2017-08-15T15:28:00-05:00 2016-09-30 621517792 Pershing Yoakley & Associates P C 2220 Sutherland Ave Knoxville TN 37919 990 2015-10-01 581954432 NORTHSIDE HOSPITAL INC NORT 4048518000 1000 JOHNSON FERRY ROAD NE ATLANTA GA 303421611 DEBORAH S MITCHAM CFO 4048518000 2017-08-10 1 Deborah O Ernsberger P00364912 8656730844 2015 2021-01-29 14:40:06Z ROBERT T QUATTROCCHI 1000 JOHNSON FERRY ROAD NE ATLANTA GA 303421611 2874233046 0 X WWW.NORTHSIDE.COM X 1991 GA TO BE A CENTER OF EXCELLENCE IN PROVIDING HIGH-QUALITY HEALTH CARE. 11 5 15416 1037 12860116 -1587350 4189243 2560786 2518339576 2834239060 20533759 14586698 28795123 22846502 2571857701 2874233046 2426359 2578526 0 0 890492569 1042399044 0 0 0 1398264647 1562509909 2291183575 2607487479 280674126 266745567 1880045994 2162316109 795787729 920432451 1084258265 1241883658 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 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. 0 0 2036615326 2578526 2852753803 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 2036615326 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 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 1 0 0 0 1 1604 0 1 15416 1 1 1 0 0 0 0 0 0 0 0 0 X 11 5 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 1 GA X DEBORAH S MITCHAM 4048518000 1000 JOHNSON FERRY ROAD ATLANTA GA 30342 X Anthony J Salvatore Treasurer 1.00 1.00 X 0 0 0 Barbara Pare' Vice Chair 1.00 1.00 X 0 0 0 Dale M Bearman MD Board Member 1.00 1.00 X 0 0 0 Genevieve Fairbrother MD Board Member 1.00 X 0 0 0 Iqbal Garcha MD Board Member 40.00 X 68219 0 0 K Douglas Smith MD Chair 1.00 1.00 X 0 0 0 Mark J Sweeney Secretary 1.00 1.00 X 0 0 0 Robert E Whitley Esq Board Member 1.00 1.00 X 0 0 0 Robert T Quattrocchi President & CEO NSH, Inc. 40.00 1.00 X X 4242713 0 10115 Wayne L Ambroze MD Board Member 1.00 X 607654 0 6122 William G Hasty Jr Board Member 1.00 X 0 0 0 Deborah S Mitcham VP/CFO NSH, Inc. 40.00 1.00 X 831173 0 7373 Jorge J Hernandez Vice President/Asst. Secre 40.00 X 536285 0 2542 Janis Dubow Vice President 40.00 X 455796 0 4484 Robert Putnam Vice President 40.00 X 821731 0 5828 WILLIAM HAYES CEO of northside hospital-Cherokee 40.00 X 493535 0 9743 Tina Wakim Vice President 40.00 X 942538 0 8556 Stephen Salmieri MD gynecologic oncologist 40.00 X 830866 0 0 Gerald Feuer MD Gynecologist/Surgeon 40.00 X 932723 0 13610 Guilherme h Cantuaria MD gynecologic oncologist 40.00 X 906779 0 7153 WILLIAM EARLY MD gastroenterology/internal 40.00 X 832978 0 10115 Joseph Ricotta MD Vascular Surgeon 40.00 X 1162661 0 4917 13665651 0 90558 1120 0 1 0 Georgia Cancer Specialists I PC 1835 Savoy Drive STE 300 Atlanta GA 30342 See Schedule O 45148927 AGA LLC 550 Peachtree St Ste 1620 Atlanta GA 30308 SEE Schedule O 22655949 Atlanta Cancer Care 1100 Johnson Ferry Road STE 150 Sandy Springs GA 30342 SEE Schedule O 19872987 Baker Hostetler LLP 1170 Peachtree Street NE Ste 2400 Atlanta GA 30309 Legal Services 11947606 McKenna Long & Aldridge LLP PO Box 116573 Atlanta GA 30368 Legal Services 10028601 357 173731 2173599 213456 2560786 Net Patient Revenue 621990 2716172515 2714622755 1549760 Pharmacy Revenue 446110 87707293 6519066 81188227 Rental Income 531120 17827032 17827032 Parking Revenue 812930 2974963 2974963 Cafeteria & Vending 722210 2419378 2419378 7137879 2453018 4684861 2834239060 7183893 7183893 5568676 1834129 0 0 5568676 1834129 7402805 7402805 Miscellaneous 900099 19697841 18514743 1183098 PAssthrough investment 621300 3148661 1993487 1155174 22846502 2874233046 2752958017 12860116 105854127 X 2565989 2565989 12537 12537 13476267 10503983 2972284 829400143 646470207 182929936 39529620 30811089 8718531 103134516 80387485 22747031 56858498 44317963 12540535 22601538 22601538 27466092 453 27465639 1292601 1292601 2155635 2155635 412534340 281488278 131046062 10709899 210319 10499580 53276918 37524763 15752155 16371970 3555424 12816546 73983669 45707357 28276312 1975964 915264 1060700 1116262 770063 346199 5531158 22233 5508925 131313089 93410162 37902927 7516274 814074 6702200 Supplies 612200031 607554076 4645955 Bad debt expense 110302320 110302320 Minor Equipment purchas 20908688 7947307 12961381 Recruitment 5508852 214507 5294345 45744609 8507935 37236674 2607487479 2036615326 570872153 0 49828 53247 425854234 458398890 750285 512953 153568508 194097835 1521169 1053560 28769418 41893841 23785048 32287241 1965730284 1092922956 703031643 872807328 179697003 205737272 306757551 296876190 56261307 58597752 1880045994 2162316109 396046850 420466112 422317 1239535 31135000 17670000 63070175 60614035 305113387 420442769 795787729 920432451 X 1084258265 1241883658 1084258265 1241883658 1880045994 2162316109 X 266745567 18524630 -127644804 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 435033 435033 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. 7742074 1758394 128084 1012169 8616383 7079636 1525651 114920 978133 7742074 7044190 1352241 117482 1434277 7079636 6092371 1566045 112842 727068 7044190 5750449 1117389 112483 887950 6092371 0.34610 0.65390 0 1 1 216238479 216238479 874388263 581137730 293250533 610469775 511785226 98684549 264633767 264633767 872807328 FAS 106 Accrual 1260782 Interchange finance liability 66077245 FMV of swap agreement 204922 Rent obligation, long-term portion 15076781 other liability -64788 Obligations under capital lease 10025 Reserve for malpractice 116514065 Retirement plan obligations 221363800 Net Intercompany -63 420442769 X Part V, Line 4: Northside Hospital, Inc. and Northside Hospital Foundation, Inc. have endowment funds that consist of 39 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, 2016 and 2015, 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 104782252 104782252 0.04020 184891991 92440683 92451308 0.03550 289674243 92440683 197233560 0.07570 3951906 434357 3517549 0.00130 229000 158409 70591 0.00000 585630 198376 387254 0.00010 1205063 1205063 0.00050 5971599 791142 5180457 0.00190 295645842 93231825 202414017 0.07760 1057638 1057638 0.00040 1057638 1057638 0.00040 1 24472399 281292386 344973502 -63681116 X 1 0 1 Gwinnett Endoscopy Center Inc Outpatient Center 0.15000 0.85000 2 Midtown Endoscopy Center LLC Outpatient Center 0.15000 0.85000 3 North Crescent Endoscopy Suite LLC Outpatient Center 0.70000 0.30000 4 Woodstock Endoscopy Center LLC Outpatient Center 0.15000 0.85000 5 West Metro Endoscopy Center LLC Outpatient Center 0.15000 0.85000 6 Northwest Endoscopy Center LLC Outpatient Center 0.15000 0.85000 8 ENT Surgery Center of Atlanta LLC Ambulatory Surgery 0.63330 0.36670 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 Southern Crescent Endoscopy Center Suite PC Outpatient Center 0.15000 0.85000 12 The Hand & Upper Extremity Surgery Center of GA LLC Ambulatory Surgery 0.51000 0.19000 13 Nasa Surgery Center LLC Ambulatory Surgery 0.70000 0.30000 14 Soverign Rehabilitation Center LLC Rehabilitation Center 0.88000 0.12000 3 1 Northside Hospital 1000 Johnson Ferry Road Atlanta GA 30342 060-604 X X X A 2 Northside Hospital - Forsyth 1200 Northside Forsyth Drive Cumming GA 30041 058-604 X X X A 3 Northside Hospital - Cherokee 450 Northside Cherokee Blvd Canton GA 30115 028-552 X X X A Facility Reporting Group - A 0 0 1 X X X X X X X X X 16 1 1 0 1 X http://www.northside.com X 1 16 0 1 0 1 X 125.000000000000 250.000000000000 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 X 1 X 0 0 Part V, Section B Facility Reporting Group A Facility Reporting Group A consists of: - Facility 1: Northside Hospital, - Facility 2: Northside Hospital - Forsyth, - Facility 3: Northside Hospital - Cherokee Group A-Facility 1 -- Hospitals - Atlanta, Cherokee, Forsyth Part V, Section B, line 3j: Northside Hospital, Inc. ("Northside") completed a CHNA for each of its hospital facilities identified in Part V, Section 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 community stakeholders who broadly represented the interests of each hospital facility's Community and specifically sought to identify stakeholders with special knowledge of, or expertise in, public health. Northside then developed the Stakeholder Assessment Discussion Guide (a copy of which is included as Appendix A in each hospital facility's CHNA) and conducted, either in person or by telephone, interviews with a qualified representative of each identified stakeholder. The following is a comprehensive list of organizations Northside contacted to help identify the needs of the hospital facilities' Community needs: (1) March of Dimes, (2) Good Samaritan Health Center of Atlanta, (3) Good Samaritan Health Center of Cobb, (4) Visiting Nurse Health System, (5) Forsyth Health Department, (6) Georgia Highlands Medical Services, (7) Good Shepherd Clinic of Dawson County, (8) Bethesda Community Clinic, (9) Good Samaritan Health Center of Pickens, (10) United Way of Cherokee County, (11) HomeStretch, (12) M.U.S.T. Ministries, (13) United Way of Forsyth County, (14) North Fulton Community Charities, (15) North Fulton Senior Services, (16) United Way of Greater Atlanta, (17) City of Sandy Springs, (18) Cherokee County Manager, (19) Cherokee County Schools, (20) City of Cumming, (21) City of Canton, (22) Cherokee County Chamber of Commerce, (23) Pickens Chamber of Commerce, and (24) 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. Northside utilized similar resources, processes and procedures in conducting its hospital facilities' CHNAs; additionally, the CHNAs were conducted simultaneously. Group A-Facility 1 -- Hospitals - Atlanta, Cherokee, Forsyth Part V, Section B, line 11: Based on the results of Northside's 2016 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 2016 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) Affordability, Access to Care & Uninsured, (3) Primary Care, (4) Mental Health/Addiction, and (5) HIV/AIDS.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 20e: In addition, Northside publishes the financial assistance policy on their website. 147 1 - Northside Hospital Cancer Institute - Maco 308 Coliseum Drive Suite 120 Macon GA 31217 PHYSICIAN SERVICES/ OUTPATIENT SERVICES 2 - Medical Associates of North Georgia - Cant 320 Hospital Road Canton GA 30114 PHYSICIAN SERVICES 3 - Northside Hospital Cancer Institute - Mill 624 Martin Luther King Jr Drive Milledgeville GA 31061 PHYSICIAN SERVICES/ OUTPATIENT SERVICES 4 - ENT of Georgia - Alpharetta Alpharetta 3400-C Old Milton Pkwy Suite Alpharetta GA 30005 PHYSICIAN SERVICES 5 - Laureate Medical Group - Atlanta 6135 Barfield Road Atlanta GA 30328 PHYSICIAN SERVICES 6 - Northside Hospital Cancer Institute - Athe 125 King Avenue Suite 200 Athens GA 30606 PHYSICIAN SERVICES/ OUTPATIENT SERVICES 7 - Northside Hospital Cancer Institute - Blue 101 Riverstone Vista Suite 102 Blue Ridge GA 30513 PHYSICIAN SERVICES/ OUTPATIENT SERVICES 8 - Northside Hospital Cancer Institute - Blai 308 Deep South Farm Road Suite 200 Blairsville GA 30512 PHYSICIAN SERVICES/ OUTPATIENT SERVICES 9 - Northside Hospital Cancer Institute - Grif 747 S 8th Street Suite C Griffin GA 30224 PHYSICIAN SERVICES/ OUTPATIENT SERVICES 10 - Primary Care Physicians of Atlanta 5670 Peachtree Dunwoody Road Suite 1200 Atlanta GA 30342 PHYSICIAN SERVICES 11 - Atlanta Clinical Care 5673 Peachtree Dunwoody Road Suite 330 Atlanta GA 30342 PHYSICIAN SERVICES 12 - Northside Heart - Roswell 1285 Upper Hembree Rd Roswell GA 30076 PHYSICIAN SERVICES 13 - Atlanta Institute for ENT - Atlanta 5670 Peachtree Dunwoody Road Suite 1280 Atlanta GA 30342 PHYSICIAN SERVICES 14 - Northside Total Joint Specialists - Alpha 3400 C-Old Milton Parkway Suite 290 Alpharetta GA 30005 PHYSICIAN SERVICES 15 - Gwinnett Advanced Surgery Center LLC 2131 Fountain Drive Snellville GA 30078 AMBULATORY SURGERY 16 - The Imaging Center of Warner Robins 2706 Watson Boulevard Suite D Warner Robins GA 31093 OUTPATIENT CENTER 17 - Laureate Medical Group - Atlanta 550 Peachtree Street NE Suite 1550 Atlanta GA 30308 PHYSICIAN SERVICES 18 - Northside Hospital Cancer Institute - Gree 1000 Cowles Clinic Way - Magnolia Building Greensboro GA 30642 PHYSICIAN SERVICES/ OUTPATIENT SERVICES 19 - Urology Specialists of Atlanta 5673 Peachtree Dunwoody Road Suite 910 Atlanta GA 30342 PHYSICIAN SERVICES 20 - Pulmonary & Critical Care of Atlanta 960 Johnson Ferry Rd Suite 500 Atlanta GA 30342 PHYSICIAN SERVICES 21 - Internal Medicine Associates of John's Cre 3340 Paddocks Parkway Suwanee GA 30024 PHYSICIAN SERVICES 22 - Premier Care for Women 960 Johnson Ferry Rd Suite 400 Atlanta GA 30342 PHYSICIAN SERVICES 23 - North Atlanta ENT 1400 Northside Forsyth Drive Suite 240 Cumming GA 30041 PHYSICIAN SERVICES 24 - Northside Hospital Cancer Institute - Hawk 214 Perry Highway Hawkinsville GA 31036 PHYSICIAN SERVICES/ OUTPATIENT SERVICES 25 - Northside Heart - Atlanta 5670 Peachtree Dunwoody Rd Suite 880 Atlanta GA 30342 PHYSICIAN SERVICES 26 - MRI & Imaging of Athens 845 Prince Avenue Athens GA 30606 OUTPATIENT CENTER 27 - Endocrine Specialist of Atlanta 975 Johnson Ferry Road Suite 400 Atlanta GA 30342 PHYSICIAN SERVICES 28 - Northside Heart - Woodstock 900 Towne Lake Pkwy Suite 400 Woodstock GA 30189 PHYSICIAN SERVICES 29 - Atlanta Colon and Rectal Surgery - Atlanta 5667 Peachtree Dunwoody Road Suite 330 Atlanta GA 30342 PHYSICIAN SERVICES 30 - Northside Cherokee Orthopedics Sports Med 684 Sixes Road Suite 130 Holly Springs GA 30142 PHYSICIAN SERVICES 31 - Cumming Family Medicine - Cumming 765 Lanier 400 Parkway Cumming GA 30040 PHYSICIAN SERVICES 32 - Northside Family Medicine and Urgent Care 5610 Bethelview Rd Cumming GA 30040 PHYSICIAN SERVICES 33 - Perimeter North Family Medicine - Alpharet 3400-A Old Milton Pkwy Suite 130 Alpharetta GA 30005 PHYSICIAN SERVICES 34 - Northside Family Practice 960 Woodstock Pkwy Suite 300 Woodstock GA 30188 PHYSICIAN SERVICES 35 - Northside Vascular Surgery - Atlanta 980 Johnson Ferry Rd Suite 1040 Atlanta GA 30342 PHYSICIAN SERVICES 36 - Chattahoochee Surgical Group - Cumming 980 Sanders Road Suite 100 Cumming GA 30042 PHYSICIAN SERVICES 37 - Mt Vernon Internal Medicine 755 Mt Vernon Hwy NE Suite 400 Sandy Springs GA 30328 PHYSICIAN SERVICES 38 - Northside Pulmonary and Sleep Medicine - C 1400 Northside Forsyth Dr Suite 280 Cumming GA 30041 PHYSICIAN SERVICES 39 - Laureate Medical Group - Alpharetta 3400-C Old Milton Parkway Suite 500 Alpharetta GA 30005 PHYSICIAN SERVICES 40 - Northside Neurology 1400 Northside Forsyth Dr Suite 250 Cumming GA 30041 PHYSICIAN SERVICES 41 - Georgia Pulmonary and Critical Care Consul 1505 Northside Blvd Suite 3000 Cumming GA 30041 PHYSICIAN SERVICES 42 - Perimeter North Family Medicine - Woodstoc 900 Towne Lake Pkwy Suite 210 Woodstock GA 30189 PHYSICIAN SERVICES 43 - Northside Heart - Cumming 1505 Northside Blvd Suite 3600 Cumming GA 30040 PHYSICIAN SERVICES 44 - Cumming Family Medicine - Cumming 303 Pirkle Ferry Road Cumming GA 30040 PHYSICIAN SERVICES 45 - Windermere Medical Clinic - Cumming 3850 Windermere Parkway Suite 105 Cumming GA 30041 PHYSICIAN SERVICES 46 - Atlanta Colon and Rectal Surgery - Canton 15 Reinhardt College Parkway Suite 105 Canton GA 30114 PHYSICIAN SERVICES 47 - Northside Vascular Surgery - Cumming 1505 Northside Forsyth Drive Suite 2400 Cumming GA 30041 PHYSICIAN SERVICES 48 - Dunwoody Dermatology LLC 4360 Chamblee Dunwoody Road Suite 260 Atlanta GA 30341 PHYSICIAN SERVICES 49 - Perimeter North Family Medicine - Atlanta 960 Johnson Ferry Rd NE Suite 300 Atlanta GA 30342 PHYSICIAN SERVICES 50 - Laureate Medical Group - Jonesboro 7823 Spivey Station Boulevard Suite 310 Jonesboro GA 30236 PHYSICIAN SERVICES 51 - University Gynecologic Oncology 960 Johnson Ferry RoadSuite 130 Atlanta GA 30342 PHYSICIAN SERVICES 52 - Northside Family Medicine and Urgent Care 4800 Old Towne Pkwy Suite 150 Marietta GA 30068 PHYSICIAN SERVICES 53 - North Georgia OBGYN Specialist 900 Towne Lake Pkwy Suite 404 Woodstock GA 30188 PHYSICIAN SERVICES 54 - Northside Family Medicine and Urgent Care 684 Sixes Rd Suite 125 Holly Springs GA 30115 PHYSICIAN SERVICES 55 - Georgia Colon and Rectal Surgeons - Atlant 5445 Meridian Mark Suite 180 Atlanta GA 30342 PHYSICIAN SERVICES 56 - Northside Hospital Cardiovascular Care 980 Johnson Ferry Road Suite 520 Atlanta GA 30342 PHYSICIAN SERVICES 57 - Atlanta Cardiac & Thoracic Surgical Associ 960 Johnson Ferry Road Suite 100 Atlanta GA 30342 PHYSICIAN SERVICES 58 - Northside Cherokee Pediatrics - Holly Spri 684 Sixes Rd Suite 220 Holly Springs GA 30115 PHYSICIAN SERVICES 59 - Peachtree Dunwoody Internal Medicine and R 875 Johnson Ferry Rd NE Suite 200 Atlanta GA 30342 PHYSICIAN SERVICES 60 - Ravry Medical Group 5505 Peachtree Dunwoody Rd Suite 650 Atlanta GA 30342 PHYSICIAN SERVICES 61 - MRI & Imaging of Habersham 638 Historic Highway 441 North Suite D Demorest GA 30535 OUTPATIENT CENTER 62 - Midtown Medical Associates 550 Peachtree St Ne Suite 1230 Atlanta GA 30308 PHYSICIAN SERVICES 63 - North Point Pulmonary Associates - Cumming 1505 Northside Forsyth Blvd Suite 3400 Cumming GA 30041 PHYSICIAN SERVICES 64 - North Georgia Diabetes and Endocrinology - 1505 Northside Blvd Suite 2800 Cumming GA 30041 PHYSICIAN SERVICES 65 - Georgia Gynecologic Oncology - Lawrencevil 759 Old Norcross Road Lawrenceville GA 30046 PHYSICIAN SERVICES 66 - Cherokee Lung and Sleep - Canton 460 Northside Cherokee Blvd Suite 130 Canton GA 30114 PHYSICIAN SERVICES 67 - Northside Family Medicine and Urgent Care 81 Northside Dawson Dr Dawsonville GA 30534 PHYSICIAN SERVICES 68 - North Atlanta Pulmonary and Sleep 993 Johnson Ferry Rd 300 Building C Atlanta GA 30342 PHYSICIAN SERVICES 69 - Town Lake Primary Care 900 Towne Lake Pkwy Suite 410 Woodstock GA 30189 PHYSICIAN SERVICES 70 - Goyco Internal Medicine 900 Sanders Rd Suite B Cumming GA 30041 PHYSICIAN SERVICES 71 - Perimeter North Family Medicine - Cumming 1505 Northside Blvd Suite 4400 Cumming GA 30041 PHYSICIAN SERVICES 72 - Perimeter North Family Medicine - Suwanee 3890 Johns Creek Pky Suite 230 Suwanee GA 30024 PHYSICIAN SERVICES 73 - Georgia Colon and Rectal Surgeons - Fayett 1260 Hwy 54 W Suite 100 Fayetteville GA 30214 PHYSICIAN SERVICES 74 - Atlanta Gynecologic Oncology - Atlanta 980 Johnson Ferry Rd NE Suite 900 Atlanta GA 30342 PHYSICIAN SERVICES 75 - Melanoma Specialists of Georgia 980 Johnson Ferry Road Suite 940 Atlanta GA 30342 PHYSICIAN SERVICES 76 - Laureate Medical Group - Holly Springs 684 Sixes Road Suite 265 Holly Springs GA 30115 PHYSICIAN SERVICES 77 - Northside Vascular Surgery - Canton 145 Riverstone Terrace Suite 101 Canton GA 30114 PHYSICIAN SERVICES 78 - Laureate Medical Group - Marietta 1121 Johnson Ferry Road Building One Suit Marietta GA 30068 PHYSICIAN SERVICES 79 - Alpharetta Foot and Ankle Specialists 3400-A Old Milton Parkway Suite 500 Alpharetta GA 30005 PHYSICIAN SERVICES 80 - Atlanta Colon and Rectal Surgery - Cumming 1505 Northside Boulevard Suite 1900 Cumming GA 30041 PHYSICIAN SERVICES 81 - Georgia Colon and Rectal Surgeons - Lawren 721 Wellness Way Suite 200 Lawrenceville GA 30045 PHYSICIAN SERVICES 82 - Internal Medicine Practice of Northside 10745 Westside Way Suite 125 Alpharetta GA 30009 PHYSICIAN SERVICES 83 - Northside Atlanta Orthopedics and Sports M 5555 Peachtree Dunwoody Road NE Suite 101 Atlanta GA 30342 PHYSICIAN SERVICES 84 - Cumming Family Medicine - Dawsonville 133 Prominence Court Suite 230 Dawsonville GA 30535 PHYSICIAN SERVICES 85 - Northside Cherokee Pediatrics - Woodstock 900 Towne Lake Parkway Suite 306 Woodstock GA 30189 PHYSICIAN SERVICES 86 - Georgia Colon and Rectal Surgeons - Cummin 1505 Northside Blvd Suite 2900 Cumming GA 30041 PHYSICIAN SERVICES 87 - Cumming Family Medicine - Marble Hill 25 Foothills Parkway Marble Hill GA 30149 PHYSICIAN SERVICES 88 - North Georgia Diabetes and Endocrinology - 4310 Johns Creek Pkwy Suite 100 Suwanee GA 30024 PHYSICIAN SERVICES 89 - Premier Neurological Care - Canton 145 Riverstone Terrace Suite 102 Canton GA 30114 PHYSICIAN SERVICES 90 - Roswell Internal Medicine Specialists 11785 Northfall Lane Suite 505 Alpharetta GA 30004 PHYSICIAN SERVICES 91 - Bariatric Innovations of Atlanta 6135 Barfield Road Suite 150 Sandy Springs GA 30328 PHYSICIAN SERVICES 92 - Northside Heart - Sandy Springs 6135 Barfield Road Suite 100 Sandy Springs GA 30328 PHYSICIAN SERVICES 93 - Georgia Gynecologic Oncology - Atlanta Timeshare 2001 Peachtree Road Suite 650 Atlanta GA 30309 PHYSICIAN SERVICES 94 - Ellijay Women's Specialists 433 Highland Pkwy Suite 203 East Ellijay GA 30540 PHYSICIAN SERVICES 95 - Northside Cherokee Surgical Associates 900 Towne Lake Pkwy Suite 412 Woodstock GA 30189 PHYSICIAN SERVICES 96 - Newtown Medical 3400-A Old Milton Pkwy Suite 200 Alpharetta GA 30005 PHYSICIAN SERVICES 97 - Medical Associates of North Georgia - Ball 470 Valley Street Suite 200 Ball Ground GA 30107 PHYSICIAN SERVICES 98 - Georgia Colon and Rectal Surgeons - Decatu 2801 North Decatur Road Suite 120 Decatur GA 30033 PHYSICIAN SERVICES 99 - Lanier Family Practice 1080 Sanders Road Suite 100 Cumming GA 30041 PHYSICIAN SERVICES 100 - Georgia Colon and Rectal Surgeons - Atlant 1 Baltimore Place Suite 290 Atlanta GA 30308 PHYSICIAN SERVICES 101 - Reproductive Surgical Specialists 1800 Northside Forysth Drive Suite 380 Cumming GA 30041 PHYSICIAN SERVICES 102 - Georgia Colon and Rectal Surgeons - Alphar 3400 C Old Milton Pkwy Suite 185 Alpharetta GA 30005 PHYSICIAN SERVICES 103 - Northside Heart - Alpharetta 3400-C Old Milton Pkwy Suite 360 Alpharetta GA 30005 PHYSICIAN SERVICES 104 - Windermere Medical Clinic - Canton 200 Eagles Nest Dr Suite 300D Canton GA 30115 PHYSICIAN SERVICES 105 - Anderson Family Medicine 81 Northside Dawson Drive Suite 205 Dawsonville GA 30534 PHYSICIAN SERVICES 106 - Sleep Disorders Center of Georgia 993-C Johnson Ferry Rd Suite 301 Atlanta GA 30342 PHYSICIAN SERVICES 107 - Gordon J Azar Sr MD Internal Medicine 960 Johnson Ferry Road Suite 235 Atlanta GA 30342 PHYSICIAN SERVICES 108 - Ankle & Foot Centers of North Georgia - Da 133 Prominence Court Suite 210 Dawsonville GA 30534 PHYSICIAN SERVICES 109 - Atlanta Cardiac & Thoracic Surgical Associ 1100 Northside Forsyth Drive Suite 410 Cumming GA 30041 PHYSICIAN SERVICES 110 - Atlanta Gynecologic Oncology - Marietta 780 Canton Rd Suite 405 Marietta GA 30060 PHYSICIAN SERVICES 111 - Randy Rudderman MD- Plastic Surgeon 3400-C Old Milton Pkwy Suite 450 Alpharetta GA 30005 PHYSICIAN SERVICES 112 - Perimeter Advanced Surgery Center 4553 North Shallowford Road Atlanta GA 30338 AMBULATORY SURGERY 113 - Glenridge Northside Gynecology 5445 Meridian Mark Suite 120 Atlanta GA 30342 PHYSICIAN SERVICES 114 - North Atlanta Breast Care 1100 Norside Forsyth Drive Suite 450 Cumming GA 30041 PHYSICIAN SERVICES 115 - Northside East Cobb Orthopedics and Sports 1163 Johnson Ferry Rd Suite 250 Marietta GA 30068 PHYSICIAN SERVICES 116 - Ankle & Foot Centers of North Georgia - Al 3180 North Point Parkway Building 300 Su Alpharetta GA 30005 PHYSICIAN SERVICES 117 - Ankle & Foot Centers of North Georgia - Cu 3275 Market Place Blvd LakePoint Prof Bl Cumming GA 30041 PHYSICIAN SERVICES 118 - Atlanta Cardiac & Thoracic Surgical Associ 308 Deep South Farm Road Blairsville GA 30512 PHYSICIAN SERVICES 119 - Atlanta Colon and Rectal Surgery - Mariett 780 Canton Road NE Suite 315 Marietta GA 30060 PHYSICIAN SERVICES 120 - Atlanta Colon and Rectal Surgery - Roswell 1380 Upper Hembree Road Roswell GA 30076 PHYSICIAN SERVICES 121 - Atlanta Institute for ENT - Sandy Springs 5730 Glenridge Dr Suite T-200 Sandy Springs GA 30328 PHYSICIAN SERVICES 122 - Chattahoochee Surgical Group - Alpharetta 3400-A Old Milton Pkwy Suite 210 Alpharetta GA 30005 PHYSICIAN SERVICES 123 - Chattahoochee Surgical Group - Dawsonville 200 Dawson Commons Circle Suite 210 Dawsonville GA 30534 PHYSICIAN SERVICES 124 - Cherokee Lung and Sleep - Blairsville 308 Deep South Farm Rd Blairsville GA 30512 PHYSICIAN SERVICES 125 - North Point Pulmonary Associates - Alphare 3400-C Old Milton Pkwy Suite 425 Alpharetta GA 30005 PHYSICIAN SERVICES 126 - Northside Cherokee Orthopedics Sports Med 900 Towne Lake Pkwy Suite 320 Woodstock GA 30189 PHYSICIAN SERVICES 127 - Northside Pulmonary and Sleep Medicine - B 4700 Nelson Brogden Blvd NE Suite 125 Buford GA 30518 PHYSICIAN SERVICES 128 - Northside Pulmonary and Sleep Medicine - D 200 Dawson Commons Circle Suite 210 Dawsonville GA 30534 PHYSICIAN SERVICES 129 - Northside Total Joint Specialists - Alpha 3400 C-Old Milton Parkway Suite 190 Alpharetta GA 30005 PHYSICIAN SERVICES 130 - Northside Total Joint Specialists - Cummi 1505 Northside Blvd Suite 3500 Cumming GA 30041 PHYSICIAN SERVICES 131 - Northside Total Joint Specialists - Cummi 1100 Northside Forsyth Drive Suite 250 Cumming GA 30041 PHYSICIAN SERVICES 132 - Perimeter North Family Medicine - Atlanta 960 Johnson Ferry Rd NE Suite 340 Atlanta GA 30342 PHYSICIAN SERVICES 133 - Perimeter North Family Medicine - Canton 460 Northside Cherokee Blvd Suite 170 Canton GA 30115 PHYSICIAN SERVICES 134 - Premier Neurological Care - Alpharetta 11820 Northfall Lane Suite 1103 Alpharetta GA 30009 PHYSICIAN SERVICES 135 - Premier Neurological Care - Cartersville 100 Market Place Blvd Suite 307 Cartersville GA 30121 PHYSICIAN SERVICES 136 - ENT of Georgia - Peachtree 550 Peachtree Street Suite 1640 Atlanta GA 30308 PHYSICIAN SERVICES 137 - ENT of Georgia - Peachtree Dunwoody 5673 Peachtree Dunwoody Road Suite 150 Atlanta GA 30342 PHYSICIAN SERVICES 138 - ENT of Georgia - Decatur 484 Irvin Ct Suite 140 Decatur GA 30030 PHYSICIAN SERVICES 139 - ENT of Georgia - Lawrenceville 748 Old Norcross Rd Suite 100 Lawrenceville GA 30045 PHYSICIAN SERVICES 140 - ENT of Georgia - Marietta 3901 Roswell Road Suite 225 Marietta GA 30062 PHYSICIAN SERVICES 141 - ENT of Georgia - Marietta 2550 Windy Hill Road Suite 307 Marietta GA 30067 PHYSICIAN SERVICES 142 - ENT of Georgia - Sandy Springs 755 Mt Vernon Hwy NE Suite 370 Sandy Springs GA 30328 PHYSICIAN SERVICES 143 - ENT of Georgia - Snellville 1700 Tree Lane Suite 470 Snellville GA 30078 PHYSICIAN SERVICES 144 - ENT of Georgia - Suwanee 4320 Suwanee Dam Road Suite 200 Suwanee GA 30024 PHYSICIAN SERVICES 145 - ENT of Georgia - Suwanee 4245 Johns Crk Pkwy Suite D Suwanee GA 30024 PHYSICIAN SERVICES 146 - Georgia Gynecologic Oncology - Atlanta 980 Johnson Ferry Road Suite 910 Atlanta GA 30342 PHYSICIAN SERVICES 147 - Georgia Gynecologic Oncology - Cumming Timeshare 1505 Northside Blvd Suite 380 Cumming GA 30041 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 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 it's 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 6a: Northside Hospital, Inc. prepares an annual community benefit report. The report is made available to the public. 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 $110,302,320 has been removed from total expense to compute the percentage in column (f). Part II, Community Building Activities: Biennially, Northside Hospital, Inc. ("Northside") conducts a community-based Physician Need Analysis for Northside Hospital-Cherokee ("NHC") and Northside Hospital-Forsyth ("NHF"). NHC and NHF each are sole county providers and as such must ensure that appropriate medical services are accessible to the residents of the communities served. Each hospital's Physician Need Analysis defines a geographic area compliant with the Federal Physician Self-Referral Law, identifies NHC and NHF medical staff members with an office in the defined geographic area, identifies non-Northside physicians with an office in the defined geographic area, and includes a quantitative analysis of each community's physician need ("Community Physician Need"). Based on the findings of the analyses, Northside engages in recruitment efforts designed to ensure that sufficient qualified health professionals are available to meet the identified Community Physician Need. Through these analyses, Northside has identified a defined numeric need for one-half physician full-time equivalent ("FTE") or more in twenty-seven specialties in NHC's Stark-compliant geographic area and a need for one-half physician FTE or more in thirty specialties in NHF's Stark-compliant geographic area. Both NHC and NHF are concentrating recruitment efforts on primary care and surgical specialties with an emphasis on recruiting needed physicians into Forsyth, Dawson, Pickens, and Cherokee counties to meet the identified Community Physician Need. 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. 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 2016 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. 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 supercedes 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 metrics when they were readily available at the county level. Part VI, Line 3: Northside informs and educates patients and persons who are billed for patient care about their eligibility for financial assistance and Northside's Financial Assistance Program in numerous ways. Northside conspicuously posts notice of its Financial Assistance Program and how to access its Financial Assistance Policy and Financial Assistance Application at all major points of access to its inpatient and outpatient facilities, these points of access include the hospitals' patient waiting rooms and emergency departments. For patients that pre-register over the phone for hospital services, Northside verbally informs patients of its Financial Assistance Program and provides patients with information on how to obtain a copy of Northside's Financial Assistance Policy and Financial Assistance Application via Northside's website or via mail. Additionally, upon admission to one of its hospitals for services, Northside provides each patient a registration packet that includes information on its Financial Assistance Program. Further, a Financial Counselor will speak with all patients during either the pre-registration process or upon admission and explain Northside's Financial Assistance Program. If a patient indicates a need or requests more information regarding Financial Assistance, Northside will refer the patient to a Financial Assistance Counselor who will work directly with the patient to assist the patient in applying for Financial Assistance. In order to expedite the Financial Assistance process, Northside uses third party software to help identify patients that qualify for Financial Assistance based on publicly available information (e.g., participation in statefunded 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 IRC Section 501(r) Final Rule. The Northside Community consists of Fulton, Forsyth, Cherokee, DeKalb, Cobb, Gwinnett, Dawson, and Pickens Counties.In 2015, the estimated 3.7 million residents of the Northside Community accounted for 37% of Georgia's total population. The Northside Community is slightly younger than Georgia overall, with a median age of 35.6 compared to Georgia's 36.2. Overall, the 2015 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. Part VI, Line 5: Northside Hospital, Inc. is a charitable organization and as such is engaged in numerous activities to provide relief to the poor, the distressed, or the underprivileged. Northside routinely provides financial assistance, health professions education, cash and in-kind donations, community health improvement services, research, and community-building activities. Many of these efforts have been reported throughout this return.In addition to the numerous community benefit activities Northside engages in throughout the year, Northside also invests surplus funds back into expanding access to services for all people throughout its Community. For example, Northside is investing $280 million in building a new, state-of-the-art replacement hospital, medical office building and parking deck in Cherokee County. The replacement hospital will increase Northside Cherokee's inpatient capacity from 84 inpatient beds to 105 and will provide the Community with a more visible, easy-to-access hospital conveniently located off a major interstate highway. In Forsyth County, Northside has invested $44.6 million in a three-story medical/surgical tower expansion at Northside Hospital-Forsyth. This expansion will increase Northside Forsyth's inpatient bed capacity from 231 inpatient beds to 247. In Fulton County, the System's largest and oldest hospital campus also is undergoing significant expansion and renovation. Northside is investing $128.5 million in Northside Atlanta through the construction of a new five-story medical/surgical tower, campus-wide renovations and a new parking deck. Upon completion, Northside Atlanta's inpatient bed capacity will increase from 537 beds to 590 beds. Part VI, Line 6: Northside Hospital, Inc. includes three hospitals - Northside Hospital - Atlanta in Sandy Springs, Northside Hospital - Cherokee in Canton and Northside Hospital - Forsyth in Cumming. These hospitals and nearly 80 other offsite locations make up the Northside Hospital System which serves a primary area that includes 21 counties with a total population of more than 5 million. In addition to providing hospital-based medical services, 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, we produce an annual report which is made available to the public on our website, www.northside.com. 1 AMERICAN CANCER SOCIETY PO BOX 56566 ATLANTA GA 30343 131788491 501(c)(3) 98500 general support AMERICAN HEART ASSOCIATION 1101 NORTHCHASE PKWY SUITE 1 MARIETTA GA 30067 135613797 501(c)(3) 160000 general support AMERICAN RED CROSS 1955 MONROE DRIVE NE ATLANTA GA 30324 530196605 501(c)(3) 35000 general support ARTHRITIS FOUNDATION GEORGIA PO BOX 78423 ATLANTA GA 30357 581341679 501(c)(3) 90675 general support ATLANTA TRACK CLUB INC 3097 E Shadowlawn Ave Ne Atlanta GA 30305 581367422 501(c)(3) 75000 general support BICYCLE RIDE ACROSS GEORGIA PO BOX 871111 STONE MOUNTAIN GA 30087 581576748 501(c)(4) 75000 general support CANCER SUPPORT COMMUNITY OF ATLANTA (PREVIOUSLY WELLNESS COMMUNITY) 5775 PEACHTREE DUNWOODY RD SUITE C-225 ATLANTA GA 30342 582142151 501(c)(3) 557264 general support COBB CHAMBER OF COMMERCE PO BOX 671868 MARIETTA GA 300060032 580198114 501(c)(6) 28500 general support DAWSON COUNTY CHAMBER OF COMMERCE PO BOX 299 DAWSONVILLE GA 30534 581950100 501(c)(6) 24350 general support GEORGIA CENTER FOR ONCOLOGY RESEARCH AND EDUCATION 50 HURT PLAZA SUITE 704 ATLANTA GA 30303 571159979 501(c)(3) 20000 general support GEORGIA CHAMBER OF COMMERCE 233 PEACHTREE STREET SUITE 2000 ATLANTA GA 30303 581537370 501(c)(6) 40000 general support GEORGIA OVARIAN CANCER ALLIANCE 6065 Roswell Road Suite 512 ATLANTA GA 30328 582424106 501(c)(3) 40000 general support GREATER NORTH FULTON CHAMBER OF COMMERCE 11605 HAYNES BRIDGE RD ALPHARETTA GA 30004 581157316 501(c)(6) 93200 general support LEUKEMIA AND LYMPHOMA SOCIETY 3715 NORTHSIDE PARKWAY NW NORTHCREE 400 SUITE 300 ATLANTA GA 30327 135644916 501(c)(3) 25000 general support MARCH OF DIMES 1275 MAMORONECK AVE WHITE PLAINS NY 10605 131846366 501(c)(3) 510000 general support MERCY CARE FOUNDATION 1100 JOHNSON FERRY RD NE BUILDING 2 SUITE LL80 ATLANTA GA 30342 581448522 501(c)(3) 50000 general support MOREHOUSE SCHOOL OF MEDICINE 720 Westview Drive SW ATLANTA GA 303101495 581438873 501(c)(3) 100000 general support MUSCULAR DYSTROPHY ASSOCIATION 2310 PARKLANE DRIVE SUITE 375 ATLANTA GA 30345 131665552 501(c)(3) 21000 general support NORTH FULTON COMMUNITY CHARITIES 11270 ELKINS ROAD ROSWELL GA 30076 581521088 501(c)(3) 25000 general support OVARIAN CANCER INSTITUTE 960 JOHNSON FERRY RD STE 130 ATLANTA GA 30342 582445245 501(c)(3) 160000 general support PARTNERSHIP AGAINST DOMESTIC VIOLENCE 315 W PONCE DE LEON STE 735 ATLANTA GA 30030 581314556 501(c)(3) 22500 general support PORTAL DE SALUD INC PO BOX 921605 PEACHTREE CORNERS GA 30092 472672341 501(c)(3) 30000 general support SANDY SPRINGS SOCIETY PO BOX 720074 ATLANTA GA 30358 581868282 501(c)(3) 20000 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 TRAVELER'S AID OF METRO ATLANTA 75 MARIETTA STREET SUITE 400 ATLANTA GA 30303 580566247 501(c)(3) 25000 general support VISITING NURSE HEALTH SYSTEM 5775 GLENRIDGE DRIVE NE SUITE E200 ATLANTA GA 30328 580566250 501(c)(3) 200000 general support 20 6 Scholarship / Educational Assistance 2 12537 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 0 0 Robert T Quattrocchi President & CEO NSH, Inc. 1523793 0 1448819 0 1270101 0 0 0 10115 0 4252828 0 0 0 Wayne L Ambroze MD Board Member 468418 0 137092 0 2144 0 0 0 6122 0 613776 0 0 0 Deborah S Mitcham VP/CFO NSH, Inc. 576629 0 248064 0 6480 0 0 0 7373 0 838546 0 0 0 Jorge J Hernandez Vice President/Asst. Secre 372585 0 154186 0 9514 0 0 0 2542 0 538827 0 0 0 Janis Dubow Vice President 343756 0 97823 0 14217 0 0 0 4484 0 460280 0 0 0 Robert Putnam Vice President 580109 0 217487 0 24135 0 0 0 5828 0 827559 0 0 0 WILLIAM HAYES CEO of northside hospital-Cherokee 408760 0 74927 0 9848 0 0 0 9743 0 503278 0 0 0 Tina Wakim Vice President 651717 0 276046 0 14775 0 0 0 8556 0 951094 0 0 0 Stephen Salmieri MD gynecologic oncologist 718677 0 110469 0 1720 0 0 0 0 0 830866 0 0 0 Gerald Feuer MD Gynecologist/Surgeon 772875 0 154913 0 4935 0 0 0 13610 0 946333 0 0 0 Guilherme h Cantuaria MD gynecologic oncologist 784619 0 121038 0 1122 0 0 0 7153 0 913932 0 0 0 WILLIAM EARLY MD gastroenterology/internal 816376 0 11667 0 4935 0 0 0 10115 0 843093 0 0 0 Joseph Ricotta MD Vascular Surgeon 393371 0 0 0 769290 0 0 0 4917 0 1167578 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 thirteen 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") Agreement which is designed to provide him supplemental income over his life in retirement. The SERP payments are based on a mathematical formula, pursuant to a signed contract, and are reviewed and assessed for reasonableness by an outside consultant and the Compensation Committee of the Board of Directors and ultimately by the full Board before payment is made. The SERP vests and disburses incremental funding payouts each two or three years. Calendar year 2015 was such a year. Northside does not consider the SERP payment to be deferred compensation for tax reporting purposes. The CEO is eligible for an annual incentive which includes various measurements for achievements of quality, operational, strategic, and financial targets as established by the Board. The compensation committee determines the incentive plan and approves the payments/calculations in accordance with the plan annually. In addition, Joseph Ricotta, M.D. (included in the top five highest paid employees) received a contractual payment of $768,865 during 2015, which is reported in Part II, column B(iii). A Hospital Authority of Fulton County 581033907 360053GW6 2011-12-12 51910000 Provide funds to refund a prior issue - 2/16/2003; 2/2/1994 0 0 0 B Hospital Authority of Fulton County 581033907 360053GX4 2011-12-12 16260000 Provide funds to refund a prior issue - 2/16/2003 0 0 0 A 51910000 325322 51584678 2011 1 0 1 1 B 16260000 101902 16158098 2011 1 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 A 1 0 0 0 0 0 B 1 1 1 Wells Fargo Bank 4.750000000000 0 0 0 0 0 A 0 B 0 Schedule K, Part III, Line 9 Section 7.2 of the Tax Certificate specifies Northside's continuing compliance procedures with respect to IRC Sec. 148. Inasmuch as this was a current refunding with no pledged funds and no unspent project fund proceeds to which a temporary period would apply relating to rate of expenditure or the interest rate on interim investments, those procedures are directed at compliance with IRC Sec. 148(f), in particular, relating to calculation and payment of any arbitrage rebate. Northside Anesthesiology Consultants LLC K. Douglas Smith, M.D., board member & NS Anesthesiology Cons off./owner 3969098 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 126468 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 2015 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 372301 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 70853 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 2015 to Rachel Bearman for services rendered to the organization. 0 Jennifer Whitley Robert E. Whitley, board member & Jennifer Whitley family member 35795 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 2015 to Jennifer Whitley for services rendered to the organization. 0 Program Service Accomplishments (cont'd) Emergency Services In FY2016, total emergency room visits increased 4.8% across the Northside system, surpassing 169,000. Due to continued volume growth and in order to serve patients in a timely manner, Northside initiated several projects in FY2016 with the goals of reducing patient wait times and improving operational efficiencies. These projects included: - "Team Triage" at the Forsyth ER which expanded triage capacity and enables patients to be seen by a provider in the triage area that can examine, treat and discharge the patient without having to place the patient in an Emergency Department bed. This concept allows patients to be seen faster and cuts door-to-triage and door-to-provider times. Given its success, this concept is being implemented at the Atlanta campus in FY 2017. - The Atlanta campus ER initiated a process improvement project dubbed "Decision-to-Discharge - Actual Discharge". This initiative's goal was to improve operational efficiency and improve ER throughput. At the project's conclusion, Atlanta's ER experienced a 6-7 minute reduction in the timeframe to deliver care. Oncology Services In 2016, the Northside Hospital Cancer Institute ("NHCI") continued to strengthen its services and infrastructure to better support the growing cancer care needs of the communities served. Below is a summary of the major successes in 2016: - Successfully completed Year 2 of the National Cancer Institute (NCI) Oncology Research Program grant and ranked No. 2 NCI Community Oncology Research Program (NCORP) community site in the U.S. for accruals to NRG Oncology research protocols. - Continued to be ranked nationally by NCI as a top accrual site to high-priority Precision Medicine trials. - Received three-year Commission on Cancer (CoC) reaccreditation with commendation. - Awarded Outstanding Achievement Award for the 5th consecutive survey cycle by CoC. - Received three-year National Accreditation Program for Breast Centers reaccreditation. - First hospital in Georgia to be awarded the Lung Cancer Disease Specific Care Certification by Joint Commission, making NHCI one of only six hospitals in the U.S. with this certification. - NHCI's affiliated partners, Georgia Cancer Specialists (GCS) and Atlanta Cancer Care (ACC), continue active participation in the Quality Oncology Practice Initiative (QOPI) program. - Enrolled in the National Quality Measures for Breast Centers (NQMBC) data submission and benchmarking initiative. - Successfully completed Foundation for the Accreditation of Cellular Therapy (FACT) reaccreditation for Blood and Marrow Transplant clinical program. - Chosen to partner with Cancer Support Community Atlanta (CSCA) for the Cancer Moonshot 2020 Initiative. Radiology Services - In late FY2015 Northside increased its imaging network from 36 locations to nearly 60 locations. The expanded geographic coverage enables Northside to provide complimentary services to Oncology and Primary Care providers, as well as to provide expanded access to imaging services to its patients. - In FY2016 Northside's radiology network experienced a volume of over 535,000 patient encounters. - In furtherance of its charitable mission, Northside developed an Imaging Charity Referral Program which aims to connect uninsured/underinsured patients in need of imaging services with one of Northside's fifteen charitable imaging locations ("Charitable Imaging Location"). (While all Northside locations accept patients regardless of their ability to pay and provide financial assistance to those who qualify for such assistance under Northside's Financial Assistance Program, Northside's Charitable Imaging Locations have specific and separate indigent/charity care commitments resulting from Georgia's Certificate of Need program.) Initiated in July 2015, the Imaging Charity Referral Program received nearly 300 patient referrals in the first three (3) months. - In FY2016, Northside's Imaging Charity Referral Program received over 800 referrals from its safety net clinic and federal qualified health center referral partners. - Below is a testimonial from one of Northside's Imaging Charity Referral Program partners, demonstrating the effectiveness of this valuable outreach program. "Good Samaritan Health Center (Atlanta) is a non-profit medical clinic serving uninsured and underserved families throughout the Atlanta metro region. Without Northside's program, our patients would not have access to ultrasounds, CT scans, or MRIs. The team at Northside demonstrates compassion and caring for our patients. They process referrals in a timely manner. They contact every patient, often multiple times. The team also contacts our providers with updates and insures all reports are delivered immediately. We had an uninsured 32 year-old mother present. She was concerned about pelvic pain. Her provider scheduled a pelvic ultrasound which was scheduled within two weeks. The radiology report was promptly sent to us and the radiologist reported a possible mass on her ovary and recommended a follow up CT scan. Northside's team scheduled the CT scan immediately. The results indicated a highly suspicious ovarian mass. We then reached out to one of Northside's patient navigators who scheduled her with gynecology oncology. The patient has since underwent surgery which revealed ovarian cancer. Fortunately, her tumor has now been removed and the cancer was detected before metastasizing. She went from presenting as a new patient to having life-saving surgery within two months due entirely to Northside's exceptional program." [Medical Services Director - Good Samaritan Health Center] Surgical Services - In FY2016, total surgeries increased 8.4% across the Northside system, surpassing 53,000. - Northside hosted the Southeastern Society for Plastic and Reconstructive Surgeons' Annual Breast Symposium. The symposium attracted over 400 attendees with international participation from over 20 countries. - In June 2016, Northside Atlanta implemented a colorectal surgical site infection bundle. The bundle is a series of strategies/interventions aimed at decreasing surgical site infections in colorectal surgery patients. The effort included surgeon, anesthesia and nurse-led initiatives that are aimed at infection prevention. In June 2016, Northside Atlanta, Forsyth and Cherokee had zero colon surgical site infections. - In addition to the financial assistance services provided to patients who qualify for such services under Northside's Financial Assistance Program, in furtherance of its charitable mission and in response to an identified community need, Northside created the Financial Access Surgery Program ("FASP"). The FASP was established and designed to provide medically-necessary, non-emergent surgical services and all related ancillary services at no cost, to uninsured/underinsured patients. Northside entered into formal referral agreements with several community organizations including Federally Qualified Health Centers and safety net clinics located across Georgia. Demand for the program was so great that Northside subsequently created the FASP Overflow Program and expanded the number of locations to four (4). In FY2016, the FASP received over 700 referrals from its community partners. - Below is a testimonial from one of Northside's FASP referral partners, demonstrating the effectiveness of this valuable outreach program. "We are the busiest safety-net clinic in Gwinnett County; we provided more than 17,000 patient encounters during 2015. We have been a FASP partner since Spring 2012. FASP has been the most important hospital-based charitable program we work with. When we see patients back in our office after a FASP referral, they are always highly complementary of the excellent care they received. Many patients have had years of medical uncertainty and discomfort before FASP and are so relieved and grateful after FASP they are reduced to tears when thanking us for the services they received. Too often we find that low cost diagnostic and surgical services are in limited supply and available only at limited times. Too often we find that, even after discounting, many organizations and providers' fees remain unaffordable for our patients. In contrast, FASP accepts our referrals year round and is always striving to help us be responsive to patients' various medical needs. If not for FASP, we could not have been as impactful in the lives of so many patients in recent years." [Executive Director - Good Samaritan Health Center - Lawrenceville] Women's Services - In FY2016, delivery volume remains strong across the Northside system with deliveries surpassing 20,000. - Northside Hospital Atlanta ("NHA") is consistently ranked as the nation's leader in maternity services, delivering more babies than any other hospital. In CY2015, the most recent data available, Northside Hospital-Atlanta again was the national leader in maternity services with just over 16,100 births while the next closest provider had just over 14,800 births. - In Georgia, NHA is the leader in maternity services including high-risk perinatal services. In 2015, the most recent data available, NHA cared for nearly 780 high-risk perinatal patients with the next closest provider caring for approximately 530 patients. - NHA's expertise in caring for the most fragile neonates also is unsurpassed. In 2015, the most recent data available, NHA cared for more than 5,100 neonates (excluding normal newborns) with the next closest provider caring for more than 2,000 neonates (excluding normal newborns). - Georgia ranks "at or near the bottom" in maternal deaths in the US, which is a serious public health concern within the state. Currently, the number of deaths and causes of maternal deaths are not properly documented. As such, the Centers for Disease Control determined that a review committee should be convened to investigate maternal mortality in the state. The Georgia Maternal Mortality Review Committee aims to develop prevention recommendations for maternal death and disseminate their findings throughout Georgia to policy makers, healthcare providers, healthcare facilities, and the general public. In furtherance of its charitable mission and to enhance public health, Northside's Clinical Outcomes Manager joined this committee and actively participates in the committee's activities with the full monetary support of Northside. 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 11 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 sign-off on 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 87 clinicians and 105 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 cloangiopancreatography. 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 125 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 28 clinicians and 64 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 281,488,278. Management and general expenses 131,046,062. Fundraising expenses 0. Total expenses 412,534,340. Form 990, Part XI, line 9: change in pension: -122,987,267. equity transfer: -792,389. income from joint venture: -3,150,590. Other Changes in Net Assets: -714,558. Community Benefits Report - Fiscal Year 2016 Northside Hospital is committed to the health and wellness of our community. As such, we dedicate ourselves to being a center of excellence in providing health care of the highest quality. We pledge compassionate support, personal guidance and uncompromising standards to our patients in their individual journeys toward health of body and mind. To ensure innovative and unsurpassed care for our patients, we are dedicated to maintaining our position as a regional leader in select medical specialties. And, to enhance the wellness of our community, we commit ourselves to providing a diverse array of educational and outreach programs. Our Community Benefit Philosophy In addition to providing high quality hospital-based medical services, Northside Hospital provides a number of community-based services, designed to improve the health of individuals who live, work and play in the areas we serve. Working with various organizations, hospital employees and medical staff, Northside participates in health education and screenings and provides support activities for individuals in the community, including vulnerable populations. Because Northside Hospital Inc. is not-for-profit and is not required to return profits to shareholders like taxable organizations, we reinvest our revenues, in excess of expenses, in order to enhance our capacity to deliver high-quality health care to the communities we serve. These resources provide for a long-term focus on the recruitment and retention of outstanding medical professionals, enhanced research and technologies, and new facilities and services. In addition, such resources enable us to provide numerous programs and activities that provide treatment or promote health and healing as a response to identified community needs. "Community Benefit" Defined Community Benefit applies to activities or programs that respond to identified community health needs and that seek to achieve one or more of the following objectives: - improving access to health services - enhancing public health - advancing increased general knowledge - relieving or reducing government's burden to improve health The information presented in this report demonstrates the level of community service and benefits that we have provided to the community during fiscal year 2016 - October 1, 2015 through September 30, 2016. FINANCIAL ASSISTANCE / CHARITY CARE Northside Hospital treats all patients, regardless of age, sex, creed, race, national origin or source of payment. All patients are treated equally in respect to charges, bed assignments and medical care, regardless of ability to pay. We provide care without charge, or at discounted rates, to patients who meet certain criteria. Such cases are not reported as revenue or listed as accounts receivable. We maintain records to identify and monitor the indigent and charity care we provide. These records include the amount of charges forgone for services and supplies provided under the charity care policy. In FY2016, Northside Hospital provided $390,784,537 in indigent and charity care. Uncompensated care including indigent and charity care and uncollected accounts represented $501,088,105. COMMUNITY HEALTH IMPROVEMENT SERVICES Corporate & Community Health Education In response to requests from the community, Northside Hospital physicians and employees regularly provide free lectures through the hospital's Speakers Bureau. Health-related topics include exercise, nutrition & weight control, women & heart disease, breast health, sleep disorders, and more. In FY2016, 807 people were served at 16 events, involving 64 staff hours. Northside's Smoking Cessation Program offers participants tips on how to quit, manage stress, avoid weight gain, cope with withdrawal symptoms and much more. The seven-week sessions use a combination of group discussion and interaction, with nicotine replacement therapy, to provide the support needed to quit smoking. All classes are facilitated by trained Northside Hospital staff. Additional resources including online support services and referrals to telephone counseling also are available. In FY2016, the program enrolled 36 participants. The Northside Hospital Cancer Institute's community outreach staff provide community education and outreach programs throughout the year about breast cancer, prostate cancer, lung cancer, cancer prevention, the importance of screening and other cancer-related topics. In FY2016, 2,241 Northside staff hours served 32,466 people. Approximately 79,000 people attended events where Northside was present. Check It Out! is a collaborative effort between Northside and the Greater Atlanta Hadassah, which provides breast health education to high school junior and senior girls, teaching them proper breast self-exam technique and the importance of early detection and understanding risk factors. Schools in Cobb, Fulton and DeKalb counties have accepted the program as part of their health curriculum. In FY2016, the program was presented to 12 high schools, reaching 1,266 girls. Northside Hospital Website / Online Education Northside Hospital's official website, northside.com, features a health encyclopedia and video library of general health content about surgeries and procedures including dedicated online educational centers for cancer, weight loss surgery and pregnancy. More than 735,515 people visited this content in FY2016, including: - 11,455 unique page views of weight loss surgery content - 11,475 page views of online cancer center - 35,464 page views of maternity and women's center content Northside's Lifetime of Care Magazine, available online and in print, is a free health magazine geared toward women ages 30-65. The magazine is published three times a year and mailed to 490,000 individuals. The editorial staff dedicates approximately 220 hours of work per year. Maternal and Infant Health Education The Northside Hospital MothersFirst Program is a valuable resource to women who are already pregnant or considering becoming pregnant. MothersFirst offers pertinent education, classes, support groups, hospital tours and other services for women throughout the many stages of their childbearing years, from early pregnancy through the early childhood of their baby. MothersFirst offers four classes that qualify as community benefit - Labor & Birth, CPR, Baby Essentials and Breastfeeding. In FY2016, 7,164 people attended these classes (657 class sessions). At Northside Hospital, we want to support the decision to breastfeed. The American Academy of Pediatrics recommends exclusive breastfeeding for baby's first six months of life. Northside's "Warm Line" lactation telephone hotline is available to anyone in the community and offers breastfeeding advice from certified lactation consultants. The Warm Line is available 7 days a week, from 8:30 a.m. to 4:30 p.m., and served 15,312 people (with 3,186 staff hours) in FY2016. Northside also offers a free Breastfeeding eLearning Program on northside.com, which allows 24/7 access to information, videos, PDFs and animations about breastfeeding. Approximately 809 people accessed the eLearning Program in FY2016. Support Groups Support Groups offer patients and the community a way to cope with the issues they face with the comfort of knowing that others are willing to help. Northside offers various support groups, conducted at the hospitals and led by Northside staff who organize, lecture and facilitate. These support groups are open to the community, regardless of where medical care was received. - Mom-Me Connection offers breastfeeding support for new moms. Three groups meet each week in Dunwoody, Alpharetta, Cumming, and Canton. Each group is facilitated by a certified lactation consultant. Approximately 2,038 people attended in FY2016. - Two monthly Bariatric Support Groups are held (in Atlanta and Cumming) for any bariatric patient, pre or post-surgery. A third group is held in Atlanta for patients who are more than one year past surgery. Approximately 518 people attend the support groups in FY2016. - Two Stroke Support Groups for stroke survivors and their families meet monthly at Northside's Atlanta and Alpharetta campuses. The groups host speakers and provide networking and social support for stroke survivors and their families. Approximately 15-20 people attended the groups each month in FY2016. - Northside's Outpatient Behavioral Health Department offers a Women's Empowerment Therapeutic Group for women, age 40+, who are undergoing cancer treatment or are in remission from cancer. Two licensed social workers lead and moderate the group. Topics include: self-case/health and wellness, intimacy/sexuality, grief and loss, relationships, and new factors in your life since diagnosis. In FY2016, 15-20 people attended this group. - Caring and Coping is a support group for parents and grandparents who have lost a baby due to miscarriage, ectopic pregnancy, stillbirth or newborn death. Meetings are held once a month and are facilitated by two staff members. Approximately 20 people attended each meeting in FY2016, with approximately 25% of attendees coming from other hospitals. - Rainbow PALS (Pregnancy after Loss Support) is a social support group for parents considering or experiencing a subsequent pregnancy following the loss of a baby. Meetings are usually once a month and are facilitated by a staff member of Northside's H.E.A.R.T.strings Perinatal Bereavement & Palliative Care Office, with a memorial event being held in October. Approximately 14 people attended each meeting in FY2016, with approximately 4 attendees coming from other hospitals. - ANEW is a social support group for parents, who are raising surviving multiple(s) following the loss of one or more multiple(s). The group meets twice a month and is facilitated by a H.E.A.R.T.strings staff member. A memorial event is held once per year. Approximately 10 people attended each meeting in FY2016, with approximately 2-4 of attendees coming from other hospitals. Partnering with Schools Northside Hospital's Partners In Education program sponsors 111 schools in seven north metro Atlanta counties: Cherokee, Cobb, Dawson, DeKalb, Forsyth, Fulton and Gwinnett. Through these partnerships, Northside provides clinic supplies; participates in fundraisers; supports Career Days and invests in other student programs that promote health and wellness, science, safety and anti-bullying; sponsors teacher appreciation/recognition events; and much more. In FY2016, 320 staff hours were spent serving approximately 150,000 people. Through Northside Hospital-Cherokee's Junior Health Advocates, medical professionals speak to an array of healthy living topics, tailored to children grades PK-8. Topics include Nutrition Nation, Buddy Not Bully, Happy Hands, House Rules, Drug Free Me, Fitness Fun, Squeaky Clean Hygiene, Tooth Truth, Summer Safety, and Net Safe Navigator. Each class offers a 45-minute interactive presentation. Students receive an activity book and gift to reinforce each subject. In FY2016, the program arranged 622 classes (624 classroom hours), reaching 18,040 students. Northside also partners with the Learning for Life Healthcare Exploring Program, which offers local high school students (grades 9-12) who are considering a career in health care a unique, insider's view of the hospital and its many careers. Throughout the seven-month program, which is affiliated with the Boy Scouts of America, the students visit many areas of the hospital, performing exercises and participating during lectures by healthcare professionals. Each class focuses on a different area of health care - cardiology, robotic surgery, radiology, oncology, pharmacy, women's services and other specialties. During the 2015-16 session, 18 students participated in the program, facilitated by 120 staff hours. For outstanding high school students interested in pursuing a career in health care, Northside Hospital-Cherokee participates in the Cherokee County Schools' Work Based Learning Program - Youth Apprenticeship. The unpaid internship offers an observation-only experience for students, who rotate through eleven different departments of the hospital including surgery, radiology and the emergency department for an hour each weekday during the school year. Students also receive American Heart Association HeartSaver/AED training. In FY2016, 35 students participated in the program at the hospital. Two employees managed the program, spending approximately 20 hours. The Northside Hospital-Forsyth Laboratory participates in Lambert High School's Health Sciences Program to help prepare students for advanced health care education and industry placement. The high school provides the content, skills and safety procedures as it relates to clinical laboratory and healthcare diagnostics. Students job shadow at Northside for a total of 30 weeks, rotating through six departments within the Laboratory including Chemistry, Hematology, Blood and Tissue Bank, Phlebotomy, Microbiology and Histology/Pathology. Students get hands-on experience, reviewing and analyzing data and working with real equipment. Diagnostic Phlebotomy and Internship Students were able to interact first hand with patients, nurses and physicians in a clinical setting. In FY2016, 109 students participated for a total of 1,200 hours. More than ten Northside staff members spent 400 hours organizing and supervising the program. The Northside Hospital-Atlanta Auxiliary's Puppet Program travels to schools in DeKalb, Cobb and North Fulton counties, educating children in grades PK-4 about medical check-ups, peer pressure, and drug and alcohol abuse. In FY2016, the program conducted 25 puppet shows, reaching 2,746 students. Volunteers provided more than 100 hours and drove more than 780 miles. Northside's call center handles the scheduling of the puppet shows. In FY2016, the department spent approximately 8 -16 hours fielding calls from schools and scheduling. SUBSIDIZED HEALTH SERVICES Corporate & Community Health Fairs Northside provides free on-site health screenings at corporate and community locations throughout the year to raise health care awareness and to promote prevention and early detection of diseases. Health screenings include cholesterol/glucose testing, blood pressure screening, body composition analysis, osteoporosis screening, pulmonary function testing, sleep quality screening, cancer risk assessment, diabetes assessment, coronary risk profile and audiology screening. In FY2016, Northside offered health screenings at 27 community and 16 corporate events, reaching 3,759 people. More than 3,025 staff hours were spent on the planning and implementation of the events. Community Screenings Throughout the year, Northside also offers disease-specific health screenings at the hospital's campuses in Atlanta, Alpharetta, Cherokee and Forsyth. Screenings are offered at low cost or completely free to those who qualify. - Four Prostate Cancer Screenings took place, reaching 349 men. - Five free Skin Cancer Screenings were held, with 521 participants; 117 people were recommended for follow-up treatment because of abnormal findings. - 2 free Stroke Screenings were held, with 130 participants - 15 people were recommended for follow-up treatment because of abnormal findings. - In recognition of Better Hearing and Speech Month in May, the Audiology Department offered free Hearing Screenings to 64 individuals, and 23 were referred for further evaluation. The Audiology Department also provided free Hearing Screenings through the Cherokee County School District's "Give a Kid a Chance" Program. Screenings were provided to 123 school children. 6 children were referred for further testing. Northside's Financial Access Surgery Program (FASP) is designed to eliminate financial obstacles faced by the uninsured or underinsured in obtaining non-emergent, yet medically-necessary, outpatient surgical and endoscopy services including Screening and Diagnostic Colonoscopies. The services are provided at no cost to qualified participants. This program serves 12 counties - Bartow, Cherokee, Cobb, Dawson, DeKalb, Forsyth, Fulton, Gilmer, Gwinnett, Hall, Lumpkin, and Pickens Counties. In FY2016, 50 screening colonoscopies were performed as well as 270 colonoscopies for diagnostic workups. RESEARCH The Northside Hospital Research Program works to provide patients with the latest treatments and prevention methods being tested through clinical trials. Staff organize and manage all aspects of the clinical trials offered, with the goal of providing access to cutting-edge clinical trials in a community setting and ensuring that the safety of trial participants is the top priority. In FY2016, 34,057 staff hours were spent on research, 487 people were served, and 274 research projects were performed. Specialties include blood and marrow transplant, cardiology, critical care, endocrinology, oncology, orthopedics, pulmonology, rheumatology, and vascular surgery. HEALTH PROFESSIONS EDUCATION The FY2016 Atlanta Cancer Symposium: Engaging the Experts focused on malignant hematology, breast cancer, and gynecologic cancer. Approximately 50 staff hours (4 people) coordinated the event; 186 attended. In May 2016, the hospital hosted the 4th Annual Women and Stroke Symposium. This activity is designed to provide educational content for neurologists and physicians in related fields regarding the unique challenges for women and stroke risk. Risks include hormone treatment, pregnancy, and cardiovascular health. Information about the advances in practice, treatment, prevention, and care of the stroke patient, including women experiencing stroke, will be presented. This education for the stroke professional is a vital component to providing quality patient care and achieving excellent patient outcomes long-term. Approximately 25 staff hours coordinated the event; 100 attended. CASH AND IN-KIND DONATIONS Cancer Institute Through the Northside Hospital Cancer Institute, approximately 500 hours were allocated to community benefit planning, operational support and fundraising. Another 225 staff hours were spent preparing and writing grants to allow Northside to increase access to cancer care. Northside was awarded four grants related to breast cancer in FY2016, totaling $239,641. Approximately 200 staff hours were spent preparing and writing these grants to provide the following services free of charge to vulnerable populations through the hospital's Breast Care Program Fund: - 602 screening mammograms - 296 diagnostic mammograms - 214 ultrasounds - 70 breast biopsies - 34 cyst aspirations - Genetic counseling and testing for uninsured/underserved women: 710 women screened using B-RST tool, of which 120 had a moderate or positive screen result; 12 patients counseled; eight women tested; one woman tested positive for the BRCA2 genetic mutation. Two colon cancer grants were received ($30,045), one from Colon Cancer Alliance that provided $25 gasoline cards or taxi vouchers to patients unable to drive to screening or cancer treatment appointments, and the other from the Colon Cancer Coalition that provided colon prep kits for patients preparing for a colonoscopy. Sponsorships In addition to the excellent medical care and educational programs, Northside provides financial assistance to more than 241 charitable organizations each year. The hospital's four-member Sponsorship Committee reviews all requests received and determines whether or not each organization complements the hospital's Mission and Values and meets geographic and demographic parameters that the hospital has established throughout its primary and secondary service areas. More than 1,000 hours were spent compiling, reviewing and approving sponsorship requests in FY2016. Picture and A Promise Northside collaborates with the American Heart Association to provide awareness and education of cardiovascular disease. The Picture and A Promise Booth is offered at the hospital's community screenings and other community events. It allows participants the opportunity to make a "promise" to their hearts to make lifestyle changes to be more heart healthy. In FY2016, Northside contributed $30,000 for the sponsorship of this program. Tennis Against Breast Cancer In October 2015, Northside Hospital organized the 12th annual "Tennis Against Breast Cancer" event, luncheon and fashion show at multiple locations in North Fulton and Forsyth counties to raise community awareness of breast cancer prevention and education, and 1,118 women participated in the event, which raised $201,700 for the hospital's Breast Care Program Fund. Approximately 320 hours were spent coordinating the event. Miracle Babies In November 2015, Northside hosted the third annual Miracle Babies, a Northside Hospital fundraising event to raise financial assistance and support for families facing a financial hardship due to having a newborn in the hospital's neonatal intensive care unit (NICU). More than $101,140 was raised for the Miracle Babies fund, and 145 people attended the event. Charity Golf Classic The Northside Hospital Charity Golf Classic is a corporate fundraiser for the Northside Hospital Blood & Marrow Transplant Program (BMT) and General Research Program. The FY2016 event raised $499,575 - 50 percent for the BMT Program and 50 percent for the Cancer Research Fund. The event was attended by 272 people and coordinated by 110 staff hours. Wine, Women and Shoes Approximately 415 people attended Northside's Wine, Women and Shoes event, benefitting the Ovarian and Gynecology Cancer Research Fund. More than $231,580 was raised. Approximately 120 staff hours were spent coordinating the event. Blood Drives Northside Hospital is a partner with the Metro Atlanta Red Cross and hosts blood drives for hospital staff and the community. In FY2016, 90.5 staff hours were spent coordinating 25 blood drives, at which 1,258 pints of blood were donated. Baby Alumni Birthday Party The 2016 Northside Hospital Baby Alumni Birthday Party at Zoo Atlanta was Atlanta's largest birthday party. More than 6,000 children and their families celebrated and enjoyed face painters, crafts, birthday cookies as well as an evening visit of the animal exhibits. Approximately 3,600 pounds of non-perishable foods, diapers and baby wipes were brought by guests and donated to the Atlanta Community Food Bank. COMMUNITY BENEFIT OPERATIONS Northside Hospital's Planning Department performs the health system's Community Health Needs Assessment once every three years. Approximately 77 staff hours were spent on this activity in FY2016. Northside's Community Connection Employee Volunteer Program is coordinated by one staff member, who spent 2,080 staff hours coordinating volunteers participating in community benefit activities / programs throughout the community in FY2016. The hospital's sponsorship activities are coordinated by a Community Development Specialist in the Marketing Department, who worked more than 1,000 hours in FY2016 assessing and coordinating sponsorships that meet community benefit guidelines. COMMUNITY-BUILDING ACTIVITIES The Georgia Maternal Mortality Review Committee aims to identify pregnancy-associated deaths and their causes and review contributing factors and interventions that may reduce these deaths. Northside's Clinical Outcomes Manager joined the committee. The hospital offers full monetary support of her time/costs associated with going to the committee's meetings - three meetings, 32 hours in FY2016. BROAD-BASED COMMUNITY OUTREACH (Non Community Benefit) Employee Volunteerism (The Community Connection) Northside Hospital promotes and encourages community volunteerism among its physicians, employees, Auxilians and their families and friends. Each year, staff and physicians volunteer their time, talents and resources to make a positive impact and build strong and healthy communities. In FY2016, more than 4,250 Community Connection volunteers donated more than 29,660 hours of their time to more than 100 community service projects in the hospital's service areas. Employees help strengthen their communities by supporting the following Atlanta Region community organizations and charities and many more in the community. - A Touch of Warmth - American Cancer Society - American Diabetes Association - American Red Cross - Atlanta Community Food Bank - Atlanta Day Shelter for Women - American Heart Association - Atlanta Mission - Back on My Feet - Boys and Girls Club of Metro Atlanta - Brookhaven Acute Nursing Home - Children's Restoration Network - City of Alpharetta - Colon Cancer Alliance - Drake House - Georgia Ovarian Cancer Alliance - Gwinnett Children's Shelter - Jesse's House - MedShare International - MUST Ministries - No One Alone Shelter - OneSight - Open Hand - Partnership Against Domestic Violence - Project Turn Around - Second Wind Dreams - The Place of Forsyth County - Toys for Tots - TurnAround Ministries - United Way of Forsyth County - United Way of Metropolitan Atlanta Program Highlights: - Cell phones are collected throughout the year for the Partnership Against Domestic Violence to support women and their children in their effort to live violence free. - In celebration of the 14th Annual Absolutely Incredible Kid Day, Northside employees wrote hand-written letters of encouragement to every student at High Point Elementary, a Title I school. These letters showed support of the student's dreams and goals for success. - Employees provided healthy snacks for children at No One Alone Shelter who have been affected by domestic violence. These snacks are essential to the children's weekly support group, where through snacks and activities children increase their self-esteem, learn safety skills and improve their behavior. - Northside's annual "Operation Book Bag," a book bag and school supply drive benefiting Children's Restoration Network, was by far Northside's biggest year ever. More than 1,000 new book bags filled with school supplies were collected and distributed to homeless children in the metro Atlanta area. - Every month, more than fifteen employees from Northside's Business Office visit amazing seniors at a local retirement center. During these visits, seniors and employees play BINGO, celebrate birthdays and spend quality time together. The seniors love children, so several employees bring their children and families with them to visit. The bonds between volunteers and the seniors has steadily grown. Employees also adopt the more than 150 residents to provide them with a personal care package during the holiday season. - Northside's March of Dimes - March for Babies campaign was a big success. Northside and its family partners were the No. 1 health care fundraising team and the No. 2 team overall in the state of Georgia for 2016. - Northside employees, families, and friends filled the wish lists of homeless children in the Metro Atlanta Area. Northside partnered with Children's Restoration Network to ensure that more than 4,000 homeless children in Metro Atlanta had a memorable and meaningful Christmas. - Departments, individuals and their families helped employees who have received assistance from the Northside Shares Help Fund create memorable holidays for their children. The Northside Hospital Shares Help fund provides aid to employees in dire financial need resulting from an emergency. - Northside Hospital-Cherokee's Holiday Toy Drive provided toys to the Boys & Girls Club of Cherokee County. - Northside participated in the Second Wind Dreams project to provide gifts for seniors at nursing homes, and staff members had the opportunity to shop for the seniors, and some invited family and friends to deliver gifts to seniors on Christmas Eve or Christmas Day. - Throughout the year, employees donated basic needs items from a wish list to the Partnership Against Domestic Violence. The items benefit victims of domestic violence who reside in safe houses and their Supportive Housing Programs. - Through Open Hand, staff members pack meals for delivery to persons with HIV/AIDS, the sick and shut-ins and the elderly. Open Hand prepares and delivers two freshly cooked meals, every day, seven days a week, to people with AIDS or HIV-related illnesses who need them. This project depends on the participation of more than 100 volunteers each day to cook, pack and deliver the meals. - Employees at the Northside Hospital-Forsyth campus volunteer annually at Hands on Forsyth, Taste of Forsyth, the Cumming Country Fair and Festival, United Way of Forsyth, The Place, and the Drake House. - Employees at Northside Hospital-Cherokee participated in various community projects including the Taste of Canton, Cherokee Family Violence Center and MUST Ministries. Northside Hospital's Health Resource Center/medical library is open to the community and is home to a vast collection of medical information, including books, journals and online resources. The Library offers electronic access to more than 400 medical journals, as well as print subscriptions to more than 150 journals. Internet access to health information databases is also available. Staff is available to provide literature searches. We also provide proctoring services to distance learners. The Health Resource Center's highly trained staff is available to assist patrons with finding what they want and/or need. OUR COMMITMENT 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. north atlanta professional services LLC 1000 Johnson Ferry Road Atlanta GA 30342 205106086 Professional Services GA 0 0 Northside Hospital Inc Northside Cardiovascular Professional Services LLC 1000 Johnson Ferry Road Atlanta GA 30342 331105310 Professional Services GA 0 0 Northside Hospital Inc Northside Surgery Centers LLC 1000 Johnson Ferry Road Atlanta GA 30342 010642336 Healthcare Services GA 0 1926585 Northside Hospital Inc Surgery Center of Georgia LLC 1000 Johnson Ferry Road Atlanta GA 30342 582169517 Surgery Center GA 0 0 Northside Surgery Centers LLC Northside Surgical Professional Services LLC 1000 Johnson Ferry Road Atlanta GA 30342 451259671 Professional Services GA 0 0 Northside Hospital Inc Northside Primary Care Professional Services LLC 1000 Johnson Ferry Road Atlanta GA 30342 451259435 Professional Services GA 0 0 Northside Hospital Inc Surgicoe Real Estate LLC 1000 Johnson Ferry Road Atlanta GA 30342 582558486 Surgery Center GA 0 0 Northside Surgery Centers LLC Northside Atlanta Surgery Centers LLC 1000 Johnson Ferry Road Atlanta GA 30342 454364531 Healthcare Services GA 0 0 Northside Hospital Inc Atlanta Advanced Surgery Center LLC 1000 Johnson Ferry Road Atlanta GA 30342 371663139 Surgery Center GA 0 252050 Northside Atlanta Surgery Centers LLC Northside Forsyth Surgery Centers LLC 1000 Johnson Ferry Road Atlanta GA 30342 454364708 Surgery Center GA 0 0 Northside Hospital Inc Gwinnett Advanced Surgery Center LLC 1000 Johnson Ferry Road Atlanta GA 30342 455067682 Surgery Center GA 2765486 3963496 Northside Hospital Inc AGA Professional Services LLC 1000 Johnson Ferry Road Atlanta GA 30342 453694469 Professional Services GA 0 0 Northside Hospital Inc Galen Advisors LLC 1000 Johnson Ferry Road Atlanta GA 30342 262016143 Medical Billing Services GA 5380840 4570159 Northside Hospital Inc LMG at Northside LLC 1000 Johnson Ferry Road Atlanta GA 30342 581436087 Professional Services GA 34141330 11245710 Northside Hospital Inc Northside 993 LLC 1000 Johnson Ferry Road Atlanta GA 30342 466251430 Real Estate Services GA 4104511 30441650 Northside Hospital Inc NSH Cancer Institute Professional Services A LLC 1000 Johnson Ferry Road Atlanta GA 30342 460667707 Oncology Services GA 0 0 Northside Hospital Inc NSH Cancer Institute Professional Services G LLC 1000 Johnson Ferry Road Atlanta GA 30342 460676654 Oncology Services GA 0 0 Northside Hospital Inc Georgia Surgical Professional Services LLC 1000 Johnson Ferry Road Atlanta GA 30342 463858353 Professional Services GA 0 0 northside hospital Inc Medical Associates Professional Services LLC 1000 Johnson Ferry Road Atlanta GA 30342 463806922 Professional Services GA 0 0 northside hospital Inc Urological Professional Services LLC 1000 Johnson Ferry Road Atlanta GA 30342 465757579 Professional Services GA 0 0 northside hospital Inc Perimeter Professional Services LLC 1000 Johnson Ferry Road Atlanta GA 30342 471088986 Professional Services GA 0 0 northside hospital Inc Cherokee County Investors LLC 1000 Johnson Ferry Road Atlanta GA 30342 300834387 Real Estate Services GA 0 0 northside hospital Inc Northside Urgent Care Holding LLC 1000 Johnson Ferry Road Atlanta GA 30342 471625673 Professional Services GA 0 0 northside hospital Inc Forrest Park Preserve Holdings LLC 1000 Johnson Ferry Road Atlanta GA 30342 474363731 professional Services GA 0 0 northside hospital Inc Advanced Joint Surgery Specialists LLC 1000 Johnson Ferry Road Atlanta GA 30342 474793694 surgery Center GA 0 0 northside hospital Inc Urology Specialists of Atlanta North LLC 1000 Johnson Ferry Road Atlanta GA 30342 472619158 Professional Services GA 0 0 northside hospital Inc Northside Imaging LLC 1000 Johnson Ferry Road Atlanta GA 30342 473958809 radiology services GA 0 0 northside hospital Inc Advanced Surgery Center Perimeter LLC 1000 Johnson Ferry Road Atlanta GA 30342 473080613 surgery Center GA 319229 37898 northside hospital Inc AGA Clinical Services LLC 1000 Johnson Ferry Road Atlanta GA 30342 811319493 Professional Services GA 0 0 Northside Hospital Inc Urology Clinical Services LLC 1000 Johnson Ferry Road Atlanta GA 30342 813281163 Professional Services GA 0 0 Northside Hospital Inc Northside Foundation Inc 1000 Johnson Ferry Road Atlanta GA 30342 581653541 Raise & collect funds in furtherance of Northside Hospital's exempt purpose GA 501(c)(3) Line 7 Northside Health Services Inc 0 Northside Health Services Inc 1000 Johnson Ferry Road Atlanta GA 30342 581917328 Parent Holding Company GA 501(c)(3) Line 11c, III-FI N/A 0 Northside Shares Help Inc 1000 Johnson Ferry Road Atlanta GA 30342 581458873 Public Charity, organized employee relief fund GA 501(c)(3) Line 7 Northside Health Services Inc 0 ENT Surgery Center of Atlanta 5673 Peachtree Dunwoody Rd Suite 94 atlanta GA 30342 200075229 Ambulatory surgery GA Northside Hospital inc related 501837 1633205 0 0 0.63330 Hand and Upper Extremity Surgery Center 980 Johnson Ferry Rd NE Ste 1020 atlanta GA 30342 200147862 outpatient Surgery GA northside Hospital inc related 130805 3349990 0 0 0.51000 Sovereign Rehabilitation of Georgia LLC 5555 Peachtree Dunwoody Rd NE 225 Atlanta GA 30342 205084665 Rehabilitation Center GA Northside Hospital inc related 0 0 0.88000 NASA Surgery Center LLC 1100 Johnson Ferry Rd Ste 180 Sandy Springs GA 30342 581954432 Ambulatory Surgery GA Northside Hospital inc related -10303 987296 0 0 0.70000 Northern Crescent Endoscopy Suite LLC 550 Peachtree Street Suite 1620 Atlanta GA 30308 582453504 Outpatient Surgery GA northside Hospital inc related 1586721 13973254 0 0 0.69990 Urology Surgical Partners LLC 5673 Peachtree Dunwoody Rd Suite 91 atlanta GA 30342 582622573 ambulatory surgery GA northside Hospital inc related 161956 2752472 0 0 0.70000 Northside Ventures Inc 1000 Johnson Ferry Road Atlanta GA 30342 581954456 Leasing Company GA N/A C 0 0 1 1 0 0 0 0 0 0 1 1 0 0 0 0 0 1 0 0 Part I, Column D: In most instances where (D) total income is zero, entities were established for billing identification only and no assets, income or employees are applicable to employer identification number.