670 PEACHTREE DUNWOODY RD STE 1230-SUB ATLANTA GA 30342 PHYSICIAN SERVICES 187 - SURGICAL SPECIALISTS OF ATLANTA -MARIETTA 4800 OLDE TOWNE PARKWAY STE 110B MARIETTA GA 30068 PHYSICIAN SERVICES 188 - ARTHRITIS AND TOTAL JOINT SPECIALIST -CUMM 1505 NORTHSIDE FORSYTH DR STE 3500 CUMMING GA 30041 PHYSICIAN SERVICES 189 - NORTH GEORGIA DIABETES AND ENDOCRINOLOGY - 1505 NORTHSIDE FORSYTH DR STE 2850 CUMMING GA 30041 PHYSICIAN SERVICES 190 - NORTHSIDE VASCULAR SURGERY -CUMMING 1505 NORTHSIDE FORSYTH DRIVE SUITE 2400 CUMMING GA 30041 PHYSICIAN SERVICES 191 - ARTHRITIS AND TOTAL JOINT SPECIALIST -ATLA 1110 WEST PEACHTREE STREET STE 940 ATLANTA GA 30309 PHYSICIAN SERVICES 192 - SURGICAL SPECIALISTS OF ATLANTA -ATLANTA 5670 PEACHTREE DUNWOODY RD STE 920 ATLANTA GA 30342 PHYSICIAN SERVICES 193 - GEORGIA GYNECOLOGIC ONCOLOGY -ATLANTA 980 JOHNSON FERRY ROAD STE 910 ATLANTA GA 30342 PHYSICIAN SERVICES 194 - NORTHSIDE HEART -ATLANTA 5670 PEACHTREE DUNWOODY RD STE 880 ATLANTA GA 30342 PHYSICIAN SERVICES 195 - SOUTHEASTERN NEUROSURGICAL SPECIALISTS -AT 2001 PEACHTREE ROAD STE 670 ATLANTA GA 30309 PHYSICIAN SERVICES 196 - ALPHARETTA FOOT AND ANKLE SPECIALISTS -ALP 3400 OLD MILTON PARKWAY STE 500 ALPHARETTA GA 30005 PHYSICIAN SERVICES 197 - SOUTHEASTERN NEUROSURGICAL SPECIALISTS -AT 1100 NORTHSIDE FORSYTH DRIVE SUITE 360B CUMMING GA 30041 PHYSICIAN SERVICES 198 - GENERAL SURGEONS OF GWINNETT -LAWRENCEVILL 631 PROFESSIONAL DRIVE STE 470 LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 199 - NORTHSIDE HEART -MARIETTA 4800 OLDE TOWNE PARKWAY STE 420 MARIETTA GA 30068 PHYSICIAN SERVICES 200 - NORTHSIDE CHEROKEE SURGICAL ASSOCIATES -WO 900 TOWNE LAKE PARKWAY STE 412 WOODSTOCK GA 30189 PHYSICIAN SERVICES 201 - ATLANTA GYNECOLOGIC ONCOLOGY -CANTON 460 NORTHSIDE CHEROKEE BLVD STE 400 CANTON GA 30115 PHYSICIAN SERVICES 202 - NORTHSIDE HEART -WOODSTOCK 900 TOWNE LAKE PARKWAY STE 400 WOODSTOCK GA 30189 PHYSICIAN SERVICES 203 - NORTH GEORGIA DIABETES AND ENDOCRINOLOGY - 3890 JOHNS CREEK PARKWAY STE 360 SUWANEE GA 30024 PHYSICIAN SERVICES 204 - NORTHSIDE HEART -ALPHARETTA 3400 OLD MILTON PARKWAY STE 360 ALPHARETTA GA 30005 PHYSICIAN SERVICES 205 - NORTHSIDE HOSPITAL SPORTS MEDICINE NETWORK 900 TOWNE LAKE PARKWAY STE 320 WOODSTOCK GA 30189 PHYSICIAN SERVICES 206 - ARTHRITIS AND TOTAL JOINT SPECIALIST -BRAS 1255 FRIENDSHIP ROAD STE 310 BRASELTON GA 30517 PHYSICIAN SERVICES 207 - ARTHRITIS AND TOTAL JOINT SPECIALIST -GAIN 1475 JESSE JEWELL PKWY NE STE 310 GAINESVILLE GA 30501 PHYSICIAN SERVICES 208 - NORTHSIDE HOSPITAL SPORTS MEDICINE NETWORK 2000 HOWARD FARM DRIVE STE 300 CUMMING GA 30041 PHYSICIAN SERVICES 209 - ARTHRITIS AND TOTAL JOINT SPECIALIST -ALPH 3400 OLD MILTON PARKWAY STE 290 ALPHARETTA GA 30005 PHYSICIAN SERVICES 210 - NORTHSIDE NEUROLOGY -CUMMING 1400 NORTHSIDE FORSYTH DR STE 250 CUMMING GA 30041 PHYSICIAN SERVICES 211 - CHEROKEE BREAST CARE -CANTON 684 SIXES ROAD STE 230 CANTON GA 30115 PHYSICIAN SERVICES/ OUTPATIENT SERVICES 212 - ANKLE AND FOOT CENTERS OF NORTH GEORGIA -D 81 NORTHSIDE DAWSON DRIVE STE 204 DAWSONVILLE GA 30534 PHYSICIAN SERVICES 213 - ARTHRITIS AND TOTAL JOINT SPECIALIST -WOOD 960 WOODSTOCK PARKWAY STE 200 WOODSTOCK GA 30188 PHYSICIAN SERVICES 214 - ATLANTA CARDIAC AND THORACIC SURGICAL ASSO 308 DEEP SOUTH FARM ROAD STE 200 BLAIRSVILLE GA 30512 PHYSICIAN SERVICES 215 - NORTH ATLANTA MEDICAL ASSOCIATES -DECATUR 2545 LAWRENCEVILLE HIGHWAY STE 200 DECATUR GA 30033 PHYSICIAN SERVICES 216 - ARTHRITIS AND TOTAL JOINT SPECIALIST -CANT 470 NORTHSIDE CHEROKEE BLVD STE 160 CANTON GA 30115 PHYSICIAN SERVICES 217 - BARIATRIC INNOVATIONS OF ATLANTA -ATLANTA 6135 BARFIELD ROAD STE 150 ATLANTA GA 30328 PHYSICIAN SERVICES 218 - ARTHRITIS AND TOTAL JOINT SPECIALIST -LAWR 771 OLD NORCROSS ROAD STE 135 LAWRENCEVILLE GA 30045 PHYSICIAN SERVICES 219 - CHEROKEE LUNG AND SLEEP -CANTON 460 NORTHSIDE CHEROKEE BLVD STE 130 CANTON GA 30115 PHYSICIAN SERVICES 220 - UNIVERSITY GYNECOLOGIC ONCOLOGY -ATLANTA 960 JOHNSON FERRY ROAD STE 130 ATLANTA GA 30342 PHYSICIAN SERVICES 221 - NORTHSIDE PULMONARY AND SLEEP MEDICINE -BU 4700 NELSON BROGDON BLVD STE 125 BUFORD GA 30019 PHYSICIAN SERVICES 222 - GEORGIA ORTHOPEDIC SPECIALISTS -CARTERSVIL 970 JOE FRANK HARRIS PKWY STE 120 CARTERSVILLE GA 30120 PHYSICIAN SERVICES 223 - SOUTHEASTERN PRIMARY CARE SPECIALISTS -FAY 105 CARNEGIE PLACE STE 111 FAYETTEVILLE GA 30214 PHYSICIAN SERVICES 224 - WINDERMERE MEDICAL CLINIC -CUMMING 200 EAGLES NEST DRIVE SUITE 300 CANTON GA 30115 PHYSICIAN SERVICES 225 - SOUTHEASTERN PRIMARY CARE SPECIALISTS -FAY 105 CARNEGIE PLACE STE 103 FAYETTEVILLE GA 30214 PHYSICIAN SERVICES 226 - ATLANTA CARDIAC AND THORACIC SURGICAL ASSO 1100 NORTHSIDE FORSYTH DRIVE SUITE 410 CUMMING GA 30041 PHYSICIAN SERVICES 227 - CHATTAHOOCHEE SURGICAL GROUP -CUMMING 980 SANDERS ROAD STE 100 CUMMING GA 30042 PHYSICIAN SERVICES 228 - MOUNT VERNON INTERNAL MEDICINE -DAWSONVILL 81 NORTHSIDE DAWSON DRIVE STE 100 DAWSONVILLE GA 30534 PHYSICIAN SERVICES 229 - NORTH GEORGIA DIABETES AND ENDOCRINOLOGY - 4310 JOHNS CREEK PARKWAY STE 100 SUWANEE GA 30024 PHYSICIAN SERVICES 230 - NORTHSIDE VASCULAR SURGERY -CANTON 460 NORTHSIDE CHEROKEE BLVD STE 100 CANTON GA 30115 PHYSICIAN SERVICES 231 - SOUTHEASTERN NEUROSURGICAL SPECIALISTS -MA 631 CAMPBELL HILL STREET STE 100 MARIETTA GA 30060 PHYSICIAN SERVICES 232 - NORTHSIDE CARDIOVASCULAR INSTITUTE 684 SIXES ROAD STE 230 HOLLY SPRINGS GA 30115 PHYSICIAN SERVICES 233 - NORTHSIDE CARDIOVASCULAR INSTITUTE 6135 BARFIELD ROAD STE 100 ATLANTA GA 30328 PHYSICIAN SERVICES 234 - NORTHSIDE CARDIOVASCULAR INSTITUTE 1150 HAMMOND DRIVE STE 520 SANDY SPRINGS GA 30328 PHYSICIAN SERVICES 235 - NORTHSIDE GWINNETT SURGICAL ASSOCIATES 631 PROFESSIONAL DRIVE STE 300 LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 236 - NORTHSIDE CARDIOVASCULAR INSTITUTE 1110 WEST PEACHTREE STREET STE 920E 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 $197,611,769 HAS BEEN REMOVED FROM TOTAL EXPENSE TO COMPUTE THE PERCENTAGE IN COLUMN (F). 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 SUPPORTED NEARLY 40 DIFFERENT COMMUNITY BUILDING ACTIVITIES OVER THE PAST YEAR INCLUDING ECONOMIC DEVELOPMENT, COMMUNITY SUPPORT AND PHYSICAL IMPROVEMENTS/HOUSING. TO ILLUSTRATE OUR COMMUNITY SUPPORT, NORTHSIDE CONTRIBUTED TO THE NOT-FOR-PROFIT ATLANTA SPEECH SCHOOL. THE ATLANTA SPEECH SCHOOL IS A UNIQUE EDUCATIONAL ORGANIZATION IN THE ATLANTA COMMUNITY, SERVING STUDENTS WITH SPECIAL NEEDS INCLUDING INFANTS AND CHILDREN WHO ARE DEAF OR HARD OF HEARING, THOSE WHO STRUGGLE WITH LANGUAGE-BASED LEARNING DISABILITIES, AND THOSE WHO HAVE SIGNIFICANT SPEECH AND/OR LANGUAGE DELAYS. THE HIGHLY-TRAINED TEACHERS AND THERAPISTS HELP CHILDREN OVERCOME OBSTACLES TO LEARNING, WITH A STRONG EMPHASIS ON READING PROFICIENCY. COMPRISING FOUR SCHOOLS, FIVE CLINICS, AND AN INNOVATIVE PROFESSIONAL DEVELOPMENT CENTER, THE SPEECH SCHOOL IMPACTS THE LIVES OF MORE THAN 12,000 CHILDREN AND ADULTS ANNUALLY WITH EMPHASIS ON GIVING EACH CHILD AND ADULT THE POWER OF LANGUAGE AND LITERACY FOR A LIFETIME. NORTHSIDE RECOGNIZES THAT HOUSING IS AN IMPORTANT SOCIAL DETERMINANT OF HEALTH, AND THAT THE ATLANTA AREA HAS EXPERIENCED RAPID RESIDENTIAL GROWTH MAKING GENTRIFICATION A GROWING CONCERN. THUS, NORTHSIDE SUPPORTED THE ATLANTA HABITAT FOR HUMANITY/MARIST WOMEN BUILD'S INITIATIVE TO BUILD AFFORDABLE HOUSING FOR SINGLE MOTHERS IN NEED. ESTABLISHED IN 2001, MARIST WOMEN BUILD ("MWB") WAS THE FIRST HIGH SCHOOL ALL-WOMEN BUILD CHAPTER IN THE WORLD. MWB'S VISION OF "WOMEN BUILDING HOMES FOR WOMEN" HAS BEEN REALIZED BY PROVIDING HOMES FOR SINGLE MOTHERS AND THEIR FAMILIES. TO DATE, MWB HAS BUILT 18 HOMES FOR 18 SINGLE MOTHERS AND THEIR 44 CHILDREN. IN 2017, 72% OF ATLANTA HABITAT HOMEOWNERS SAID THEY HAD IMPROVED HEALTH AND 84% OF THEIR CHILDREN GRADUATED FROM HIGH SCHOOL. PART III, LINE 4: NORTHSIDE PROVIDES FOR ACCOUNTS RECEIVABLE THAT COULD BECOME UNCOLLECTIBLE IN THE FUTURE BY ESTABLISHING AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS TO REDUCE THE CARRYING VALUE OF SUCH RECEIVABLES TO THEIR ESTIMATED NET REALIZABLE VALUE. NORTHSIDE ESTIMATES THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED ON HISTORICAL AND EXPECTED COLLECTIONS, ACCOUNTS RECEIVABLE AGINGS, TRENDS IN REIMBURSEMENT, GENERAL BUSINESS AND ECONOMIC CONDITIONS, AND OTHER COLLECTION INDICATORS. COLLECTIONS ARE IMPACTED BY THE ABILITY OF PATIENTS TO PAY AND THE EFFECTIVENESS OF NORTHSIDE'S COLLECTION EFFORTS. SIGNIFICANT CHANGES IN PAYOR MIX, BUSINESS OFFICE OPERATIONS, GENERAL ECONOMIC CONDITIONS, OR TRENDS IN FEDERAL AND STATE GOVERNMENTAL HEALTH CARE COVERAGE COULD AFFECT NORTHSIDE'S COLLECTION OF ACCOUNTS RECEIVABLE AND THE ESTIMATES OF THE COLLECTABILITY OF FUTURE ACCOUNTS RECEIVABLE. NORTHSIDE ALSO PERIODICALLY REVIEWS ITS OVERALL RESERVE ADEQUACY BY MONITORING HISTORICAL CASH COLLECTIONS AS A PERCENTAGE OF GROSS AND NET PATIENT SERVICE REVENUE BY PAYOR, AS WELL AS BY ANALYZING PAYOR CLASSIFICATIONS, AGED ACCOUNTS RECEIVABLE BY PAYOR, AND GENERAL BUSINESS AND ECONOMIC CONDITIONS.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 2019 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 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.FOR MORE INFORMATION ON NORTHSIDE HOSPITAL GWINNETT AND NORTHSIDE HOSPITAL DULUTH, THE COMMUNITY THEY SERVE, HOW THEY ASSESS THE NEEDS OF THAT COMMUNITY AS WELL AS PROMOTE COMMUNITY HEALTH, ADDITIONAL INFORMATION IS AVAILABLE AT HTTPS://WWW.GWINNETTMEDICALCENTER.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/. 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, AND NORTHSIDE HOSPITAL-FORSYTH DEVELOPED A SINGLE COMMUNITY DEFINITION IN COMPLIANCE WITH IRS SECTION 501(R) FINAL RULE. THE NORTHSIDE COMMUNITY CONSISTS OF CHEROKEE, COBB, DAWSON, DEKALB, FORSYTH, FULTON, GWINNETT, AND PICKENS COUNTIES.IN 2017, THE ESTIMATED 3.9 MILLION RESIDENTS OF THE NORTHSIDE COMMUNITY ACCOUNTED FOR 38% OF GEORGIA'S TOTAL POPULATION. THE NORTHSIDE COMMUNITY IS SLIGHTLY YOUNGER THAN GEORGIA OVERALL, WITH A MEDIAN AGE OF 35.9 COMPARED TO GEORGIA'S 36.5. OVERALL, THE 2017 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.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.FOR MORE INFORMATION ON NORTHSIDE HOSPITAL GWINNETT AND NORTHSIDE HOSPITAL DULUTH, THE COMMUNITY THEY SERVE, HOW THEY ASSESS THE NEEDS OF THAT COMMUNITY AS WELL AS PROMOTE COMMUNITY HEALTH, ADDITIONAL INFORMATION IS AVAILABLE AT HTTPS://WWW.GWINNETTMEDICALCENTER.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/. 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 ON 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. FOR EXAMPLE, NORTHSIDE COMMITTED $8.5 MILLION TO DEVELOP A MEDICAL OFFICE BUILDING IN HALL COUNTY, GEORGIA IN ORDER TO IMPROVE ACCESS TO OUTPATIENT SERVICES AND MEDICAL SPECIALTIES FOR RESIDENTS OF THE NORTHEASTERN REGION OF ITS COMMUNITY. NORTHSIDE ALSO COMMITTED TO INVEST $23.8 MILLION TO DEVELOP A FREESTANDING, MULTI-SPECIALTY AMBULATORY SURGERY CENTER TO BE LOCATED IN THE AFOREMENTIONED MEDICAL OFFICE BUILDING. AS PART OF ITS SURGERY CENTER PROPOSAL, NORTHSIDE COMMITTED TO SERVING THE REGION'S MOST VULNERABLE POPULATION THROUGH A PROPRIETARY PROGRAM CALLED THE BRASELTON CHARITABLE OUTPATIENT SURGERY PROGRAM WHEREBY NORTHSIDE WILL PARTNER WITH COMMUNITY SAFETY NET CLINICS TO PROVIDE MEDICALLY-NECESSARY OUTPATIENT SURGERY AND ALL RELATED ANCILLARY SUPPORT SERVICES AT NO COST TO UNINSURED OR FINANCIALLY-INDIGENT PATIENTS. PRESENTLY, THIS PROJECT IS DELAYED AS IT WINDS ITS WAY THROUGH GEORGIA'S CERTIFICATE-OF-NEED APPEALS PROCESS; HOWEVER, NORTHSIDE REMAINS COMMITTED TO THE PROJECT. NORTHSIDE IS PROCEEDING WITH A $39.8 MILLION EXPANSION OF ITS CHEROKEE COUNTY HOSPITAL. THROUGH THIS PROJECT, NORTHSIDE CHEROKEE WILL INCREASE ITS INPATIENT BED CAPACITY FROM 158 TO 211 BEDS AND WILL INCREASE THE NUMBER OF SHARED OPERATING ROOMS FROM 11 TO 15 IN ORDER TO MEET THE NEEDS OF THE COMMUNITY. FOR MORE INFORMATION ON NORTHSIDE HOSPITAL GWINNETT AND NORTHSIDE HOSPITAL DULUTH, THE COMMUNITY THEY SERVE, HOW THEY ASSESS THE NEEDS OF THAT COMMUNITY AS WELL AS PROMOTE COMMUNITY HEALTH, ADDITIONAL INFORMATION IS AVAILABLE AT HTTPS://WWW.GWINNETTMEDICALCENTER.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS/. 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, THE HOSPITAL 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. IS NOT REQUIRED TO FILE A COMMUNITY BENEFIT REPORT UNDER GEORGIA LAW; HOWEVER, IT DOES PREPARE AN ANNUAL COMMUNITY BENEFIT REPORT, AVAILABLE ON OUR WEBSITE:NORTHSIDE HOSPITAL ATLANTA, CHEROKEE AND FORSYTHHTTPS://WWW.NORTHSIDE.COM/COMMUNITY-BENEFITS-REPORTTHE FOLLOWING COMMUNITY BENEFITS REPORT WAS PREPARED FOR THE YEAR ENDED JUNE 30, 2019 FOR THE FACILITIES FORMERLY KNOWN AS GWINNETT MEDICAL CENTER - LAWRENCEVILLE AND GWINNETT MEDICAL CENTER - DULUTH. A COMMUNITY BENEFITS REPORT WAS NOT PREPARED FOR THESE HOSPITAL FACILITIES POST-MERGER UNDER NORTHSIDE FOR THE YEAR ENDED SEPTEMBER 30, 2019.HTTPS://WWW.GWINNETTMEDICALCENTER.ORG/ABOUT-US/COMMUNITY-BENEFITS-REPORT 1 MARCH OF DIMES FOUNDATION 1275 MAMORONECK AVE WHITE PLAINS NY 10605 131846366 501(C)(3) 375025 GENERAL SUPPORT AMERICAN HEART ASSOCIATION INC 1101 NORTHCHASE PKWY SUITE 1 MARIETTA GA 30067 135613797 501(C)(3) 252500 GENERAL SUPPORT ATLANTA TRACK CLUB INC 3097 E SHADOWLAWN AVE NE ATLANTA GA 30305 581367422 501(C)(3) 190000 GENERAL SUPPORT OVARIAN CANCER INSTITUTE 960 JOHNSON FERRY RD STE 130 ATLANTA GA 30342 582445245 501(C)(3) 175000 GENERAL SUPPORT AMERICAN CANCER SOCIETY PO BOX 56566 ATLANTA GA 30343 131788491 501(C)(3) 174500 GENERAL SUPPORT MUST MINISTRIES INC PO BOX 1717 MARIETTA GA 30061 582034725 501(C)(3) 125000 GENERAL SUPPORT ARTHRITIS FOUNDATION INC PO BOX 78423 ATLANTA GA 30357 581341679 501(C)(3) 103320 GENERAL SUPPORT MOREHOUSE SCHOOL OF MEDICINE 720 WESTVIEW DRIVE SW ATLANTA GA 303101495 581438873 501(C)(3) 100000 GENERAL SUPPORT CHATTAHOOCHEE NATURE CENTER INC PO BOX 769769 ROSWELL GA 30076 581275604 501(C)(3) 90000 GENERAL SUPPORT PIEDMONT PARK CONSERVANCY INC 400 PARK DRIVE NE ATLANTA GA 30306 581551369 501(C)(3) 90000 GENERAL SUPPORT THE PARTNERSHIP AGAINST DOMESTIC VIOLENCE PO BOX 361969 DECATUR GA 30036 823295945 501(C)(3) 75000 GENERAL SUPPORT BICYCLE RIDE ACROSS GEORGIA PO BOX 871111 STONE MOUNTAIN GA 30087 581576748 501(C)(4) 75000 GENERAL SUPPORT 247 GATEWAY LLC 275 PRYOR STREET SW ATLANTA GA 30303 261193832 501(C)(3) 65000 GENERAL SUPPORT AMERICAN RED CROSS 1955 MONROE DRIVE NE ATLANTA GA 30324 530196605 501(C)(3) 50000 GENERAL SUPPORT MARIETTA COBB MUSEUM OF ART 30 ATLANTA ST SE MARIETTA GA 30060 581528144 501(C)(3) 50000 GENERAL SUPPORT ATLANTA BELTLINE PARTNERSHIP INC 112 KROG STREET SUITE 14 ATLANTA GA 30307 562464486 501(C)(3) 50000 GENERAL SUPPORT TRAVELER'S AID OF METRO ATLANTA 75 MARIETTA STREET SUITE 400 ATLANTA GA 30303 580566247 501(C)(3) 50000 GENERAL SUPPORT SUSAN G KOMEN BREAST CANCER FOUNDATION PO BOX 934048 ATLANTA GA 311934048 581959763 501(C)(3) 50000 GENERAL SUPPORT GREATER NORTH FULTON CHAMBER OF COMMERCE 11605 HAYNES BRIDGE RD ALPHARETTA GA 30004 581157316 501(C)(6) 48200 GENERAL SUPPORT ARCS FOUNDATION INC PO BOX 52124 ATLANTA GA 30355 582004368 501(C)(3) 47500 GENERAL SUPPORT SOUTHEASTERN SOCIETY OF PLASTIC AND RECONSTRUCTIVE SURGEONS 12100 SUNSET HILLS ROAD SUITE 130 RESTON VA 201903221 581431500 501(C)(6) 40000 GENERAL SUPPORT GEORGIA OVARIAN CANCER ALLIANCE 6065 ROSWELL ROAD SUITE 512 ATLANTA GA 30328 582424106 501(C)(3) 30000 GENERAL SUPPORT LEUKEMIA AND LYMPHOMA SOCIETY 3715 NORTHSIDE PARKWAY NW NORTHCREE 400 SUITE 300 ATLANTA GA 30327 135644916 501(C)(3) 30000 GENERAL SUPPORT NORTH FULTON COMMUNITY CHARITIES INC 11270 ELKINS ROAD ROSWELL GA 30076 581521088 501(C)(3) 30000 GENERAL SUPPORT ATLANTA BICYCLE COALITION 899 WYLIE STREET SE ATLANTA GA 30316 581996013 501(C)(3) 30000 GENERAL SUPPORT ALS ASSOCIATION OF GEORGIA INC 5881 GLENRIDGE DRIVE SUITE 200 ATLANTA GA 30328 581943490 501(C)(3) 30000 GENERAL SUPPORT COBB CHAMBER OF COMMERCE PO BOX 671868 MARIETTA GA 300060032 580198114 501(C)(6) 29000 GENERAL SUPPORT MUSEUM OF CONTEMPORARY ART OF GEORGIA 75 BENNETT STREET ATLANTA GA 30309 582562811 501(C)(3) 25000 GENERAL SUPPORT INMAN PARK NEIGHBORHOOD ASSOCIATION 245 N HIGHLAND AVE NE STE 230 401 ATLANTA GA 30307 581869166 501(C)(4) 25000 GENERAL SUPPORT BE THE MATCH FOUNDATION 500 NORTH 5TH STREET MINNEAPOLIS MN 55401 411704734 501(C)(3) 25000 GENERAL SUPPORT DUNWOODY NATURE CENTER INC PO BOX 88070 DUNWOODY GA 30356 582009823 501(C)(3) 25000 GENERAL SUPPORT MORTEN ANDERSEN FAMILY FOUNDATION 6495 OLD SHADBURN FERRY ROAD BUFORD GA 30518 271544616 501(C)(3) 25000 GENERAL SUPPORT JACK & JILL LATE STAGE CANCER FOUNDATION 3282 NORTHSIDE PARKWAY NW SUITE 100 100 ATLANTA GA 30327 204415512 501(C)(3) 25000 GENERAL SUPPORT CITY SPRINGS THEATRE COMPANY 8601 DUNWOODY PLACE SUITE 136 SANDY SPRINGS GA 30350 821085513 501(C)(3) 25000 GENERAL SUPPORT SANDY SPRINGSPERIMETER CHAMBER SIX CONCOURSE SUITE 3 SANDY SPRINGS GA 30328 260677794 501(C)(6) 21000 GENERAL SUPPORT SANDY SPRINGS SOCIETY PO BOX 720074 ATLANTA GA 30358 581868282 501(C)(3) 20000 GENERAL SUPPORT NATIONAL CENTER FOR CIVIL AND HUMAN RIGHTS INC 250 WILLIAMS STREET NW SUITE 2322 ATLANTA GA 30303 260813637 501(C)(3) 20000 GENERAL SUPPORT GEORGIA ENSEMBLE THEATER PO BOX 607 ROSWELL GA 30076 582002934 501(C)(3) 20000 GENERAL SUPPORT ITS THE JOURNEY INC 270 CARPENTER DRIVE SUITE 515 ATLANTA GA 31328 470897591 501(C)(3) 20000 GENERAL SUPPORT ELACHEE NATURE SCIENCE CENTER 2125 ELACHEE DRIVE GAINESVILLE GA 30504 581643768 501(C)(3) 20000 GENERAL SUPPORT 34 6 SCHOLARSHIP / EDUCATIONAL ASSISTANCE 2 12560 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 ROBERT T QUATTROCCHI PRESIDENT & CEO NSH, INC. 1730256 0 1725000 0 1246867 0 7547 0 31341 0 4741011 0 0 0 SHANNON BANNA VP/CFO NSH, INC. 362382 0 123059 0 2226 0 3084 0 9098 0 499849 0 0 0 JORGE J HERNANDEZ VICE PRESIDENT/ASST. SECRE 406187 0 219460 0 43431 0 5207 0 11493 0 685778 0 0 0 JANIS DUBOW VICE PRESIDENT 366764 0 154834 0 14669 0 4499 0 10516 0 551282 0 0 0 WILLIAM HAYES CEO, NORTHSIDE HOSPITAL-CH 426860 0 85911 0 46733 0 5948 0 30968 0 596420 0 0 0 ROBERT PUTNAM VICE PRESIDENT 624237 0 249371 0 32478 0 5275 0 18753 0 930114 0 0 0 TINA WAKIM VICE PRESIDENT/COO 704384 0 246178 0 21761 0 3351 0 10516 0 986190 0 0 0 CHARLES DECOOK MD ORTHOPEDIC SURGEON 1080220 0 749832 0 2560 0 5077 0 30968 0 1868657 0 0 0 WILLIAM EARLY MD GASTROENTEROLOGY/INTERNAL 800845 0 10000 0 11149 0 0 0 21425 0 843419 0 0 0 GERALD FEUER MD GYNECOLOGIST/SURGEON 742575 0 173722 0 6592 0 6130 0 31341 0 960360 0 0 0 JIMMY JIANG MD ORTHOPEDIC SURGEON 413195 0 450684 0 2197 0 5963 0 9098 0 881137 0 0 0 KENNETH KRESS MD ORTHOPEDIC SURGEON 1066863 0 120000 0 6592 0 5654 0 17377 0 1216486 0 0 0 DEBORAH S MITCHAM FORMER VP/CFO NSH, INC. 9724 0 450000 0 37648 0 0 0 0 0 497372 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 SIXTEEN YEARS AS CEO AND FOR SEVENTEEN YEARS AS A SENIOR EXECUTIVE PRIOR TO BECOMING CEO. AS A RESULT OF HIS LEADERSHIP AND LONGEVITY, AND TO ASSIST IN HIS RETENTION, NORTHSIDE'S BOARD OF DIRECTORS HAS PROVIDED THE CEO A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") WHICH IS DESIGNED TO PROVIDE HIM WITH A SOURCE OF FUNDS FOR USE AS SUPPLEMENTAL INCOME OVER HIS LIFE IN RETIREMENT. THE SERP VESTS AND DISBURSES INCREMENTAL FUNDING PAYOUTS EACH TWO OR THREE YEARS. 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 OF THE BOARD OF DIRECTORS AND THE FULL BOARD APPROVE EACH PAYMENT BEFORE PAYMENT IS MADE. NORTHSIDE DOES NOT CONSIDER SERP PAYMENTS TO BE DEFERRED COMPENSATION FOR TAX REPORTING PURPOSES. MR. QUATTROCCHI PARTICIPATES IN A LONG-TERM INCENTIVE PLAN THAT PROVIDES AN INCENTIVE COMPENSATION OPPORTUNITY IN THE EVENT OF THE ACHIEVEMENT OF A NUMBER OF PERFORMANCE MEASURES, INCLUDING CLINICAL QUALITY STANDARDS, MEASURED OVER PERFORMANCE PERIODS EXTENDING FROM 3 TO 5 YEARS. MR. QUATTROCCHI'S ACTIVE PARTICIPATION IN THE LONG-TERM INCENTIVE PLAN CONCLUDED WITH THE PERFORMANCE PERIOD ENDING SEPTEMBER 30, 2019. NORTHSIDE ANESTHESIOLOGY CONSULTANTS LLC K. DOUGLAS SMITH, M.D., BOARD MEMBER & NS ANESTHESIOLOGY CONS OFF./OWNER 7407729 K. DOUGLAS SMITH, M.D., MEMBER OF THE NORTHSIDE HOSPITAL, INC. BOARD OF DIRECTORS, IS AN OFFICER/OWNER OF NORTHSIDE ANESTHESIOLOGY CONSULTANTS, LLC, WHICH PROVIDES MEDICAL SERVICES TO NORTHSIDE HOSPITAL, INC. TRANSACTIONS WITH THIS ENTITY ARE CONDUCTED AT ARMS-LENGTH AND ARE REPRESENTATIVE OF PAYMENTS FOR PROVISION OF ON-CALL PHYSICIAN SERVICES TO THE COMMUNITY WHICH NORTHSIDE SERVES. 0 J BRYAN WHITLEY ROBERT E. WHITLEY, BOARD MEMBER & J. BRYAN WHITLEY FAMILY MEMBER 128036 ROBERT E. WHITLEY, MEMBER OF THE NORTHSIDE HOSPITAL, INC. BOARD OF DIRECTORS, HAS A FAMILY RELATIONSHIP WITH J. BRYAN WHITLEY, AN EMPLOYEE OF NORTHSIDE HOSPITAL, INC. AMOUNT REPRESENTS FAIR MARKET VALUE COMPENSATION PAID DURING CALENDAR YEAR 2018 TO J. BRYAN WHITLEY FOR SERVICES RENDERED TO THE ORGANIZATION. 0 MEDLOCK MEDICAL LLC DALE M. BEARMAN, M.D., BOARD MEMBER & MEDLOCK MEDICAL, LLC OWNER 298571 DALE M. BEARMAN, M.D., MEMBER OF THE NORTHSIDE HOSPITAL, INC. BOARD OF DIRECTORS, HAS A GREATER THAN 5% OWNERSHIP INTEREST IN MEDLOCK MEDICAL, LLC, WHICH PROVIDES RENTAL SPACE TO NORTHSIDE HOSPITAL, INC. TRANSACTIONS WITH THIS ENTITY ARE CONDUCTED AT ARMS-LENGTH. 0 RACHEL BEARMAN DALE M. BEARMAN, M.D., BOARD MEMBER & RACHEL BEARMAN FAMILY MEMBER 80933 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 2018 TO RACHEL BEARMAN FOR SERVICES RENDERED TO THE ORGANIZATION. 0 JENNIFER WHITLEY ROBERT E. WHITLEY, BOARD MEMBER & JENNIFER WHITLEY FAMILY MEMBER 36606 ROBERT E. WHITLEY, MEMBER OF THE NORTHSIDE HOSPITAL, INC. BOARD OF DIRECTORS, HAS A FAMILY RELATIONSHIP WITH JENNIFER WHITLEY, AN EMPLOYEE OF NORTHSIDE HOSPITAL, INC. AMOUNT REPRESENTS FAIR MARKET VALUE COMPENSATION PAID DURING CALENDAR YEAR 2018 TO JENNIFER WHITLEY FOR SERVICES RENDERED TO THE ORGANIZATION. 0 ROBERT E WHITLEY JR ROBERT E. WHITLEY, BOARD MEMBER & ROBERT E. WHITLEY, JR. FAMILY MEMBER 88053 ROBERT E. WHITLEY, MEMBER OF THE NORTHSIDE HOSPITAL, INC. BOARD OF DIRECTORS, HAS A FAMILY RELATIONSHIP WITH ROBERT E. WHITLEY, JR., AN EMPLOYEE OF NORTHSIDE HOSPITAL, INC. AMOUNT REPRESENTS FAIR MARKET VALUE COMPENSATION PAID DURING CALENDAR YEAR 2018 TO ROBERT E. WHITLEY, JR. FOR SERVICES RENDERED TO THE ORGANIZATION. 0 OTB DEBORAH S. MITCHAM, FORMER OFFICER & OTB OWNER 451000 DEBORAH S. MITCHAM, FORMER VICE PRESIDENT AND CHIEF FINANCIAL OFFICER OF NORTHSIDE HOSPITAL, INC., HAS A GREATER THAN 5% OWNERSHIP INTEREST IN OTB, WHICH, DURING THE TAX YEAR, PROVIDED CONSULTING SERVICES FOR A LIMITED PERIOD AND WAS NOT CONCURRENT WITH MS. MITCHAM'S EMPLOYMENT. TRANSACTIONS WITH THIS ENTITY WERE CONDUCTED AT ARMS-LENGTH. 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. IN AUGUST 2019, NORTHSIDE AND GWINNETT HEALTH SYSTEM, INC. ("GWINNETT") EXECUTED AN AFFILIATION AND MERGER AGREEMENT WHEREBY GWINNETT AND CERTAIN SUBSIDIARIES AND AFFILIATES WERE MERGED INTO NORTHSIDE, AND NORTHSIDE WAS THE SURVIVING ENTITY. MANAGEMENT OF NORTHSIDE AND GWINNETT BELIEVE THAT SUCH AN AFFILIATION BY WAY OF MERGER WILL CREATE ADDITIONAL INTEGRATION, COORDINATION, AND SYSTEMS OF HEALTH CARE, AND THAT THE JOINT RESOURCES, COLLABORATIVE NETWORKS, AND CAPABILITIES PROVIDED BY THE MERGER WILL PERMIT NORTHSIDE TO EFFECTIVELY DESIGN AND IMPLEMENT POPULATION HEALTH STRATEGIES AND OTHER INITIATIVES TO FURTHER SERVE RESIDENTS OF THE SURROUNDING COMMUNITIES. PART III, LINE 4A: PROGRAM SERVICE ACCOMPLISHMENTS (CONT'D) REINVESTING TO ENHANCE CAPACITY AND TO DELIVER HIGH-QUALITY HEALTHCARE 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. ACCORDINGLY, NORTHSIDE HOSPITAL EARMARKED NEARLY $166 MILLION IN CAPITAL INVESTMENTS IN FY2019. NUMEROUS OF THESE ALLOCATIONS WERE DESIGNATED TO KEY SERVICE LINES SUCH AS CARDIOLOGY, ONCOLOGY AND WOMEN'S SERVICES, MANY OF WHICH OVERLAP WITH NORTHSIDE'S TOP IDENTIFIED HEALTH NEEDS IN ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT. SELECT EARMARKED INVESTMENTS INCLUDE: $1.9 MILLION FOR CARDIOLOGY SERVICES FOR DIAGNOSTIC EQUIPMENT AND TO EXPAND REHABILITATION SERVICES; $9.2 MILLION FOR ONCOLOGY SERVICES TO REPLACE AND UPGRADE RADIATION THERAPY EQUIPMENT AND TO EXPAND AND RELOCATE INFUSION SERVICES; $11.4 MILLION FOR WOMEN'S SERVICES TO ACQUIRE ADDITIONAL MONITORING EQUIPMENT AND INCUBATORS, RENOVATE FACILITIES AND ESTABLISH A NEW LOCATION FOR PERINATAL SERVICES; AND $48.5 MILLION FOR SURGICAL SERVICES TO RENOVATE AND EXPAND EXISTING OPERATING ROOMS TO ACCOMMODATE DEMAND FOR HIGHER ACUITY PROCEDURES AND TO PURCHASE STATE-OF-THE-ART ROBOTIC SURGERY EQUIPMENT AMONG OTHER THINGS. 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 REACHING OVER 290,000 PERSONS, SPENDING OVER 72,000 STAFF HOURS AND PROVIDING NEARLY $8 MILLION IN COMMUNITY BENEFIT PROGRAM ACTIVITIES. THE HIGHEST DOLLAR IMPACT CATEGORIES (I.E., BENEFIT IN EXCESS OF $1 MILLION) INCLUDE CASH AND IN-KIND DONATIONS, COMMUNITY HEALTH IMPROVEMENT SERVICES AND HEALTH PROFESSIONS EDUCATION. THROUGH CASH AND IN-KIND DONATIONS, NORTHSIDE HOSPITAL SUPPORTED OVER 250 COMMUNITY ORGANIZATIONS WHOSE MISSIONS COMPLEMENT THE HOSPITAL'S MISSION AND WHOSE INITIATIVES ALIGN WITH THE HOSPITAL'S IDENTIFIED HEALTH NEEDS. 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, GRASSROOTS ORGANIZATIONS SUCH AS BOAT PEOPLE SOS. BOAT PEOPLE SOS WAS ESTABLISHED IN 2000 WITH THE MISSION TO EMPOWER, ORGANIZE, AND EQUIP VIETNAMESE INDIVIDUALS AND COMMUNITIES IN THEIR PURSUIT OF LIBERTY AND DIGNITY. THROUGH THEIR HEALTH AWARENESS AND PROMOTION PROGRAM, BOAT PEOPLE SOS HAS PROVIDED NECESSARY HEALTH SERVICES TO OVER 2,000 UNINSURED PATIENTS. NORTHSIDE'S FINANCIAL SUPPORT HELPS TO FUND THEIR LOCAL CLINIC AND TO PROVIDE COMMUNITY HEALTH IMPROVEMENT SERVICES FOR PERSONS LIVING IN POVERTY. THE SECOND HIGHEST DOLLAR IMPACT CATEGORY, COMMUNITY HEALTH IMPROVEMENT SERVICES, INCLUDES ALMOST FIFTY PROGRAMS WITH OVER 500 OCCURRENCES. MUCH OF THE ACTIVITY 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 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 NOW HAS REFERRAL ARRANGEMENTS WITH APPROXIMATELY 20 CHARITABLE ORGANIZATIONS, INCLUDING SAFETY NET CLINICS AND FEDERALLY QUALIFIED HEALTH CENTERS, TO REFER PATIENTS WHO WOULD NOT OTHERWISE BE ABLE TO AFFORD OR OBTAIN MEDICALLY NECESSARY OUTPATIENT SURGERY. PATIENTS ARE PRE-SCREENED BASED ON FINANCIAL STATUS AND MEDICAL NECESSITY, AMONG OTHER FACTORS. THE FASP IS DESIGNED TO COVER 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 CARE 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. OVER 500 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 6 NORTHSIDE HEALTH SERVICES, THE PARENT ENTITY, ELECTS ALL THE MEMBERS OF THE GOVERNING BODY FOR NORTHSIDE HOSPITAL, INC. FORM 990, PART VI, SECTION A, LINE 7A NORTHSIDE HEALTH SERVICES, THE PARENT ENTITY, ELECTS ALL THE MEMBERS OF THE GOVERNING BODY FOR NORTHSIDE HOSPITAL, INC. FORM 990, PART VI, SECTION A, LINE 7B NORTHSIDE HEALTH SERVICES, THE PARENT ENTITY, 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; HOWEVER, NEITHER OUR AUDITED FINANCIAL STATEMENTS NOR OUR CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE TO THE PUBLIC. 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 103 CLINICIANS AND 116 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 134 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 35 CLINICIANS AND 63 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 451,085,876. MANAGEMENT AND GENERAL EXPENSES 77,284,085. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 528,369,961. FORM 990, PART XI, LINE 9: CHANGE IN PENSION -190,942,817. EQUITY TRANSFER -1,474,883. INCOME FROM JOINT VENTURES NOT ON BOOKS -779,444. OTHER CHANGES IN NET ASSETS 16,355. NET ASSETS TRANSFERED VIA INHERENT CONTRIBUTION 398,354,027. NON-CONTROLLING INTEREST 3,505,444. INTERCOMPANY REVENUE 2,719,704. PART XI, LINE 9 OTHER CHANGES IN NET ASSETS IN ACCORDANCE WITH THE AFFILIATION AND MERGER AGREEMENT BETWEEN NORTHSIDE AND GWINNETT, GWINNETT VOLUNTARILY TRANSFERRED ITS NET ASSETS TO NORTHSIDE AS THE SURVIVING ENTITY. THIS IS REPRESENTED BY THE NET ASSETS TRANSFERRED VIA INHERENT CONTRIBUTION AMOUNT $398,354,027. 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