2019-08-14T19:18:50-05:00 2018-09-30 621517792 PYA P C 2220 SUTHERLAND AVE KNOXVILLE TN 37919 990 2017-10-01 581954432 NORTHSIDE HOSPITAL INC NORT 4048518000 1000 JOHNSON FERRY ROAD NE ATLANTA GA 303421611 SHANNON A BANNA CFO 4048518000 2019-08-14 1 DEBORAH O ERNSBERGER P00364912 8656730844 35.136.33.75 2019-08-14 19:18:44 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 AF23F2A68CFF53983216DF8908F842EE3670BFA3 2017 2019-02-21 02:37:17Z ROBERT T QUATTROCCHI 1000 JOHNSON FERRY ROAD NE ATLANTA GA 303421611 3317812801 0 X WWW.NORTHSIDE.COM X 1991 GA TO BE A CENTER OF EXCELLENCE IN PROVIDING HIGH-QUALITY HEALTH CARE. 11 6 17601 980 17604049 0 1997899 1020392 3068195685 3252869985 13764887 21815756 20700814 42106668 3104659285 3317812801 2592059 3075702 0 0 1162937054 1283592604 0 0 0 1733097975 1868926366 2898627088 3155594672 206032197 162218129 2402828834 2726110697 860577883 917238461 1542250951 1808872236 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 2471239365 3075702 3289872356 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 2471239365 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 1 1646 0 1 17601 1 1 1 0 0 0 0 0 0 0 0 0 X 11 6 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 1 GA X SHANNON A BANNA 4048518000 1000 JOHNSON FERRY ROAD ATLANTA GA 30342 X ANTHONY J SALVATORE BOARD MEMBER 1.00 1.00 X 0 0 0 WILLIAM G HASTY JR BOARD MEMBER 1.00 X 0 0 0 WAYNE L AMBROZE MD BOARD MEMBER 40.00 X 513794 0 21500 ROBERT E WHITLEY ESQ BOARD MEMBER 1.00 1.00 X 0 0 0 K DOUGLAS SMITH MD BOARD MEMBER 1.00 1.00 X 0 0 0 MARK J SWEENEY BOARD MEMBER 1.00 1.00 X 0 0 0 DALE M BEARMAN MD BOARD MEMBER 1.00 1.00 X 0 0 0 BARBARA PARE' BOARD MEMBER 1.00 1.00 X 0 0 0 GENEVIEVE FAIRBROTHER MD BOARD MEMBER 1.00 X 0 0 0 IQBAL GARCHA MD BOARD MEMBER 1.00 X 0 0 0 ROBERT T QUATTROCCHI PRESIDENT & CEO NSH, INC. 40.00 1.00 X X 4867995 0 35387 JORGE J HERNANDEZ VICE PRESIDENT/ASST. SECRE 40.00 X 574173 0 15826 DEBORAH S MITCHAM VP/CFO NSH, INC. (FORMER) 40.00 1.00 X 888644 0 20562 SHANNON BANNA VP/CFO NSH, INC. (CURRENT) 40.00 1.00 X 316056 0 11726 WILLIAM HAYES CEO, NORTHSIDE HOSPITAL-CH 40.00 X 544994 0 35069 JANIS DUBOW VICE PRESIDENT 40.00 X 501521 0 14534 ROBERT PUTNAM VICE PRESIDENT 40.00 X 869614 0 22756 TINA WAKIM VICE PRESIDENT/COO 40.00 X 1028523 0 13236 WILLIAM EARLY MD GASTROENTEROLOGY/INTERNAL 40.00 X 929505 0 26902 GERALD FEUER MD GYNECOLOGIST/SURGEON 40.00 X 868452 0 35369 KENNETH KRESS MD ORTHOPEDIC SURGEON 40.00 X 1196326 0 21913 CHARLES DECOOK MD ORTHOPEDIC SURGEON 40.00 X 1536210 0 34195 NANCY WIGGERS MD RADIATION ONCOLOGIST 40.00 X 854382 0 35405 15490189 0 344380 1536 0 1 0 GEORGIA CANCER SPECIALISTS I PC 1835 SAVOY DRIVE STE 300 ATLANTA GA 30342 SEE SCHEDULE O 46230884 AGA LLC 550 PEACHTREE ST STE 1620 ATLANTA GA 30308 SEE SCHEDULE O 26607208 BAKER & HOSTETLER LLP 1170 PEACHTREE STREET NE STE 2400 ATLANTA GA 30309 LEGAL SERVICES 20652499 ATLANTA CANCER CARE PC 1100 JOHNSON FERRY ROAD STE 150 SANDY SPRINGS GA 30342 SEE SCHEDULE O 19828944 GE HEALTHCARE INC 1575 NORTHSIDE DR NW 305 ATLANTA GA 30318 BIOMEDICAL SERVICES 11582248 379 430541 282641 307210 1020392 NET PATIENT REVENUE 621990 3216877020 3094515350 9220431 113141239 RENTAL INCOME 531120 17472805 17472805 BILLING REVENUE 561000 6434111 3279321 3154790 PARKING REVENUE 812930 5924394 5924394 CAFETERIA & VENDING 722210 5241431 5241431 920224 920224 3252869985 21815756 21815756 MISCELLANEOUS 900099 37890014 34940806 2949208 PASSTHROUGH INVESTMENT 621300 4216654 2061565 2155089 42106668 3317812801 3148990526 17604049 150197834 X 3056130 3056130 19572 19572 13038487 9969519 3068968 1012022028 773814665 238207363 54706064 41829479 12876585 133296567 101921535 31375032 70529458 53928400 16601058 20422646 20422646 33889401 33889401 997131 1454 995677 2843661 2843661 471545594 320835541 150710053 12753609 403590 12350019 56087522 38895823 17191699 23539159 3866108 19673051 88090028 62459061 25630967 2588829 1057918 1530911 1433096 999424 433672 6125927 6125927 133680108 86207346 47472762 45501294 725697 44775597 SUPPLIES 760474360 756607968 3866392 BAD DEBT EXPENSE 154013312 153960784 52528 MINOR EQUIPMENT PURCHAS 13151898 8451447 4700451 RECRUITMENT 5061837 65049 4996788 36726954 31740209 4986745 3155594672 2471239365 684355307 0 55560 61314 448992646 473740545 252402 309315 212969478 218774559 126630 159474 48666545 53149179 47586833 36074069 2546431502 1281573717 995709893 1264857785 294301580 324565957 291865649 282050766 62301618 72367734 2402828834 2726110697 424592663 488148491 1713490 1986595 60000000 89491897 374271730 337611478 860577883 917238461 X 1542250951 1808872236 1542250951 1808872236 2402828834 2726110697 X 162218129 16950708 87452448 X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 636986 636986 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. FOR FY18, THERE WAS AN INCREASE IN THE DOLLAR AMOUNT FOR LOBBYING REPORTED ON PART II-B, LINE 1I OVER THE PRIOR YEAR. THE INCREASE IS DUE TO TWO YEARS OF INVOICES THAT WERE PAID DURING FY18 AND IS NOT DUE TO AN INCREASE IN LOBBYING ACTIVITY BY NORTHSIDE HOSPITAL, INC. 9083135 2049190 185144 1137100 10180369 8616383 1701861 150580 1385689 9083135 7742074 1758394 128084 1012169 8616383 7079636 1525651 114920 978133 7742074 7044190 1352241 117482 1434277 7079636 0.30460 0.69540 0 1 1 278637757 278637757 1421482101 697624795 723857306 716645981 583948922 132697059 129665663 129665663 1264857785 FAS 106 ACCRUAL 1490851 RESERVE FOR MALPRACTICE 137735302 RETIREMENT PLAN OBLIGATIONS 94204381 PERIODIC CAPITAL FINANCING LIABILITY 3554099 REAL ESTATE FINANCING LIABILITY 62608696 RENT/LEASE RELATED LIABILITIES 38018149 337611478 X PART V, LINE 4: NORTHSIDE HOSPITAL, INC. AND NORTHSIDE HOSPITAL FOUNDATION, INC. HAVE ENDOWMENT FUNDS THAT CONSIST OF 40 DONOR-RESTRICTED INDIVIDUAL FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. THE ORGANIZATIONS ADOPTED A POLICY REGARDING THE ENDOWMENTS WHOSE GENERAL PURPOSE IS TO PRESERVE THE CAPITAL AND PURCHASING POWER OF THE ORGANIZATIONS AND TO PRODUCE SUFFICIENT INVESTMENT EARNINGS FOR CURRENT AND FUTURE SPENDING NEEDS. PART X, LINE 2: NORTHSIDE HOSPITAL, INC., AND SUBSIDIARIES CONSOLIDATED FINANCIAL STATEMENTS AS OF AND FOR THE YEARS ENDED SEPTEMBER 30, 2018 AND 2017, 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 139656024 139656024 0.04650 219215980 156668248 62547732 0.02080 358872004 156668248 202203756 0.06730 48 226302 1666856 257286 1409570 0.00050 5 429 990996 92096 898900 0.00030 1 0 161974 161974 0.00010 1 666 1225281 370244 855037 0.00030 8 37000 4692034 4692034 0.00160 63 264397 8737141 719626 8017515 0.00280 63 264397 367609145 157387874 210221271 0.07010 2 5987 43507 43507 0.00000 1 0 1498 1498 0.00000 1 62 12920 9300 3620 0.00000 75163 75163 0.00000 4 6049 133088 9300 123788 0.00000 1 34126212 341338793 443953115 -102614322 X 1 0 1 GWINNETT ENDOSCOPY CENTER PC OUTPATIENT CENTER 0.15000 0.85000 2 MIDTOWN ENDOSCOPY CENTER LLC OUTPATIENT CENTER 0.15000 0.85000 3 NORTHERN CRESCENT ENDOSCOPY SUITE LLC OUTPATIENT CENTER 0.70000 0.30000 4 NORTHWEST ENDOSCOPY CENTER LLC OUTPATIENT CENTER 0.15000 0.85000 5 SOUTHERN CRESCENT ENDOSCOPY CENTER SUITE PC OUTPATIENT CENTER 0.15000 0.85000 6 WOODSTOCK ENDOSCOPY CENTER LLC OUTPATIENT CENTER 0.70000 0.30000 7 WEST METRO ENDOSCOPY CENTER LLC OUTPATIENT CENTER 0.15000 0.85000 8 ENT SURGERY CENTER OF ATLANTA LLC AMBULATORY SURGERY 0.64330 0.35670 9 PEACHTREE ORTHOPAEDIC SURGERY CENTER AT PERIMETER LLC AMBULATORY SURGERY 0.15000 0.71260 10 UROLOGY SURGICAL PARTNERS LLC AMBULATORY SURGERY 0.70000 0.30000 11 THE HAND & UPPER EXTREMITY SURGERY CENTER OF GA LLC AMBULATORY SURGERY 0.51000 0.19000 12 NASA SURGERY CENTER LLC AMBULATORY SURGERY 0.70000 0.30000 13 SOVEREIGN REHABILITATION OF GEORGIA LLC REHABILITATION CENTER 0.88000 0.12000 14 PANOLA ENDOSCOPY CENTER LLC OUTPATIENT CENTER 0.15000 0.85000 15 AOA AMC LLC ONCOLOGY CLINIC 0.49000 0.51000 16 ADVANCED CENTER FOR JOINT SURGERY LLC ORTHOPEDIC SURGERY 0.51000 0.49000 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/CHNA 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 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: NORTHSIDE FOLLOWS A VERY DETAILED AND ROBUST PROCESS PRIOR TO INITIATING ECAS. AS INDICATED IN RESPONSE TO QUESTION 20, NORTHSIDE (1) PROVIDES A WRITTEN NOTICE ABOUT UPCOMING ECAS AND A PLAIN LANGUAGE SUMMARY OF THE FAP AT LEAST 30 DAYS BEFORE INITIATING ANY ECAS, (2) NORTHSIDE MAKES REASONABLE EFFORTS TO ORALLY (AND VIA OTHER MEANS) NOTIFY INDIVIDUALS ABOUT THE FAP AND FAP APPLICATION PROCESS, AND (3) NORTHSIDE MAKES PRESUMPTIVE ELIGIBILITY DETERMINATIONS TO QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE. NORTHSIDE PROMPTLY PROCESSES ALL COMPLETE FAP APPLICATIONS. NORTHSIDE ALSO EVALUATES ALL INCOMPLETE FAP APPLICATIONS, AND IN CONNECTION WITH SUCH INCOMPLETE APPLICATIONS, TAKES THE FOLLOWING STEPS: IF NORTHSIDE DETERMINES THAT A PATIENT HAS SUBMITTED AN INCOMPLETE FAP APPLICATION, NORTHSIDE WILL (A) IMMEDIATELY SUSPEND ANY ECAS THAT MAY HAVE BEEN INITIATED AGAINST THE PATIENT AFTER THE EXPIRATION OF THE NOTIFICATION PERIOD BUT BEFORE THE EXPIRATION OF THE APPLICATION PERIOD; (B) PROVIDE THE PATIENT WITH WRITTEN NOTICE THAT DESCRIBES THE ADDITIONAL INFORMATION AND/OR DOCUMENTATION THE INDIVIDUAL MUST SUBMIT TO COMPLETE THE FAP APPLICATION AND INCLUDE A COPY OF THE FAP WITH THE WRITTEN NOTICE; AND (C) MAKE A NOTE IN THE BILLING SYSTEM INDICATING THAT ECAS SHOULD NOT BE INITIATED (OR RE-INITIATED) ON THE PATIENT'S ACCOUNT UNTIL THE EXPIRATION OF THE APPLICATION PERIOD, AND ONLY IF AT THAT POINT THE PATIENT HAS NOT SUBMITTED THE NECESSARY INFORMATION TO COMPLETE THE FAP APPLICATION. NORTHSIDE DEFINES THE NOTIFICATION PERIOD" TO MEAN THE PERIOD DURING WHICH IT MUST NOTIFY AN INDIVIDUAL ABOUT THE FAP AND BEGINS ON THE DATE THE FIRST POST-DISCHARGE BILLING STATEMENT FOR CARE WAS PROVIDED TO THE PATIENT AND ENDS ON THE 120TH DAY AFTER THE PATIENT WAS PROVIDED WITH THE FIRST POST-DISCHARGE BILLING STATEMENT FOR CARE. NORTHSIDE DEFINES THE "APPLICATION PERIOD" TO MEAN THE PERIOD DURING WHICH NORTHSIDE MUST ACCEPT AND PROCESS A FAP APPLICATION SUBMITTED BY A PATIENT. THE "APPLICATION PERIOD" BEGINS ON THE DATE CARE IS PROVIDED TO THE PATIENT AND ENDS ON THE LATER OF THE 240TH DAY AFTER THE DATE THAT THE FIRST POST-DISCHARGE BILLING STATEMENT FOR CARE IS PROVIDED OR EITHER (I) IN THE CASE OF INDIVIDUAL WHO NORTHSIDE HAS PROVIDED A NOTICE OF AT LEAST 30 DAYS PRIOR TO INITIATING ONE OR MORE ECAS, THE 30TH DAY AFTER THE DATE SUCH NOTICE IS PROVIDED, OR (II) IN THE CASE OF A PATIENT WHO NORTHSIDE HAS PRESUMPTIVELY DETERMINED TO BE ELIGIBLE FOR LESS THAN THE MOST GENEROUS ASSISTANCE AVAILABLE UNDER NORTHSIDE'S FINANCIAL ASSISTANCE PROGRAM, A REASONABLE TIME AFTER THE PATIENT HAS HAD A CHANCE TO APPLY FOR MORE GENEROUS FINANCIAL ASSISTANCE. 156 1 - NORTHSIDE HOSPITAL CANCER INSTITUTE 308 COLISEUM DRIVE SUITE 120 MACON GA 31217 PHYSICIAN SERVICES/ OUTPATIENT SERVICES 2 - NORTHSIDE HOSPITAL CANCER INSTITUTE 125 KING AVENUE SUITE 200 ATHENS GA 30606 PHYSICIAN SERVICES/ OUTPATIENT SERVICES 3 - NORTHSIDE HOSPITAL CANCER INSTITUTE 624 MARTIN LUTHER KING JR DRIVE MILLEDGEVILLE GA 31061 PHYSICIAN SERVICES/ OUTPATIENT SERVICES 4 - NORTHSIDE HOSPITAL CANCER INSTITUTE 308 DEEP SOUTH FARM ROAD SUITE 200 BLAIRSVILLE GA 30512 PHYSICIAN SERVICES/ OUTPATIENT SERVICES 5 - NORTHSIDE HOSPITAL CANCER INSTITUTE 747 SOUTH 8TH STREET SUITE C GRIFFIN GA 30224 PHYSICIAN SERVICES/ OUTPATIENT SERVICES 6 - NORTHSIDE HOSPITAL CANCER INSTITUTE 101 RIVERSTONE VISTA SUITE 102 BLUE RIDGE GA 30513 PHYSICIAN SERVICES/ OUTPATIENT SERVICES 7 - LAUREATE MEDICAL GROUP 6135 BARFIELD ROAD ATLANTA GA 30328 PHYSICIAN SERVICES 8 - MEDICAL ASSOCIATES OF NORTH GEORGIA 320 HOSPITAL ROAD CANTON GA 30114 PHYSICIAN SERVICES 9 - NORTHSIDE HOSPITAL CANCER INSTITUTE 1000 COWLES CLINIC WAY - MAGNOLIA BUILDING GREENSBORO GA 30642 PHYSICIAN SERVICES/ OUTPATIENT SERVICES 10 - NORTHSIDE HEART 1285 UPPER HEMBREE ROAD ROSWELL GA 30076 PHYSICIAN SERVICES 11 - ARTHRITIS AND TOTAL JOINT SPECIALIST 3400 C-OLD MILTON PARKWAY SUITE 290 CUMMING GA 30041 PHYSICIAN SERVICES 12 - NORTHSIDE HOSPITAL CANCER INSTITUTE 214 PERRY HIGHWAY HAWKINSVILLE GA 31036 PHYSICIAN SERVICES/ OUTPATIENT SERVICES 13 - ATLANTA CLINICAL CARE 5673 PEACHTREE DUNWOODY ROAD SUITE 330 ATLANTA GA 30342 PHYSICIAN SERVICES 14 - THE IMAGING CENTER OF WARNER ROBINS 2706 WATSON BOULEVARD SUITE D WARNER ROBINS GA 31093 OUTPATIENT CENTER 15 - AOA-AMC LLC 308 COLISEUM DRIVE SUITE 100 MACON GA 31217 PHYSICIAN SERVICES 16 - NORTHSIDE HEART 460 NORTHSIDE CHEROKEE BOULEVARD SUITE 19 CANTON GA 30115 PHYSICIAN SERVICES 17 - NORTHSIDE HOSPITAL SPORTS MEDICINE NETWORK 900 TOWNE LAKE PARKWAY SUITE 320 WOODSTOCK GA 30189 PHYSICIAN SERVICES 18 - PULMONARY AND CRITICAL CARE OF ATLANTA 960 JOHNSON FERRY ROAD SUITE 500 ATLANTA GA 30342 PHYSICIAN SERVICES 19 - LAUREATE MEDICAL GROUP 550 PEACHTREE STREET NORTHEAST SUITE 15 ATLANTA GA 30308 PHYSICIAN SERVICES 20 - UROLOGY SPECIALISTS OF ATLANTA 5673 PEACHTREE DUNWOODY ROAD SUITE 910 ATLANTA GA 30342 PHYSICIAN SERVICES 21 - NORTH GEORGIA OBGYN SPECIALISTS 900 TOWNE LAKE PARKWAY SUITE 404 WOODSTOCK GA 30188 PHYSICIAN SERVICES 22 - GWINNETT ADVANCED SURGERY CENTER LLC 2131 FOUNTAIN DRIVE SNELLVILLE GA 30078 AMBULATORY SURGERY 23 - PREMIER CARE FOR WOMEN 960 JOHNSON FERRY ROAD SUITE 400 ATLANTA GA 30342 PHYSICIAN SERVICES 24 - MRI AND IMAGING OF ATHENS 845 PRINCE AVENUE ATHENS GA 30606 OUTPATIENT CENTER 25 - ENDOCRINE SPECIALISTS OF ATLANTA 975 JOHNSON FERRY ROAD SUITE 400 ATLANTA GA 30342 PHYSICIAN SERVICES 26 - CHATTAHOOCHEE SURGICAL GROUP 980 SANDERS ROAD SUITE 100 CUMMING GA 30042 PHYSICIAN SERVICES 27 - NORTHSIDE FAMILY MEDICINE AND URGENT CARE 5610 BETHELVIEW ROAD SUITE 500 CUMMING GA 30040 PHYSICIAN SERVICES 28 - NORTHSIDE VASCULAR SURGERY 1505 NORTHSIDE FORSYTH DRIVE SUITE 2400 CUMMING GA 30041 PHYSICIAN SERVICES 29 - NORTHSIDE VASCULAR SURGERY 980 JOHNSON FERRY ROAD SUITE 1040 ATLANTA GA 30342 PHYSICIAN SERVICES 30 - INTERNAL MEDICINE ASSOCIATES OF JOHNS CREE 3380 PADDOCKS PARKWAY SUWANEE GA 30024 PHYSICIAN SERVICES 31 - UNIVERSITY GYNECOLOGIC ONCOLOGY 960 JOHNSON FERRY ROAD SUITE 130 ATLANTA GA 30342 PHYSICIAN SERVICES 32 - WINDERMERE MEDICAL CLINIC 3850 WINDERMERE PARKWAY SUITE 105 CUMMING GA 30041 PHYSICIAN SERVICES 33 - PEACHTREE DUNWOODY MEDICAL ASSOCIATES 875 JOHNSON FERRY ROAD NORTHEAST SUITE 20 ATLANTA GA 30342 PHYSICIAN SERVICES 34 - JOHNS CREEK SPECIALIST CENTER 3340 PADDOCKS PARKWAY SUWANEE GA 30024 PHYSICIAN SERVICES 35 - CUMMING FAMILY MEDICINE 765 LANIER 400 PARKWAY CUMMING GA 30040 PHYSICIAN SERVICES 36 - ATLANTA COLON AND RECTAL SURGERY 5667 PEACHTREE DUNWOODY ROAD SUITE 330 ATLANTA GA 30342 PHYSICIAN SERVICES 37 - NORTHSIDE PULMONARY AND SLEEP MEDICINE 1400 NORTHSIDE FORSYTH DRIVE SUITE 210 CUMMING GA 30041 PHYSICIAN SERVICES 38 - NORTHSIDE NEUROLOGY 1400 NORTHSIDE FORSYTH DRIVE SUITE 250 CUMMING GA 30041 PHYSICIAN SERVICES 39 - NORTHSIDE FAMILY PRACTICE 960 WOODSTOCK PARKWAY SUITE 300 WOODSTOCK GA 30188 PHYSICIAN SERVICES 40 - LAUREATE MEDICAL GROUP 3400-C OLD MILTON PARKWAY SUITE 500 ALPHARETTA GA 30005 PHYSICIAN SERVICES 41 - SOUTHEASTERN NEUROSURGICAL SPECIALISTS 980 JOHNSON FERRY ROAD NORTHEAST SUITE 49 ATLANTA GA 30309 PHYSICIAN SERVICES 42 - NORTHSIDE FAMILY MEDICINE AND URGENT CARE 684 SIXES ROAD SUITE 125 HOLLY SPRINGS GA 30115 PHYSICIAN SERVICES 43 - PERIMETER NORTH MEDICAL ASSOCIATES 900 TOWNE LAKE PARKWAY SUITE 210 WOODSTOCK GA 30189 PHYSICIAN SERVICES 44 - CHEROKEE LUNG AND SLEEP 460 NORTHSIDE CHEROKEE BOULEVARD SUITE 10 CANTON GA 30114 PHYSICIAN SERVICES 45 - NORTHSIDE HEART 1505 NORTHSIDE BOULEVARD SUITE 3600 CUMMING GA 30041 PHYSICIAN SERVICES 46 - NORTHSIDE HOSPITAL CARDIOVASCULAR CARE 980 JOHNSON FERRY ROAD SUITE 520 ATLANTA GA 30342 PHYSICIAN SERVICES 47 - CUMMING FAMILY MEDICINE 303 PIRKLE FERRY ROAD CUMMING GA 30040 PHYSICIAN SERVICES 48 - ATLANTA CARDIAC AND THORACIC SURGICAL ASSO 960 JOHNSON FERRY ROAD SUITE 100 ATLANTA GA 30342 PHYSICIAN SERVICES 49 - PERIMETER NORTH MEDICAL ASSOCIATES 3400-A OLD MILTON PARKWAY SUITE 130 ALPHARETTA GA 30005 PHYSICIAN SERVICES 50 - NORTHSIDE HOSPITAL SPORTS MEDICINE NETWORK 3400-C OLD MILTON PARKWAY SUITE 190 ALPHARETTA GA 30005 PHYSICIAN SERVICES 51 - NORTHSIDE FAMILY MEDICINE AND URGENT CARE 4800 OLDE TOWNE PARKWAY SUITE 150 MARIETTA GA 30068 PHYSICIAN SERVICES 52 - NORTH POINT PULMONARY ASSOCIATES 3400-C OLD MILTON PARKWAY SUITE 425 ALPHARETTA GA 30005 PHYSICIAN SERVICES 53 - ATLANTA COLON AND RECTAL SURGERY 780 CANTON ROAD NORTHEAST SUITE 315 MARIETTA GA 30060 PHYSICIAN SERVICES 54 - LAUREATE MEDICAL GROUP 7823 SPIVEY STATION BOULEVARD SUITE 310 JONESBORO GA 30236 PHYSICIAN SERVICES 55 - PERIMETER NORTH MEDICAL ASSOCIATES 960 JOHNSON FERRY ROAD NORTHEAST SUITE ATLANTA GA 30342 PHYSICIAN SERVICES 56 - NORTHSIDE CHEROKEE PEDIATRICS 684 SIXES ROAD SUITE 220 HOLLY SPRINGS GA 30115 PHYSICIAN SERVICES 57 - GENERAL SURGEONS OF GWINNETT 1800 TREE LANE SUITE 330 SNELLVILLE GA 30078 PHYSICIAN SERVICES 58 - MEDICAL ASSOCIATES OF NORTH GEORGIA 460 NORTHSIDE CHEROKEE BOULEVARD SUITE 30 CANTON GA 30115 PHYSICIAN SERVICES 59 - GEORGIA COLON AND RECTAL SURGICAL ASSOCIAT 5445 MERIDIAN MARK SUITE 180 ATLANTA GA 30342 PHYSICIAN SERVICES 60 - NORTHSIDE FAMILY MEDICINE AND URGENT CARE 81 NORTHSIDE DAWSON DRIVE SUITE 100 DAWSONVILLE GA 30535 PHYSICIAN SERVICES 61 - MRI AND IMAGING OF HABERSHAM 638 HISTORIC HIGHWAY 441 NORTH SUITE D DEMOREST GA 30535 OUTPATIENT CENTER 62 - NORTH GEORGIA DIABETES AND ENDOCRINOLOGY 1505 NORTHSIDE BOULEVARD SUITE 2800 CUMMING GA 30041 PHYSICIAN SERVICES 63 - GEORGIA GYNECOLOGIC ONCOLOGY 759 OLD NORCROSS ROAD LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 64 - MIDTOWN MEDICAL ASSOCIATES 1110 WEST PEACHTREE STREET NORTHWEST SUIT ATLANTA GA 30309 PHYSICIAN SERVICES 65 - PERIMETER NORTH MEDICAL ASSOCIATES 1505 NORTHSIDE BOULEVARD SUITE 4400 CUMMING GA 30041 PHYSICIAN SERVICES 66 - NORTHSIDE VASCULAR SURGERY 460 NORTHSIDE CHEROKEE BOULEVARD SUITE 10 CANTON GA 30115 PHYSICIAN SERVICES 67 - MOUNT VERNON INTERNAL MEDICINE 755 MOUNT VERNON HIGHWAY NORTHEAST SUITE SANDY SPRINGS GA 30328 PHYSICIAN SERVICES 68 - PERIMETER NORTH MEDICAL ASSOCIATES 3890 JOHNS CREEK PARKWAY SUITE 230 SUWANEE GA 30024 PHYSICIAN SERVICES 69 - RAVRY MEDICAL GROUP 5505 PEACHTREE DUNWOODY ROAD SUITE 650 ATLANTA GA 30342 PHYSICIAN SERVICES 70 - NORTHSIDE CHEROKEE PEDIATRICS 900 TOWNE LAKE PARKWAY SUITE 306 WOODSTOCK GA 30189 PHYSICIAN SERVICES 71 - GOYCO INTERNAL MEDICINE 900 SANDERS ROAD SUITE B CUMMING GA 30041 PHYSICIAN SERVICES 72 - MARTHA M BOONE MD 3400 OLD MILTON PARKWAY BUILDING A SUITE ALPHARETTA GA 30005 PHYSICIAN SERVICES 73 - GEORGIA PULMONARY AND CRITICAL CARE CONSUL 1505 NORTHSIDE BOULEVARD SUITE 3000 CUMMING GA 30041 PHYSICIAN SERVICES 74 - GEORGIA COLON AND RECTAL SURGICAL ASSOCIAT 1260 HWY 54 WEST SUITE 100 FAYETTEVILLE GA 30214 PHYSICIAN SERVICES 75 - ATLANTA GYNECOLOGIC ONCOLOGY 980 JOHNSON FERRY ROAD NE SUITE 900 ATLANTA GA 30342 PHYSICIAN SERVICES 76 - LAUREATE MEDICAL GROUP 4800 OLDE TOWNE PARKWAY SUITE 400 MARIETTA GA 30068 PHYSICIAN SERVICES 77 - MELANOMA AND SARCOMA SPECIALISTS OF GEOR 980 JOHNSON FERRY ROAD SUITE 940 ATLANTA GA 30342 PHYSICIAN SERVICES 78 - NORTH ATLANTA PULMONARY AND SLEEP 993 JOHNSON FERRY ROAD SUITE 300 BUILDIN ATLANTA GA 30342 PHYSICIAN SERVICES 79 - TOWN LAKE PRIMARY CARE 900 TOWNE LAKE PARKWAY SUITE 410 WOODSTOCK GA 30189 PHYSICIAN SERVICES 80 - GEORGIA COLON AND RECTAL SURGICAL ASSOCIAT 721 WELLNESS WAY SUITE 200 LAWRENCEVILLE GA 30045 PHYSICIAN SERVICES 81 - INTERNAL MEDICINE PRACTICE OF NORTHSIDE 10745 WESTSIDE WAY SUITE 125 ALPHARETTA GA 30009 PHYSICIAN SERVICES 82 - ALPHARETTA FOOT AND ANKLE SPECIALISTS 2000 HOWARD FARM DRIVE SUITE 340 CUMMING GA 30041 PHYSICIAN SERVICES 83 - LAUREATE MEDICAL GROUP 684 SIXES ROAD SUITE 265 HOLLY SPRINGS GA 30115 PHYSICIAN SERVICES 84 - NORTH GEORGIA DIABETES AND ENDOCRINOLOGY 3350 PADDOCKS PARKWAY SUWANEE GA 30024 PHYSICIAN SERVICES 85 - ATLANTA LIVER AND PANCREAS SURGICAL SPEC 980 JOHNSON FERRY ROAD SUITE 170 ATLANTA GA 30342 PHYSICIAN SERVICES 86 - ATLANTA COLON AND RECTAL SURGERY 1505 NORTHSIDE BOULEVARD SUITE 1900 CUMMING GA 30041 PHYSICIAN SERVICES 87 - BARIATRIC INNOVATIONS OF ATLANTA 6135 BARFIELD ROAD SUITE 150 SANDY SPRINGS GA 30328 PHYSICIAN SERVICES 88 - GEORGIA COLON AND RECTAL SURGICAL ASSOCIAT 1505 NORTHSIDE BOULEVARD SUITE 2900 CUMMING GA 30041 PHYSICIAN SERVICES 89 - NORTHSIDE CHEROKEE SURGICAL ASSOCIATES 900 TOWNE LAKE PARKWAY SUITE 412 WOODSTOCK GA 30189 PHYSICIAN SERVICES 90 - NORTHSIDE HOSPITAL SPORTS MEDICINE NETWORK 5555 PEACHTREE DUNWOODY ROAD NORTHEAST SU ATLANTA GA 30342 PHYSICIAN SERVICES 91 - ANKLE AND FOOT CENTERS OF NORTH GEORGIA 81 NORTHSIDE DAWSON DRIVE SUITE 204 DAWSONVILLE GA 30534 PHYSICIAN SERVICES 92 - CUMMING FAMILY MEDICINE 133 PROMINENCE COURT SUITE 230 DAWSONVILLE GA 30535 PHYSICIAN SERVICES 93 - CUMMING FAMILY MEDICINE 25 FOOTHILLS PARKWAY MARBLE HILL GA 30149 PHYSICIAN SERVICES 94 - EAST COBB FAMILY MEDICINE 1121 JOHNSON FERRY ROAD BUILDING ONE S MARIETTA GA 30068 PHYSICIAN SERVICES 95 - ROSWELL INTERNAL MEDICINE SPECIALISTS 11785 NORTHFALL LANE SUITE 505 ALPHARETTA GA 30004 PHYSICIAN SERVICES 96 - WINDERMERE MEDICAL CLINIC 200 EAGLES NEST DRIVE SUITE 300D CANTON GA 30115 PHYSICIAN SERVICES 97 - MEDICAL ASSOCIATES OF NORTH GEORGIA 470 VALLEY STREET SUITE 200 BALL GROUND GA 30107 PHYSICIAN SERVICES 98 - NORTHSIDE HOSPITAL SPORTS MEDICINE NETWORK 4800 OLDE TOWNE PARKWAY SUITE 430 MARIETTA GA 30068 PHYSICIAN SERVICES 99 - NORTH ATLANTA BREAST CARE 1400 NORTHSIDE FORSYTH DRIVE SUITE 290 CUMMING GA 30041 PHYSICIAN SERVICES 100 - REPRODUCTIVE SURGICAL SPECIALISTS 1800 NORTHSIDE FORSYTH DRIVE SUITE 380 CUMMING GA 30041 PHYSICIAN SERVICES 101 - ARTHRITIS AND TOTAL JOINT SPECIALIST 1255 FRIENDSHIP ROAD SUITE 200 BRASELTON GA 30517 PHYSICIAN SERVICES 102 - NEWTOWN MEDICAL 3400-A OLD MILTON PARKWAY SUITE 200 ALPHARETTA GA 30005 PHYSICIAN SERVICES 103 - ANDERSON FAMILY MEDICINE 81 NORTHSIDE DAWSON DRIVE SUITE 205 DAWSONVILLE GA 30534 PHYSICIAN SERVICES 104 - KENNESAW FAMILY MEDICINE 6110 PINE MOUNTAIN ROAD SUITE 102 KENNESAW GA 30152 PHYSICIAN SERVICES 105 - GEORGIA COLON AND RECTAL SURGICAL ASSOCIAT 1110 WEST PEACHTREE STREET NORTHWEST SUIT ATLANTA GA 30309 PHYSICIAN SERVICES 106 - LANIER FAMILY PRACTICE 1080 SANDERS ROAD SUITE 100 CUMMING GA 30041 PHYSICIAN SERVICES 107 - NORTHSIDE HOSPITAL SPORTS MEDICINE NETWORK 960 JOHNSON FERRY ROAD SUITE 415 ATLANTA GA 30342 PHYSICIAN SERVICES 108 - NORTHSIDE FAMILY MEDICINE AND URGENT CARE 11685 ALPHARETTA HIGHWAY SUITE 150 ROSWELL GA 30076 PHYSICIAN SERVICES 109 - GEORGIA COLON AND RECTAL SURGICAL ASSOCIAT 2801 NORTH DECATUR ROAD SUITE 120 DECATUR GA 30033 PHYSICIAN SERVICES 110 - NORTHSIDE HOSPITAL SPORTS MEDICINE NETWORK 684 SIXES ROAD SUITE 130 HOLLY SPRINGS GA 30115 PHYSICIAN SERVICES 111 - SLEEP DISORDERS CENTER OF GEORGIA 993-C JOHNSON FERRY ROAD SUITE 301 ATLANTA GA 30342 PHYSICIAN SERVICES 112 - SOUTHEASTERN PRIMARY CARE SPECIALISTS 105 CARNEGIE PLACE SUITE 103 FAYETTEVILLE GA 30214 PHYSICIAN SERVICES 113 - GEORGIA COLON AND RECTAL SURGICAL ASSOCIAT 3400-A OLD MILTON PARKWAY SUITE 440 ALPHARETTA GA 30005 PHYSICIAN SERVICES 114 - ATLANTA GYNECOLOGIC ONCOLOGY 460 NORTHSIDE CHEROKEE BOULEVARD SUITE 40 CANTON GA 30115 PHYSICIAN SERVICES 115 - CHEROKEE BREAST CARE 684 SIXES ROAD SUITE 230 HOLLY SPRINGS GA 30115 PHYSICIAN SERVICES 116 - PERIMETER NORTH MEDICAL ASSOCIATES 10515 BELLS FERRY ROAD SUITE 200 CANTON GA 30114 PHYSICIAN SERVICES 117 - LAUREATE MEDICAL GROUP 460 NORTHSIDE CHEROKEE BOULEVARD SUITE 17 CANTON GA 30115 PHYSICIAN SERVICES 118 - ATLANTA CARDIAC AND THORACIC SURGICAL ASSO 1100 NORTHSIDE FORSYTH DRIVE SUITE 410 CUMMING GA 30041 PHYSICIAN SERVICES 119 - CHEROKEE LUNG AND SLEEP 900 TOWNE LAKE PARKWAY SUITE 206 WOODSTOCK GA 30189 PHYSICIAN SERVICES 120 - GORDON J AZAR SR MD INTERNAL MEDICINE 960 JOHNSON FERRY ROAD SUITE 235 ATLANTA GA 30342 PHYSICIAN SERVICES 121 - INTERNAL MEDICINE SPECIALIST OF ROSWELL 11685 ALPHARETTA HIGHWAY SUITE 270 ATLANTA GA 30076 PHYSICIAN SERVICES 122 - ATLANTA GYNECOLOGIC ONCOLOGY 780 CANTON ROAD SUITE 405 MARIETTA GA 30060 PHYSICIAN SERVICES 123 - NORTH POINT PULMONARY ASSOCIATES 1400 NORTHSIDE FORSYTH DRIVE SUITE 240 CUMMING GA 30041 PHYSICIAN SERVICES 124 - NORTH POINT PRIMARY CARE 3180 NORTH POINT PARKWAY BUILDING 200 SU ALPHARETTA GA 30005 PHYSICIAN SERVICES 125 - PRIMARY CARE OF MILTON 980 BIRMINGHAM VILLAGE SUITE 304 MILTON GA 30004 PHYSICIAN SERVICES 126 - GEORGIA GYNECOLOGIC ONCOLOGY 980 JOHNSON FERRY ROAD SUITE 910 ATLANTA GA 30342 PHYSICIAN SERVICES 127 - NORTH GEORGIA OBGYN SPECIALISTS 433 HIGHLAND PARKWAY SUITE 203 EAST ELIJAY GA 30540 PHYSICIAN SERVICES 128 - UNIVERSITY GYNECOLOGIC ONCOLOGY 1100 NORTHSIDE FORSYTH DRIVE SUITE 420 CUMMING GA 30041 PHYSICIAN SERVICES 129 - PERIMETER ADVANCED SURGERY CENTER 1100 JOHNSON FERRY ROAD CENTER POINTE ONE ATLANTA GA 30342 AMBULATORY SURGERY 130 - NORTHSIDE HOSPITAL SPORTS MEDICINE NETWORK 1839 BUFORD HIGHWAY NORTHEAST SUITE 100 BUFORD GA 30518 PHYSICIAN SERVICES 131 - NORTH GEORGIA OBGYN SPECIALISTS 2855 OLD HIGHWAY 5 NORTH SUITE 110 BLUE RIDGE GA 30513 PHYSICIAN SERVICES 132 - NORTHSIDE HOSPITAL SPORTS MEDICINE NETWORK 11685 ALPHARETTA HIGHWAY SUITE 170 ROSWELL GA 30076 PHYSICIAN SERVICES 133 - NORTHSIDE HOSPITAL SPORTS MEDICINE NETWORK 1110 WEST PEACHTREE STREET SUITE 950 ATLANTA GA 30309 PHYSICIAN SERVICES 134 - WINDERMERE MEDICAL CLINIC 386 HIGHWAY 441 BYPASS BALDWIN GA 30511 PHYSICIAN SERVICES 135 - CUMMING FAMILY MEDICINE 765 LANIER 400 PARKWAY SUITE 200 CUMMING GA 30040 PHYSICIAN SERVICES 136 - NORTHSIDE FAMILY MEDICINE AND URGENT CARE 1110 WEST PEACHTREE STREET NORTHWEST SUIT ATLANTA GA 30309 PHYSICIAN SERVICES 137 - NORTHSIDE HOSPITAL SPORTS MEDICINE NETWORK 2000 HOWARD FARM DRIVE SUITE 305 CUMMING GA 30041 PHYSICIAN SERVICES 138 - LAUREATE MEDICAL GROUP 2000 HOWARD FARM DRIVE SUITE 400 CUMMING GA 30041 PHYSICIAN SERVICES 139 - NORTHSIDE HEART 900 TOWNE LAKE PARKWAY SUITE 400 WOODSTOCK GA 30189 PHYSICIAN SERVICES 140 - NORTHSIDE HEART 4800 OLDE TOWNE PARKWAY SUITE 420 MARIETTA GA 30068 PHYSICIAN SERVICES 141 - NORTHSIDE HEART 3400-C OLD MILTON PARKWAY SUITE 360 ALPHARETTA GA 30005 PHYSICIAN SERVICES 142 - NORTHSIDE HEART 5670 PEACHTREE DUNWOODY ROAD SUITE 880 ATLANTA GA 30342 PHYSICIAN SERVICES 143 - NORTHSIDE HEART 6135 BARFIELD ROAD NORTHEAST SUITE 100 SANDY SPRINGS GA 30328 PHYSICIAN SERVICES 144 - ARTHRITIS AND TOTAL JOINT SPECIALIST 1100 NORTHSIDE FORSYTH DRIVE SUITE 250 CUMMING GA 30041 PHYSICIAN SERVICES 145 - ARTHRITIS AND TOTAL JOINT SPECIALIST 1110 WEST PEACHTREE STREET NORTHWEST SUIT ATLANTA GA 30309 PHYSICIAN SERVICES 146 - ARTHRITIS AND TOTAL JOINT SPECIALIST 1505 NORTHSIDE BOULEVARD SUITE 3500 CUMMING GA 30041 PHYSICIAN SERVICES 147 - ARTHRITIS AND TOTAL JOINT SPECIALIST 5670 PEACHTREE DUNWOODY ROAD SUITE 1250 ATLANTA GA 30342 PHYSICIAN SERVICES 148 - ARTHRITIS AND TOTAL JOINT SPECIALIST 960 WOODSTOCK PARKWAY SUITE 200 WOODSTOCK GA 30188 PHYSICIAN SERVICES 149 - ARTHRITIS AND TOTAL JOINT SPECIALIST 771 OLD NORCROSS ROAD SUITE 135 LAWRENCEVILLE GA 30046 PHYSICIAN SERVICES 150 - NORTHSIDE HOSPITAL SPORTS MEDICINE NETWORK 3280 PEACHTREE ROAD NORTHEAST SUITE 160 ATLANTA GA 30309 PHYSICIAN SERVICES 151 - ATLANTA CARDIAC AND THORACIC SURGICAL ASSO 1110 WEST PEACHTREE STREET NORTHEAST SUIT ATLANTA GA 30309 PHYSICIAN SERVICES 152 - SOUTHEASTERN NEUROSURGICAL SPECIALISTS 631 CAMPBELL HILL STREET SUITE 100 MARIETTA GA 30060 PHYSICIAN SERVICES 153 - ALPHARETTA FOOT AND ANKLE SPECIALISTS 3400-A OLD MILTON PARKWAY SUITE 500 ALPHARETTA GA 30005 PHYSICIAN SERVICES 154 - NORTHSIDE MEDICAL SPECIALISTS 145 RIVERSTONE TERRACE SUITE 100 CANTON GA 30114 PHYSICIAN SERVICES 155 - NORTHEAST GEORGIA DIAGNOSTIC CLINIC 1240 JESSE JEWEL PARKWAY SUITE 500 GAINESVILLE GA 30501 PHYSICIAN SERVICES 156 - NORTHEAST GEORGIA DIAGNOSTIC CLINIC 1270 FRIENDSHIP ROAD SUITE 100 BRASELTON GA 30517 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 ITS PROPRIETARY SOURCE TO DETERMINE PROPENSITY TO PAY. THESE TOOLS ARE USED TO DETERMINE SOMEONE'S QUALIFICATIONS FOR A CHARITY DISCOUNT OR FREE CARE IN ADDITION TO THE FPG THRESHOLDS STATED ABOVE. PART I, LINE 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 $154,013,312 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 2018 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 SUPERSEDES THE DEBT COLLECTION POLICY IN ANY SITUATION WHERE A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE. PART VI, LINE 2: NORTHSIDE DEVELOPED A STANDARDIZED PROCESS FOR CONDUCTING ITS COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA"). IN SHORT, NORTHSIDE'S CHNA PROCESS INCLUDED: - DEFINING THE NORTHSIDE COMMUNITY. - REVIEWING NORTHSIDE INTERNAL DATA. - REVIEWING PUBLICLY AVAILABLE HEALTH DATA. - REVIEWING PROPRIETARY QUANTITATIVE CONSUMER RESEARCH DATA. - PERFORMING STAKEHOLDER INTERVIEWS. - SUMMARIZING AND PRIORITIZING THE HEALTH NEEDS IDENTIFIED WITHIN NORTHSIDE'S COMMUNITY. - DEVELOPING AN IMPLEMENTATION STRATEGY TO ADDRESS THE IDENTIFIED NEEDS. - PRESENTING THE FINALIZED CHNA REPORT AND IMPLEMENTATION STRATEGY TO THE BOARD OF DIRECTORS OF NORTHSIDE HOSPITAL, INC. FOR ADOPTION. - PROVIDING CONTINUED PUBLIC ACCESS TO NORTHSIDE'S CHNA REPORT VIA WWW.NORTHSIDE.COM/COMMUNITY AND PROVIDING AN OPPORTUNITY FOR PUBLIC FEEDBACK VIA NORTHSIDE.CHNA@NORTHSIDE.COM.NORTHSIDE UTILIZED AN EVIDENCE-BASED MODEL OF POPULATION HEALTH ADAPTED FROM THE WISCONSIN POPULATION HEALTH INSTITUTE AND ALSO UTILIZED BY COUNTY HEALTH RANKINGS AND ROADMAPS. THIS MODEL ILLUSTRATES THE COMPLEXITY OF ASSESSING A COMMUNITY'S HEALTH STATUS BY OUTLINING THE FACTORS THAT ACT IN COMBINATION TO DETERMINE THE CURRENT STATUS OF A COMMUNITY'S HEALTH. THE EVIDENCE-BASED MODEL OUTLINES THE HEALTH DETERMINANTS (DEMOGRAPHICS AND SOCIAL ENVIRONMENT, HEALTHCARE ACCESS AND QUALITY, HEALTH BEHAVIORS, AND THE PHYSICAL ENVIRONMENT) THAT LEAD TO THE HEALTH OUTCOMES IN A COMMUNITY (MORBIDITY AND MORTALITY).THE CENTERS FOR DISEASE CONTROL AND PREVENTION ("CDC") PERFORMED A SYSTEMATIC LITERATURE REVIEW TO DETERMINE A COMMON SET OF HEALTH METRICS THAT SHOULD BE USED TO MEASURE BOTH THE HEALTH DETERMINANTS AND HEALTH OUTCOMES. NORTHSIDE USED THE CDC'S LIST OF "MOST FREQUENTLY RECOMMENDED HEALTH METRICS" TO DETERMINE WHAT VARIABLES TO CONSIDER FOR NORTHSIDE'S CURRENT CHNA. NORTHSIDE UTILIZED THE CDC'S RECOMMENDED VARIABLES AND METRIC WHEN THEY WERE READILY AVAILABLE AT THE COUNTY LEVEL. PART VI, LINE 3: NORTHSIDE INFORMS AND EDUCATES PATIENTS AND PERSONS WHO ARE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE AND NORTHSIDE'S FINANCIAL ASSISTANCE PROGRAM IN NUMEROUS WAYS. NORTHSIDE CONSPICUOUSLY POSTS NOTICE OF ITS FINANCIAL ASSISTANCE PROGRAM AND HOW TO ACCESS ITS FINANCIAL ASSISTANCE POLICY AND FINANCIAL ASSISTANCE APPLICATION AT ALL MAJOR POINTS OF ACCESS TO ITS INPATIENT AND OUTPATIENT FACILITIES - THESE POINTS OF ACCESS INCLUDE THE HOSPITALS' PATIENT WAITING ROOMS AND EMERGENCY DEPARTMENTS. FOR PATIENTS THAT PRE-REGISTER OVER THE PHONE FOR HOSPITAL SERVICES, NORTHSIDE VERBALLY INFORMS PATIENTS OF ITS FINANCIAL ASSISTANCE PROGRAM AND PROVIDES PATIENTS WITH INFORMATION ON HOW TO OBTAIN A COPY OF NORTHSIDE'S FINANCIAL ASSISTANCE POLICY AND FINANCIAL ASSISTANCE APPLICATION VIA NORTHSIDE'S WEBSITE OR VIA MAIL. ADDITIONALLY, UPON ADMISSION TO ONE OF ITS HOSPITALS FOR SERVICES, NORTHSIDE PROVIDES EACH PATIENT A REGISTRATION PACKET THAT INCLUDES INFORMATION ON ITS FINANCIAL ASSISTANCE PROGRAM. FURTHER, A FINANCIAL COUNSELOR WILL SPEAK WITH ALL PATIENTS DURING EITHER THE PRE-REGISTRATION PROCESS OR UPON ADMISSION AND EXPLAIN NORTHSIDE'S FINANCIAL ASSISTANCE PROGRAM. IF A PATIENT INDICATES A NEED OR REQUESTS MORE INFORMATION REGARDING FINANCIAL ASSISTANCE, NORTHSIDE WILL REFER THE PATIENT TO A FINANCIAL ASSISTANCE COUNSELOR WHO WILL WORK DIRECTLY WITH THE PATIENT TO ASSIST THE PATIENT IN APPLYING FOR FINANCIAL ASSISTANCE. IN ORDER TO EXPEDITE THE FINANCIAL ASSISTANCE PROCESS, NORTHSIDE USES THIRD PARTY SOFTWARE TO HELP IDENTIFY PATIENTS THAT QUALIFY FOR FINANCIAL ASSISTANCE BASED ON PUBLICLY AVAILABLE INFORMATION (E.G., PARTICIPATION IN STATE-FUNDED PRESCRIPTION PROGRAMS, PARTICIPATION IN THE WOMEN, INFANTS AND CHILDREN (WIC) PROGRAM, PARTICIPATION IN THE SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP, FORMERLY FOOD STAMPS), SUBSIDIZED SCHOOL LUNCH PROGRAM ELIGIBILITY, OR ELIGIBILITY FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS). PATIENTS THAT ARE IDENTIFIED BY SUCH THIRD-PARTY SOFTWARE AS ELIGIBLE TO RECEIVE FINANCIAL ASSISTANCE WILL NOT BE REQUIRED TO COMPLETE THE FINANCIAL ASSISTANCE APPLICATION AND INSTEAD WILL AUTOMATICALLY BE DEEMED TO QUALIFY FOR FINANCIAL ASSISTANCE. FURTHER, NORTHSIDE'S FINANCIAL COUNSELORS WILL ASSIST PATIENTS WITH APPLYING TO PROGRAMS THAT THEY ARE ELIGIBLE FOR, BUT NOT CURRENTLY ENROLLED IN, SUCH AS STATE OR FEDERAL HEALTHCARE PROGRAMS OR DRUG DISCOUNT PROGRAMS. NORTHSIDE ALSO INCLUDES A SUMMARY OF ITS FINANCIAL ASSISTANCE PROGRAM, INCLUDING HOW TO OBTAIN MORE INFORMATION AND APPLY FOR FINANCIAL ASSISTANCE, ON ALL PATIENT BILLS. LASTLY, NORTHSIDE WORKS WITH MANY COMMUNITY OUTREACH PROGRAMS TO PROVIDE FINANCIAL ASSISTANCE TO PATIENTS WHO QUALIFY FOR FREE OR DISCOUNTED SERVICES THROUGH THESE PROGRAMS. TO EXPEDITE THE FINANCIAL ASSISTANCE PROCESS FOR SUCH PATIENTS, NORTHSIDE PROVIDES A PRE-APPROVAL PROCESS FOR ALL PATIENTS WHO ARE REFERRED FOR MEDICALLY NECESSARY SERVICES VIA A COMMUNITY OUTREACH PROGRAM. THIS PROCESS ALLOWS PATIENTS TO QUALITY FOR FINANCIAL ASSISTANCE PRIOR TO RECEIVING HOSPITAL SERVICES, THEREBY RELIEVING THE PATIENTS OF THE STRESS AND BURDEN OF THE FINANCIAL ASPECT OF THEIR CARE AND ALLOWING THEM TO FOCUS ON THEIR HEALTH, WELL-BEING AND RECOVERY. PART VI, LINE 4: NORTHSIDE BEGAN THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS BY DEFINING EACH HOSPITAL'S COMMUNITY, WHICH INCLUDED (I) DEFINING EACH FACILITY'S PRIMARY PATIENT CATCHMENT AREA; (II) MAPPING THE MEDICALLY UNDERSERVED AREAS AROUND EACH FACILITY TO ENSURE THAT NO MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS WERE EXCLUDED WITHIN OR NEAR THE PRIMARY CATCHMENT AREAS; AND (III) MAPPING EACH FACILITY'S DISTRIBUTION OF OUTPATIENT SERVICES ACROSS THE REGION. THE RESULTS OF THIS PROCESS REVEALED SIGNIFICANT OVERLAP BETWEEN THE COMMUNITIES SERVED BY EACH NORTHSIDE HOSPITAL FACILITY. THUS, NORTHSIDE HOSPITAL-ATLANTA, NORTHSIDE HOSPITAL-CHEROKEE, AND NORTHSIDE HOSPITAL-FORSYTH DEVELOPED A SINGLE COMMUNITY DEFINITION IN COMPLIANCE WITH THE 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 INVESTED APPROXIMATELY $280 MILLION IN BUILDING A NEW, STATE-OF-THE-ART REPLACEMENT HOSPITAL, MEDICAL OFFICE BUILDING AND PARKING DECK IN CHEROKEE COUNTY. THE REPLACEMENT HOSPITAL INCREASED NORTHSIDE CHEROKEE'S INPATIENT CAPACITY FROM 84 INPATIENT BEDS TO 105 AND PROVIDES THE COMMUNITY WITH A MORE VISIBLE, EASY-TO-ACCESS HOSPITAL CONVENIENTLY LOCATED OFF A MAJOR INTERSTATE HIGHWAY. IN FORSYTH COUNTY, IN ORDER TO MEET THE COMMUNITY'S HEALTHCARE NEEDS, NORTHSIDE EXPANDED NORTHSIDE HOSPITAL FORSYTH'S INPATIENT BED CAPACITY FROM 247 INPATIENT BEDS TO 284. IN FULTON COUNTY, THE SYSTEM'S LARGEST AND OLDEST HOSPITAL CAMPUS ALSO IS UNDERGOING SIGNIFICANT EXPANSION AND RENOVATION. NORTHSIDE IS INVESTING APPROXIMATELY $200 MILLION IN NORTHSIDE ATLANTA THROUGH THE CONSTRUCTION OF A NEW EIGHT-STORY MEDICAL/SURGICAL TOWER, THE ADDITION OF FOUR OPERATING ROOMS, AND OTHER CAMPUS-WIDE RENOVATIONS AS WELL AS A NEW PARKING DECK. UPON COMPLETION OF THE NEW EIGHT-STORY TOWER, NORTHSIDE ATLANTA'S INPATIENT BED CAPACITY WILL INCREASE FROM 537 BEDS TO 621 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) 144250 GENERAL SUPPORT AMERICAN HEART ASSOCIATION 1101 NORTHCHASE PKWY SUITE 1 MARIETTA GA 30067 135613797 501(C)(3) 250000 GENERAL SUPPORT AMERICAN RED CROSS 1955 MONROE DRIVE NE ATLANTA GA 30324 530196605 501(C)(3) 50000 GENERAL SUPPORT ARCS FOUNDATION INC PO BOX 52124 ATLANTA GA 30355 582004368 501(C)(3) 47500 GENERAL SUPPORT ARTHRITIS FOUNDATION OF GEORGIA PO BOX 78423 ATLANTA GA 30357 581341679 501(C)(3) 130000 GENERAL SUPPORT ATLANTA BALLET INC 1695 MARIETTA BOULEVARD NW ATLANTA GA 30318 581047778 501(C)(3) 50000 GENERAL SUPPORT ATLANTA BELTLINE PARTNERSHIP INC 112 KROG STREET SUITE 14 ATLANTA GA 30307 562464486 501(C)(3) 45000 GENERAL SUPPORT ATLANTA TRACK CLUB INC 3097 E SHADOWLAWN AVE NE ATLANTA GA 30305 581367422 501(C)(3) 165000 GENERAL SUPPORT BE THE MATCH FOUNDATION 500 NORTH 5TH STREET MINNEAPOLIS MN 55401 411704734 501(C)(3) 20000 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 5775 PEACHTREE DUNWOODY RD SUITE C-225 ATLANTA GA 30342 582142151 501(C)(3) 211964 GENERAL SUPPORT CHATTAHOOCHEE NATURE CENTER INC PO BOX 769769 ROSWELL GA 30076 581275604 501(C)(3) 70000 GENERAL SUPPORT COBB CHAMBER OF COMMERCE PO BOX 671868 MARIETTA GA 300060032 580198114 501(C)(6) 28500 GENERAL SUPPORT DUNWOODY NATURE CENTER INC PO BOX 88070 DUNWOODY GA 30356 582009823 501(C)(3) 20000 GENERAL SUPPORT GEORGIA AQUARIUM INC 225 BAKER STREET NW ATLANTA GA 30313 582574918 501(C)(3) 112500 GENERAL SUPPORT GEORGIA OVARIAN CANCER ALLIANCE 6065 ROSWELL ROAD SUITE 512 ATLANTA GA 30328 582424106 501(C)(3) 30000 GENERAL SUPPORT GREATER NORTH FULTON CHAMBER OF COMMERCE 11605 HAYNES BRIDGE RD ALPHARETTA GA 30004 581157316 501(C)(6) 25000 GENERAL SUPPORT HADASSAH THE WOMEN'S ZIONIST ORGANIZATION OF AMERICA 1606 COOPER FOSTER PARK RD W LORAIN OH 44053 346607994 501(C)(3) 25000 GENERAL SUPPORT INMAN PARK NEIGHBORHOOD ASSOCIATION 245 N HIGHLAND AVE NE STE 230 401 ATLANTA GA 30307 581869166 501(C)(4) 25000 GENERAL SUPPORT LEUKEMIA AND LYMPHOMA SOCIETY 3715 NORTHSIDE PARKWAY NW NORTHCREE 400 SUITE 300 ATLANTA GA 30327 135644916 501(C)(3) 30000 GENERAL SUPPORT LOVE NOT LOST INC 1551 DUNWOODY VILLAGE PARKWAY 88872 DUNWOODY GA 30338 474760639 501(C)(3) 20000 GENERAL SUPPORT MARCH OF DIMES 1275 MAMORONECK AVE WHITE PLAINS NY 10605 131846366 501(C)(3) 478365 GENERAL SUPPORT MARIETTA COBB MUSEUM OF ART 30 ATLANTA ST SE MARIETTA GA 30060 581528144 501(C)(3) 50000 GENERAL SUPPORT MEDSHARE INTERNATIONAL 3240 CLIFTON SPRINGS ROAD DECATUR GA 30034 582433968 501(C)(3) 60000 GENERAL SUPPORT MOREHOUSE SCHOOL OF MEDICINE 720 WESTVIEW DRIVE SW ATLANTA GA 303101495 581438873 501(C)(3) 105000 GENERAL SUPPORT MUSEUM OF CONTEMPORARY ART OF GEORGIA 75 BENNETT STREET ATLANTA GA 30309 582562811 501(C)(3) 40000 GENERAL SUPPORT OVARIAN CANCER INSTITUTE 960 JOHNSON FERRY RD STE 130 ATLANTA GA 30342 582445245 501(C)(3) 320000 GENERAL SUPPORT PGA TOUR INC 100 PGA TOUR BLVD PONTE VEDRA FL 32082 520999206 501(C)(6) 38000 GENERAL SUPPORT PIEDMONT PARK CONSERVANCY INC 400 PARK DRIVE NE ATLANTA GA 30306 581551369 501(C)(3) 50000 GENERAL SUPPORT SANDY SPRINGS SOCIETY PO BOX 720074 ATLANTA GA 30358 581868282 501(C)(3) 20000 GENERAL SUPPORT SANDY SPRINGSPERIMETER CHAMBER OF COMMERCE SIX CONCOURSE SUITE 3 SANDY SPRINGS GA 30328 260677794 501(C)(6) 21000 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 SUSAN G KOMEN BREAST CANCER FOUNDATION PO BOX 934048 ATLANTA GA 311934048 581959763 501(C)(3) 30000 GENERAL SUPPORT THE DRAKE HOUSE INC 10500 CLARA DRIVE ROSWELL GA 30075 200943038 501(C)(3) 25000 GENERAL SUPPORT THE PARTNERSHIP AGAINST DOMESTIC VIOLENCE PO BOX 361969 DECATUR GA 30036 823295945 501(C)(3) 118000 GENERAL SUPPORT TRAVELER'S AID OF METRO ATLANTA 75 MARIETTA STREET SUITE 400 ATLANTA GA 30303 580566247 501(C)(3) 30000 GENERAL SUPPORT VISITING NURSE HEALTH SYSTEM 5775 GLENRIDGE DRIVE NE SUITE E200 ATLANTA GA 30328 580566250 501(C)(3) 50000 GENERAL SUPPORT 30 7 SCHOLARSHIP / EDUCATIONAL ASSISTANCE 3 19572 PART I, LINE 2: THE ORGANIZATION HAS GUIDELINES IN PLACE THAT ARE TO BE USED IN REVIEWING THE ELIGIBILITY OF GRANTEES. ALL GRANTS REQUIRE WRITTEN DOCUMENTATION AND APPROPRIATE LEVELS OF APPROVAL. X 1 1 X X X X X X 0 1 0 0 0 0 0 1 0 WAYNE L AMBROZE MD BOARD MEMBER 445669 0 63117 0 5008 0 1385 0 20115 0 535294 0 0 0 ROBERT T QUATTROCCHI PRESIDENT & CEO NSH, INC. 1496122 0 1242519 0 2129354 0 5982 0 29405 0 4903382 0 0 0 JORGE J HERNANDEZ VICE PRESIDENT/ASST. SECRE 386576 0 164865 0 22732 0 5119 0 10707 0 589999 0 0 0 DEBORAH S MITCHAM VP/CFO NSH, INC. (FORMER) 604664 0 273491 0 10489 0 6136 0 14426 0 909206 0 0 0 SHANNON BANNA VP/CFO NSH, INC. (CURRENT) 265441 0 50319 0 296 0 3194 0 8532 0 327782 0 0 0 WILLIAM HAYES CEO, NORTHSIDE HOSPITAL-CH 410447 0 82607 0 51940 0 6037 0 29032 0 580063 0 0 0 JANIS DUBOW VICE PRESIDENT 352617 0 127725 0 21179 0 4596 0 9938 0 516055 0 0 0 ROBERT PUTNAM VICE PRESIDENT 600698 0 239780 0 29136 0 5196 0 17560 0 892370 0 0 0 TINA WAKIM VICE PRESIDENT/COO 680772 0 304341 0 43410 0 3433 0 9803 0 1041759 0 0 0 WILLIAM EARLY MD GASTROENTEROLOGY/INTERNAL 634357 0 125936 0 169212 0 0 0 26902 0 956407 0 0 0 GERALD FEUER MD GYNECOLOGIST/SURGEON 742621 0 119239 0 6592 0 6115 0 29254 0 903821 0 0 0 KENNETH KRESS MD ORTHOPEDIC SURGEON 1042790 0 120000 0 33536 0 5654 0 16259 0 1218239 0 0 0 CHARLES DECOOK MD ORTHOPEDIC SURGEON 962259 0 566775 0 7176 0 5163 0 29032 0 1570405 0 0 0 NANCY WIGGERS MD RADIATION ONCOLOGIST 592404 0 258620 0 3358 0 6000 0 29405 0 889787 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 FIFTEEN 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 WITH A SOURCE OF FUNDS FOR USE AS SUPPLEMENTAL INCOME OVER HIS LIFE IN RETIREMENT. THE SERP VESTS AND DISBURSES INCREMENTAL FUNDING PAYOUTS EACH TWO OR THREE YEARS. THE SERP PAYMENTS ARE BASED ON A MATHEMATICAL FORMULA, PURSUANT TO A SIGNED CONTRACT, AND ARE REVIEWED AND ASSESSED PERIODICALLY FOR REASONABLENESS BY AN OUTSIDE CONSULTANT. THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS AND THE FULL BOARD APPROVE EACH PAYMENT BEFORE PAYMENT IS MADE. NORTHSIDE DOES NOT CONSIDER SERP PAYMENTS TO BE DEFERRED COMPENSATION FOR TAX REPORTING PURPOSES. MR. QUATTROCCHI PARTICIPATES IN A LONG-TERM INCENTIVE PLAN THAT PROVIDES AN INCENTIVE COMPENSATION OPPORTUNITY IN THE EVENT OF THE ACHIEVEMENT OF A NUMBER OF PERFORMANCE MEASURES, INCLUDING CLINICAL QUALITY STANDARDS, MEASURED OVER PERFORMANCE PERIODS EXTENDING FROM 3 TO 5 YEARS. THIS FIRST PERFORMANCE PERIOD UNDER THIS PROGRAM ENDED SEPTEMBER 30, 2017 WITH A PAYMENT HAVING BEEN EARNED BY MR. QUATTROCCHI. NORTHSIDE ANESTHESIOLOGY CONSULTANTS LLC K. DOUGLAS SMITH, M.D., BOARD MEMBER & NS ANESTHESIOLOGY CONS OFF./OWNER 5381513 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 126683 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 2017 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 407384 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 83039 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 2017 TO RACHEL BEARMAN FOR SERVICES RENDERED TO THE ORGANIZATION. 0 JENNIFER WHITLEY ROBERT E. WHITLEY, BOARD MEMBER & JENNIFER WHITLEY FAMILY MEMBER 35917 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 2017 TO JENNIFER WHITLEY FOR SERVICES RENDERED TO THE ORGANIZATION. 0 ROBERT E WHITLEY JR ROBERT E. WHITLEY, BOARD MEMBER & ROBERT E. WHITLEY, JR. FAMILY MEMBER 85749 ROBERT E. WHITLEY, MEMBER OF THE NORTHSIDE HOSPITAL, INC. BOARD OF DIRECTORS, HAS A FAMILY RELATIONSHIP WITH ROBERT E. WHITLEY, JR., AN EMPLOYEE OF NORTHSIDE HOSPITAL, INC. AMOUNT REPRESENTS FAIR MARKET VALUE COMPENSATION PAID DURING CALENDAR YEAR 2017 TO ROBERT E. WHITLEY, JR. FOR SERVICES RENDERED TO THE ORGANIZATION. 0 PROGRAM SERVICE ACCOMPLISHMENTS (CONT'D) REINVESTING TO ENHANCE CAPACITY AND TO DELIVER HIGH-QUALITY HEALTHCARE TO THE COMMUNITIES WE SERVE: BECAUSE NORTHSIDE HOSPITAL INC. IS NOT-FOR-PROFIT AND IS NOT REQUIRED TO RETURN PROFITS TO SHAREHOLDERS LIKE TAXABLE ORGANIZATIONS, WE ROUTINELY REINVEST OUR CASH RESERVES IN ORDER TO ENHANCE OUR CAPACITY AND ABILITY TO DELIVER HIGH-QUALITY HEALTH CARE TO THE COMMUNITIES WE SERVE. ACCORDINGLY, NORTHSIDE HOSPITAL EARMARKED NEARLY $212 MILLION IN CAPITAL INVESTMENTS IN FY2018. NUMEROUS OF THESE ALLOCATIONS WERE DESIGNATED TO KEY SERVICE LINES SUCH AS ONCOLOGY, CARDIOLOGY AND WOMEN'S SERVICES, MANY OF WHICH OVERLAP WITH NORTHSIDE'S TOP IDENTIFIED HEALTH NEEDS IN ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT. SELECT EARMARKED INVESTMENTS INCLUDE: $62 MILLION FOR INPATIENT CAPACITY AND NEONATAL SERVICES EXPANSION, CONSTRUCTION OF AN ADDITIONAL MEDICAL OFFICE BUILDING AND EXPANDED PARKING FOR THE NEW NORTHSIDE HOSPITAL-CHEROKEE CAMPUS; $25.9 MILLION FOR SURGICAL SERVICES; $10.8 MILLION FOR RADIOLOGY SERVICES; $6.8 MILLION FOR ONCOLOGY SERVICES; $3.3 MILLION FOR GENERAL MEDICINE/SURGERY INPATIENT UNITS; $2.9 MILLION FOR CARDIOLOGY SERVICES; AND $2.0 MILLION FOR WOMEN'S SERVICES. PROVIDING A BROAD ARRAY OF COMMUNITY BENEFIT PROGRAM ACTIVITIES: IN FURTHERANCE OF ITS CHARITABLE MISSION AND TO MEET THE COMMUNITY'S TOP IDENTIFIED HEALTH NEEDS, NORTHSIDE HOSPITAL ENGAGES IN NUMEROUS OUTREACH AND COMMUNITY BENEFIT ACTIVITIES THROUGHOUT THE YEAR. THE CULMINATION OF THESE EFFORTS RESULTED IN NORTHSIDE HOSPITAL REACHING OVER 270,000 PERSONS, SPENDING OVER 62,000 HOURS AND PROVIDING MORE THAN $8 MILLION IN COMMUNITY BENEFIT PROGRAM ACTIVITIES. THE HIGHEST DOLLAR IMPACT CATEGORIES (I.E., BENEFIT IN EXCESS OF $1 MILLION) INCLUDE CASH AND IN-KIND DONATIONS AND COMMUNITY HEALTH IMPROVEMENT SERVICES. THROUGH CASH AND IN-KIND DONATIONS, NORTHSIDE HOSPITAL SUPPORTED OVER 200 COMMUNITY ORGANIZATIONS WHOSE MISSIONS COMPLEMENT THE HOSPITAL'S MISSION AND WHOSE INITIATIVES ALIGN WITH THE HOSPITAL'S IDENTIFIED HEALTH NEEDS. WHILE SOME OF THE RECIPIENT ORGANIZATIONS ARE WELL-KNOWN COMMUNITY GROUPS SUCH AS THE AMERICAN CANCER SOCIETY AND THE AMERICAN HEART ASSOCIATION, NORTHSIDE ALSO SUPPORTED SMALLER, GRASSROOTS ORGANIZATIONS SUCH AS BOAT PEOPLE SOS. BOAT PEOPLE SOS WAS ESTABLISHED IN 2000 WITH THE MISSION TO EMPOWER, ORGANIZE, AND EQUIP VIETNAMESE INDIVIDUALS AND COMMUNITIES IN THEIR PURSUIT OF LIBERTY AND DIGNITY. THROUGH THEIR HEALTH AWARENESS AND PROMOTION PROGRAM, BOAT PEOPLE SOS HAS PROVIDED NECESSARY HEALTH SERVICES TO OVER 2,000 UNINSURED PATIENTS. NORTHSIDE'S FINANCIAL SUPPORT HELPS TO FUND THEIR LOCAL CLINIC AND TO PROVIDE COMMUNITY HEALTH IMPROVEMENT SERVICES FOR PERSONS LIVING IN POVERTY. THE SECOND HIGHEST DOLLAR IMPACT CATEGORY, COMMUNITY HEALTH IMPROVEMENT SERVICES, INCLUDES ALMOST FIFTY PROGRAMS WITH NEARLY 470 OCCURRENCES. MUCH OF THE ACTIVITY INCLUDES COMMUNITY AND CORPORATE HEALTH SCREENINGS, COMMUNITY HEALTH EDUCATION EVENTS AND COMMUNITY-BASED CANCER SCREENINGS. HOWEVER, A COUPLE OF UNIQUE PROGRAMS MAY APPEAR SMALLER IN TERMS OF OCCURRENCES BUT HAVE A MEANINGFUL IMPACT ON THE COMMUNITY'S DISPARATE POPULATION. ONE SUCH PROGRAM IS THE FINANCIAL ACCESS SURGERY PROGRAM OR FASP. NORTHSIDE'S FASP WAS DESIGNED SPECIFICALLY TO ADDRESS AN UNMET COMMUNITY-BASED NEED FOR HIGH QUALITY, FINANCIALLY ACCESSIBLE, SPECIALTY SERVICES FOR THE UNINSURED OR UNDERINSURED POPULATION. MORE SPECIFICALLY, VARIOUS CHARITY ORGANIZATIONS AND FREE CLINICS SERVING THE METROPOLITAN ATLANTA AREA HAVE CONFIRMED DIFFICULTY SECURING ACCESS TO NEEDED OUTPATIENT SURGICAL SERVICES FOR THE POPULATIONS THEY SERVE. NORTHSIDE NOW HAS REFERRAL ARRANGEMENTS WITH APPROXIMATELY 60 CHARITABLE ORGANIZATIONS, INCLUDING SAFETY NET CLINICS AND FEDERALLY QUALIFIED HEALTH CENTERS, TO REFER PATIENTS WHO WOULD NOT OTHERWISE BE ABLE TO AFFORD OR OBTAIN MEDICALLY NECESSARY OUTPATIENT SURGERY. PATIENTS ARE PRE-SCREENED BASED ON FINANCIAL STATUS AND MEDICAL NECESSITY, AMONG OTHER FACTORS. THE FASP IS DESIGNED TO COVER THE ENTIRE SURGICAL EPISODE OF CARE INCLUDING PRE- AND POST-OPERATIVE SERVICES AND, AS NEEDED, RELATED SERVICES SUCH AS ANESTHESIA, RADIOLOGY, PHARMACY AND LABORATORY. THE FASP BEGAN IN 2012 WITH ONE (1) LOCATION AND HAS GROWN TO FOUR (4) LOCATIONS BASED ON COMMUNITY DEMAND. ANOTHER UNIQUE COMMUNITY HEALTH IMPROVEMENT PROGRAM IS NORTHSIDE'S IMAGING OUTREACH PROGRAM. THROUGH THIS PROGRAM, NORTHSIDE PROVIDES A COMPREHENSIVE RANGE OF IMAGING SERVICES TO LOW INCOME, UNINSURED OR UNDERINSURED PATIENTS. A DEDICATED IMAGING CHARITY COORDINATOR RECEIVES REFERRALS FROM COMMUNITY SAFETY NET CLINICS, ASSISTS PATIENTS WITH COMPLETING NORTHSIDE'S FINANCIAL ASSISTANCE APPLICATION PROCESS, SCHEDULES THE PATIENT'S EXAM, AND SENDS THE RESULTS BACK TO THE REFERRING CLINIC. IN ESSENCE, NORTHSIDE HAS ESTABLISHED A SUCCESSFUL MEDICAL HOME NETWORK MODEL OF CARE THAT IS DEDICATED TO SERVING THE COMMUNITY'S MOST VULNERABLE POPULATION. THESE ARE JUST A FEW EXAMPLES OF HOW NORTHSIDE HOSPITAL IS FULFILLING ITS CHARITABLE MISSION AND PROVIDING MEANINGFUL BENEFITS TO ITS COMMUNITY. FORM 990, PART VI, SECTION A, LINE 6 NORTHSIDE HEALTH SERVICES, THE PARENT ENTITY, ELECTS ALL THE MEMBERS OF THE GOVERNING BODY FOR NORTHSIDE HOSPITAL, INC. FORM 990, PART VI, SECTION A, LINE 7A NORTHSIDE HEALTH SERVICES, THE PARENT ENTITY, ELECTS ALL THE MEMBERS OF THE GOVERNING BODY FOR NORTHSIDE HOSPITAL, INC. FORM 990, PART VI, SECTION A, LINE 7B NORTHSIDE HEALTH SERVICES, THE PARENT ENTITY, MUST APPROVE BYLAW REVISIONS AND REVISIONS OF THE ARTICLES OF INCORPORATION FOR NORTHSIDE HOSPITAL, INC. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS PREPARED BY AN UNRELATED AND INDEPENDENT ACCOUNTANT USING DETAILED FINANCIAL STATEMENTS SUPPORTED BY A CONSOLIDATED AUDIT (ALSO PREPARED BY OUTSIDE, INDEPENDENT AUDITORS). NORTHSIDE FINANCIAL LEADERSHIP, INCLUDING THE SYSTEM CONTROLLER AND CFO, PERFORM A DETAILED REVIEW OF THE 990 AND APPROVAL OF THE RETURNS BEFORE THEY ARE FILED. ADDITIONALLY, OUTSIDE COUNSEL REVIEWS SEVERAL SECTIONS OF THE FORM AT NORTHSIDE'S REQUEST. FORM 990, PART VI, SECTION B, LINE 12C OFFICERS, DIRECTORS AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE AND SIGN A DISCLOSURE QUESTIONNAIRE ANNUALLY, IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY. NORTHSIDE'S LEGAL SERVICES DEPARTMENT REVIEWS CONTRACTS WITH OTHER CARE PROVIDERS, EDUCATIONAL INSTITUTIONS, MANUFACTURERS AND PAYORS TO DETERMINE WHETHER CONFLICTS OF INTEREST EXIST AND WHETHER THEY ARE IN COMPLIANCE WITH SPECIFIC LAWS AND REGULATIONS. FORM 990, PART VI, SECTION B, LINE 15 TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S CEO AND KEY EMPLOYEES, A COMPENSATION STUDY, INCLUDING PEER ORGANIZATIONS, IS COMPLETED BY AN INDEPENDENT COMPENSATION CONSULTANT. THIS INFORMATION IS SHARED WITH THE COMPENSATION COMMITTEE. INDEPENDENT MEMBERS OF THE COMPENSATION COMMITTEE DELIBERATE AND DETERMINE THE COMPENSATION OF THE CEO AND APPROVE THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES. RECORDS ARE RETAINED OF THESE DECISIONS. THE CEO'S FINAL WRITTEN EMPLOYMENT CONTRACT MUST BE APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 THE CORPORATE GOVERNANCE DOCUMENTS (SPECIFICALLY ALL ARTICLES OF INCORPORATION DOCUMENTS) ARE MADE AVAILABLE ON THE GEORGIA SECRETARY OF STATE WEBSITE. OUR CONFLICT OF INTEREST POLICY IS MADE AVAILABLE ON OUR INTRANET TO NORTHSIDE EMPLOYEES; HOWEVER, NEITHER OUR AUDITED FINANCIAL STATEMENTS NOR OUR CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE TO THE PUBLIC. WHEN AND IF APPROPRIATE REQUESTS ARE MADE BY THE PUBLIC, WE EVALUATE DISCLOSURE ON A CASE BY CASE BASIS. FORM 990, PART VI, LINE 16B IN LIEU OF ADOPTING A WRITTEN POLICY CONCERNING JOINT VENTURE ARRANGEMENTS, THE ORGANIZATION REQUIRES AND UNDERTAKES A RIGOROUS CASE-BY-CASE EVALUATION OF ITS PARTICIPATION IN ANY PROPOSED JOINT VENTURE ARRANGEMENT UNDER APPLICABLE TAX AND OTHER LAWS AND REGULATIONS. EACH PROPOSED JOINT VENTURE WITH A TAXABLE ENTITY IS REVIEWED UNDER APPLICABLE TAX LAWS, REGULATIONS, AND GUIDELINES BY OUTSIDE LEGAL COUNSEL AND ORGANIZATION PERSONNEL TO CONFIRM THAT THE JOINT VENTURE WOULD BE FORMED, OPERATED AND MANAGED IN A MANNER THAT FURTHERS THE COMMUNITY BENEFIT AND CHARITABLE PURPOSES OF THE ORGANIZATION. JOINT VENTURES WITH TAXABLE ENTITIES ARE REQUIRED TO BE STRUCTURED, INCLUDING THROUGH FINANCIAL AND GOVERNANCE PROVISIONS AND RESERVED POWERS, IN A MANNER TO SAFEGUARD THE ORGANIZATION'S EXEMPT STATUS AND ENSURE THAT THE ORGANIZATION CONTROLS ALL ASPECTS OF THE JOINT VENTURE RELATED TO ITS EXEMPT PURPOSE. FORM 990, PART VII, SECTION B: TO SERVE THE PATIENTS WITHIN NORTHSIDE'S GEOGRAPHIC REGION, NORTHSIDE ENTERED INTO A PROFESSIONAL SERVICES AGREEMENT ("PSA") BASED UPON PERSONALLY PERFORMED AND MODIFIER ADJUSTED PRODUCTIVITY WITH GEORGIA CANCER SPECIALISTS I, P.C. ("GCS") TO ENSURE ONCOLOGY AND HEMATOLOGY SERVICES ARE PROVIDED TO ALL PATIENTS WITHIN THE COMMUNITY REGARDLESS OF THE PATIENTS' ABILITY TO PAY. NORTHSIDE HAS PROVIDED A BROAD RANGE OF CANCER CARE SERVICES THROUGH ITS CANCER CARE PROGRAM AT THE NORTHSIDE HOSPITAL CANCER INSTITUTE ("NHCI"). THE NHCI, WHICH IS RECOGNIZED NATIONALLY AS A LEADER IN ONCOLOGY DIAGNOSIS, TREATMENT AND RESEARCH, OFFERS CLINICAL EXCELLENCE ON PAR WITH ACADEMIC-BASED PROGRAMS ALONG WITH THE PERSONALIZED AND ATTENTIVE CARE TYPICALLY ASSOCIATED WITH A COMMUNITY HOSPITAL. NORTHSIDE HAS COMMITTED TO BECOMING A REGIONAL AND NATIONAL LEADER THAT REDEFINES CANCER CARE, WHICH IN PART REQUIRES THE EXPANSION OF ITS GEOGRAPHIC FOOTPRINT THROUGH DEVELOPMENT OF AN AFFILIATION WITH ADDITIONAL LOCATIONS, AS WELL AS HAVING AN INTEGRATED CANCER CARE PROGRAM THAT FACILITATES COLLABORATION BETWEEN NORTHSIDE AND CLINICIANS SPECIALIZING IN ONCOLOGY SERVICES. GCS HAS A LARGE COMPLEMENT OF CLINICIANS TO ASSIST NORTHSIDE IN DEVELOPING AN OUTPATIENT ONCOLOGY SERVICES PROGRAM, SPECIALIZING IN MEDICAL ONCOLOGY AND HEMATOLOGY AND THE PROVISION OF INFUSION THERAPY SERVICES AND MEDICAL AND CLINICAL RESEARCH SERVICES. IN ACCORDANCE WITH THE PSA, GCS REMAINS A PRIVATELY-HELD ORGANIZATION WITHOUT OWNERSHIP OR MANAGEMENT BY NORTHSIDE. GCS MAINTAINS RESPONSIBILITY FOR PROVIDING ALL ADMINISTRATIVE OPERATIONS OF THE PRACTICE (E.G., STAFF BENEFITS, MALPRACTICE INSURANCE, ETC.). NORTHSIDE MAKES PAYMENTS TO GCS AT FAIR MARKET VALUE RATES FOR 1) PERSONALLY PERFORMED AND MODIFIER ADJUSTED PROFESSIONAL SERVICES 2) MANAGEMENT OVERSIGHT RESPONSIBILITIES AND 3) BILLING ARRANGEMENTS. GCS EMPLOYS APPROXIMATELY 89 CLINICIANS AND 110 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 126 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 61 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 320,835,541. MANAGEMENT AND GENERAL EXPENSES 150,710,053. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 471,545,594. FORM 990, PART XI, LINE 9: CHANGE IN PENSION 90,534,751. EQUITY TRANSFER -2,182,940. INCOME FROM JOINT VENTURES NOT ON BOOKS -1,817,157. OTHER CHANGES IN NET ASSETS -124,566. INTERCOMPANY FORGIVENESS 1,042,360. COMMUNITY BENEFITS REPORT - FISCAL YEAR 2018 ABOUT US NORTHSIDE'S COMMITMENT TO HEALTH AND WELLNESS IN THE ATLANTA COMMUNITY BEGAN IN 1970 WITH THE OPENING OF NORTHSIDE HOSPITAL ATLANTA. SINCE THEN, THE NORTHSIDE HOSPITAL SYSTEM HAS GROWN TO INCLUDE THREE GENERAL ACUTE CARE HOSPITALS, 1,051 INPATIENT BEDS, A NETWORK OF MORE THAN 2,900 PHYSICIANS, AND 15,000 EMPLOYEES. ADDITIONALLY, NORTHSIDE OPERATES MORE THAN 150 OUTPATIENT LOCATIONS IN COUNTIES ACROSS THE GREATER METROPOLITAN ATLANTA AREA. OUR MISSION THROUGH ALL OF THE GROWTH, NORTHSIDE HAS REMAINED STEADFAST AND COMMITTED TO ITS MISSION. 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 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. AND TO ENHANCE THE WELLNESS OF OUR COMMUNITY, WE COMMIT OURSELVES TO PROVIDING A DIVERSE ARRAY OF EDUCATIONAL AND OUTREACH PROGRAMS. OUR VALUES NORTHSIDE'S OUTSTANDING REPUTATION IS FUELED BY AN INSTINCTIVE DEVOTION TO A UNIQUE SET OF VALUES. THIS STATEMENT OF VALUES DEFINES AND COMMUNICATES THOSE GUIDING, MOTIVATING PHILOSOPHIES THAT HAVE LED US TO DISTINCTION: EXCELLENCE - A PRIMARY VALUE IN ALL MATTERS OF HEALTH CARE, OUR EXCELLENCE IS BORN OF INDIVIDUAL COMMITMENT TO THE HIGHEST PERSONAL POTENTIAL. FOR IF WE REACH OUR INDIVIDUAL POTENTIALS, WE CAN ACHIEVE EXCELLENCE AS AN INSTITUTION. COMPASSION - WE BELIEVE THAT EACH PERSON IS UNIQUE - PATIENT, FAMILY OR CAREGIVER - IN HEALTH, IN SICKNESS, IN LIFE, IN DEATH. EACH IS TO RECEIVE OUR RESPECT, OUR CARE, OUR APPRECIATION AND OUR CONCERN.....OUR EMPATHY. COMMUNITY - WE VALUE ITS WELL-BEING AND ARE COMMITTED TO ITS PROGRESS. IN ADDITION TO OUR SERVICES, WE PROVIDE AN IMPORTANT CORPORATE CONTRIBUTION, EXPRESSED THROUGH INVOLVEMENT WITH THE PEOPLE, ORGANIZATIONS AND JURISDICTIONS THAT VITALIZE, ENERGIZE AND SUPPORT OUR REGION. SERVICE - WE RECOGNIZE A PERSONALIZED EXPRESSION OF CARING WHICH TRANSCENDS PHYSICAL ASPECTS OF HEALTH. WE REALIZE THAT THIS DEPTH OF SERVICE TO OTHERS CAN BE THE SOURCE OF OUR OWN GROWTH AND WELL-BEING, WHILE MAINTAINING A FINANCIALLY SUCCESSFUL ORGANIZATION. TEAMWORK - OUR SUCCESS STEMS FROM TEAMWORK. WE RECOGNIZE THE EQUAL VALUE AND INDIVIDUAL CONTRIBUTION OF EACH MEMBER OF OUR TEAM. WE BELIEVE IN MUTUAL REGARD FOR EACH OTHER AND FOR OUR PATIENTS. WE ENCOURAGE TEAMWORK BY WORKING TOGETHER RESPECTFULLY, COMMUNICATING OPENLY AND SUPPORTING THE EXPRESSION OF DIFFERING OPINIONS AND PERSPECTIVES. PROGRESS & INNOVATION - WE UNDERSTAND THE NEED FOR THESE ATTRIBUTES IN PATIENT CARE AND ORGANIZATIONAL MANAGEMENT. WHILE PRESERVING THE TRADITION AND WISDOM OF THOSE WHO HAVE GONE BEFORE US, WE SEEK NEW INFORMATION AND STATE-OF-THE-ART TECHNOLOGY. WE WELCOME NEW INSIGHTS, NEW TECHNIQUES, NEW IDEAS AND WILL REMAIN LEADERS IN THE HEALTH CARE OF OUR COMMUNITY. OUR COMMUNITY NORTHSIDE'S CURRENT COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") COVERS FY 2016 - FY 2018, AND MARKS THE SECOND CYCLE OF ASSESSING, PRIORITIZING AND ADDRESSING OUR COMMUNITY'S HEALTH NEEDS. GIVEN THE GEOGRAPHIC PROXIMITY OF NORTHSIDE'S THREE HOSPITALS, NORTHSIDE HOSPITAL ATLANTA ("NHA"), NORTHSIDE HOSPITAL CHEROKEE ("NHC") AND NORTHSIDE HOSPITAL FORSYTH ("NHF"), NORTHSIDE DEVELOPED A SINGLE COMMUNITY DEFINITION FOR THE FY 2016 - FY 2018 CHNA. NORTHSIDE'S COMMUNITY IS DEFINED AS: CHEROKEE, COBB, DAWSON, DEKALB, FORSYTH, FULTON, GWINNETT, AND PICKENS COUNTIES. TOGETHER THESE COUNTIES REPRESENTED EIGHTY-FOUR PERCENT (84%) OF THE SYSTEM'S TOTAL CASES INCLUDING EIGHTY-ONE PERCENT (81%) OF NHA'S, NINETY-TWO PERCENT (92%) OF NHC'S AND EIGHTY-NINE PERCENT (89%) OF NHF'S TOTAL CASES. IDEALLY, NORTHSIDE WOULD HAVE UNLIMITED RESOURCES TO ADDRESS ALL OF THE COMMUNITY'S IDENTIFIED NEEDS. HOWEVER, IT IS NOT REALISTIC FOR ANY SINGLE ORGANIZATION TO ADDRESS ALL OF A COMMUNITY'S NEEDS, HENCE THE IMPORTANCE OF PRIORITIZING THE IDENTIFIED NEEDS. NORTHSIDE SELECTED THOSE NEEDS THAT IMPACT THE GREATEST NUMBER OF INDIVIDUALS IN THE COMMUNITY; THOSE NEEDS THAT DISPROPORTIONATELY IMPACT THE MOST VULNERABLE POPULATIONS; THOSE NEEDS THAT ARE MOST SEVERE AND/OR PREVALENT; AND THOSE NEEDS THAT NORTHSIDE HAS THE WHEREWITHAL TO ADDRESS. THUS, NORTHSIDE'S FY 2016 - FY 2018 PRIORITIZED HEALTH NEEDS INCLUDE: 1. CANCER 2. CARDIOVASCULAR DISEASE 3. HEALTHY LIFESTYLE BEHAVIORS 4. MATERNAL AND INFANT HEALTH 5. PREVENTIVE HEALTH BEHAVIORS 6. OBESITY AND DIABETES IT IS IMPORTANT TO NOTE THAT OVER THE COURSE OF ITS CHNA DEVELOPMENT, NORTHSIDE IDENTIFIED OVER FOUR HUNDRED (400) RESOURCES LOCATED THROUGHOUT THE COMMUNITY. THESE RESOURCES ARE AVAILABLE TO THE COMMUNITY TO HELP ADDRESS ALL OF THE NEEDS NORTHSIDE IDENTIFIED, INCLUDING THOSE NEEDS THAT NORTHSIDE IS NOT FORMALLY ADDRESSING. SEEKING COMMUNITY INPUT NORTHSIDE IDENTIFIED INDIVIDUALS IN THE COMMUNITY WHO COULD PROVIDE A UNIQUE PERSPECTIVE AND CONNECTION TO THE COMMUNITY AND ITS MEMBERS' HEALTH NEEDS. NORTHSIDE MADE SPECIFIC EFFORTS TO IDENTIFY STAKEHOLDERS WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. AFTER IDENTIFYING STAKEHOLDERS TO INTERVIEW, NORTHSIDE DEVELOPED THE STAKEHOLDER ASSESSMENT DISCUSSION GUIDE. THIS GUIDE WAS USED TO LEAD A DISCUSSION WITH EACH STAKEHOLDER TO LEARN ABOUT THE NEEDS AND RESOURCES WITHIN THE NORTHSIDE COMMUNITY. FOR THIS PROCESS, NORTHSIDE REACHED OUT TO 41 STAKEHOLDERS, INCLUDING REPRESENTATIVES AT ALL COUNTY-LEVEL PUBLIC HEALTH DEPARTMENTS IN THE COMMUNITY. THIS OUTREACH EFFORT RESULTED IN THE COMPLETION OF 23 STAKEHOLDER INTERVIEWS COMPRISING: PUBLIC HEALTH DEPARTMENTS (7), SAFETY-NET CLINICS (7), COMMUNITY ORGANIZATIONS (5), OTHER LOCAL GOVERNMENT (2), AND BUSINESS COMMUNITY (2). OUR COMMUNITY BENEFIT PROGRAM ACTIVITIES AS A NOT-FOR-PROFIT ENTITY, NORTHSIDE ALWAYS HAS BEEN MISSION DRIVEN TO IMPROVE THE HEALTH AND WELLBEING OF OUR COMMUNITY MEMBERS AND TO SERVE ALL, REGARDLESS OF ABILITY TO PAY. NORTHSIDE HAS A LONG HISTORY OF COMMUNITY OUTREACH WHETHER THROUGH EDUCATION, SUPPORT GROUPS, OR SCREENINGS AND HEALTH FAIRS. THROUGH THE CHNA PROCESS, NORTHSIDE'S OUTREACH EFFORTS ARE BECOMING MORE STRATEGIC IN NATURE AND MORE COLLABORATIVE. ALSO, THERE IS NOW A FORMAL FRAMEWORK AND STRUCTURE SURROUNDING NORTHSIDE'S OUTREACH EFFORTS WHICH ENABLES IMPROVED CAPTURE AND REPORTING. SINCE FY 2016, NORTHSIDE HAS INCREASED THE NUMBER OF PEOPLE REACHED VIA ITS COMMUNITY BENEFIT PROGRAM ACTIVITIES FROM JUST OVER 239,000 TO JUST OVER 270,000 (I.E., 13%) AND HAS INCREASED THE REPORTED VALUE OF THESE EFFORTS FROM ROUGHLY $4.5 MILLION TO JUST OVER $8.0 MILLION (I.E., 76%). AS NOTED PREVIOUSLY, NORTHSIDE'S CURRENT CHNA COVERS FY 2016 - FY 2018. IT WAS ADOPTED BY THE NORTHSIDE HOSPITAL PLANNING COMMITTEE IN JULY 2016 AND POSTED ON THE ORGANIZATION'S WEBSITE IN SEPTEMBER 2016. OVER THE COURSE OF FY 2017 AND FY 2018, NORTHSIDE ENGAGED IN NUMEROUS ACTIVITIES TO MEET THE SIX (6) PRIORITIZED HEALTH NEEDS NOTED ABOVE AND AS OUTLINED IN ITS IMPLEMENTATION STRATEGY. NORTHSIDE PAID PARTICULAR ATTENTION TO THE CHALLENGES FACING THE COMMUNITY'S MOST VULNERABLE POPULATIONS WHILE ALSO LOOKING TO HELP IMPROVE THE HEALTH STATUS OF THE BROADER COMMUNITY. FOLLOWING IS A HIGH-LEVEL SUMMARY OF THE OBJECTIVE MEASURES (DOLLARS SPENT AND NUMBER SERVED) OF THESE COMMUNITY BENEFIT EFFORTS. CANCER COMMUNITY HEALTH EDUCATION: -HEALTH FAIRS: NORTHSIDE'S ONCOLOGY DEPARTMENT ATTENDED 230 HEALTH FAIRS/COMMUNITY EVENTS, WHERE THEY DISTRIBUTED EDUCATIONAL MATERIALS REGARDING CANCER RISK, TREATMENT AND PREVENTION AS WELL AS PROVIDED SCREENINGS IN FY 2017 - FY 2018. EDUCATIONAL MATERIALS AND SCREENINGS WERE PROVIDED TO APPROXIMATELY 62,717 ATTENDEES, ACCOUNTING FOR $94,352 IN COMMUNITY BENEFIT. -EDUCATIONAL PRESENTATIONS: NORTHSIDE'S ONCOLOGY DEPARTMENT MADE 59 EDUCATIONAL PRESENTATIONS THROUGHOUT THE COMMUNITY TO 10,231 ATTENDEES FROM FY 2017 - FY 2018, ACCOUNTING FOR $14,875 IN COMMUNITY BENEFIT. -SMOKING CESSATION: NORTHSIDE FACILITATED 25 SMOKING CESSATION COURSES FROM FY 2017 - FY 2018 WHERE 100% OF PARTICIPANTS (87) QUIT. COMMUNITY-BASED CLINICAL HEALTH SERVICES: -PROSTATE CANCER SCREENING: THE PROSTATE CANCER SCREENING TARGETING BLACK MEN PROVIDED 94 SCREENINGS AT A 2017 EVENT, ACCOUNTING FOR $1,688 IN COMMUNITY BENEFIT. 14 ATTENDEES WITH ABNORMAL RESULTS WERE LINKED TO FOLLOW-UP CARE. -NON-HEALTH FAIR SCREENINGS: OUTSIDE OF HEALTH FAIR SETTINGS, NORTHSIDE'S ONCOLOGY DEPARTMENT HELD 19 SCREENING EVENTS (10 SKIN CANCER, 9 PROSTATE CANCER) FROM FY 2017 - FY 2018. APPROXIMATELY 2,376 PEOPLE WERE SCREENED, ACCOUNTING FOR $67,879 IN COMMUNITY BENEFIT. -HEALTH PROFESSIONALS EDUCATION: FROM FY 2017 TO FY 2018, NORTHSIDE HELD 3 CANCER-RELATED CONFERENCES THAT PROVIDED CONTINUING EDUCATION CREDITS TO HEALTH PROFESSIONALS: 1) NHCI SYMPOSIUM 2017: ONCOLOGY FOR PRIMARY CARE PHYSICIANS, 2) NHCI SYMPOSIUM 2018: A MULTIDISCIPLINARY APPROACH TO GASTROINTESTINAL CANCER, 3) GLOBAL BREAKTHROUGHS: BREAST & OVARIAN CANCER. THESE CONFERENCES HAD A TOTAL OF 214 ATTENDEES AND ACCOUNTED FOR $97,941 IN COMMUNITY BENEFIT. CARDIOVASCULAR DISEASE COMMUNITY-BASED CLINICAL HEALTH SERVICES: NHF'S CARDIOLOGY DEPARTMENT HOSTED AN ANNUAL CARDIOVASCULAR SCREENING IN FY 2017 AND FY 2018 WHERE 166 ATTENDEES RECEIVED SCREENINGS, ACCOUNTING FOR $9,993 IN COMMUNITY BENEFIT. NORTHSIDE'S CORPORATE & COMMUNITY HEALTH SOLUTIONS DEPARTMENT HOSTED 112 SCREENING EVENTS WHERE CARDIOVASCULAR SCREENINGS WERE PROVIDED REACHING 8,474 ATTENDEES AND PROVIDING $356,615 IN COMMUNITY BENEFIT. COMMUNITY HEALTH EDUCATION: NORTHSIDE'S MARKETING DEPARTMENT HOSTED ITS SPEAKER'S BUREAU SERIES IN FY 2017 AND FY 2018, WHERE 7 OF THE PRESENTATIONS WERE RELATED TO CARDIOVASCULAR DISEASES. THERE WERE 240 ATTENDEES ACCOUNTING FOR $3,002 IN COMMUNITY BENEFIT. NORTHSIDE FORSYTH'S CARDIOLOGY DEPARTMENT ATTENDED 7 COMMUNITY EVENTS FROM FY 2017 - FY 2018 WHERE EDUCATIONAL MATERIALS WERE DISTRIBUTED. APPROXIMATELY 652 ATTENDEES RECEIVED THESE MATERIALS, ACCOUNTING FOR $5,165 IN COMMUNITY BENEFIT. HEALTH PROFESSIONALS EDUCATION: FROM FY 2017 TO FY 2018, NORTHSIDE HELD 4 CARDIOVASCULAR-RELATED CONFERENCES THAT PROVIDED CONTINUING EDUCATION CREDITS TO HEALTH PROFESSIONALS. THESE CONFERENCES HAD A TOTAL OF 518 ATTENDEES. HEALTHY LIFESTYLE BEHAVIORS COMMUNITY HEALTH EDUCATION: FROM FY 2017 - FY 2018, COMMUNITY MEMBERS WERE EDUCATED ON HEALTHY LIFESTYLE BEHAVIORS BY NORTHSIDE THROUGH NHC'S LEARNING & EDUCATIONAL DEVELOPMENT DEPARTMENT: MIDDLE & HIGH SCHOOL OUTREACH, NH MARKETING DEPARTMENT'S SPEAKER'S BUREAU AND HEALTH FAIRS. A TOTAL OF 8,222 PEOPLE WERE REACHED. MATERNAL AND INFANT HEALTH COMMUNITY HEALTH EDUCATION: -CLASSES: NORTHSIDE OFFERS LOW-COST EDUCATIONAL COURSES ON SEVERAL SUBJECT MATTERS RELATED TO MATERNAL AND INFANT HEALTH, OVER 1,200 CLASSES WERE OFFERED BETWEEN FY 2017 AND FY 2018 IN THE FOLLOWING SUBJECTS: BABY ESSENTIALS, INFANT & CHILD CPR, CHILDBIRTH, AND BREASTFEEDING. 14,722 PEOPLE ATTENDED THESE COURSES. NORTHSIDE'S COMMUNITY BENEFIT STEERING COMMITTEE ("CBSC") IS DEVELOPING A PROGRAM AIMED AT REDUCING THE INCIDENCE OF GESTATIONAL DIABETES IN HISPANIC MOTHERS. COMMITTEE MEMBERS SPENT APPROXIMATELY 21 STAFF HOURS ON PLANNING ACTIVITIES FOR THIS PROGRAM IN FY 2018. -LACTATION SUPPORT: NORTHSIDE SUPPORTED 22,781 WOMEN WITH BREASTFEEDING ADVICE THROUGH NORTHSIDE'S FREE LACTATION SUPPORT LINE. ANOTHER 3,408 MOTHERS ATTENDED NORTHSIDE'S MOM-ME CONNECTION LACTATION SUPPORT GROUP. -ONLINE LIBRARY: NORTHSIDE'S WOMEN'S SERVICES DEPARTMENT HOSTED AN ONLINE LIBRARY OF MATERNITY RESOURCES, WHICH IT PAID $4,808 IN FY 2018 TO OFFER. -COMMUNITY SUPPORT GROUPS: NORTHSIDE'S PERINATAL DEPARTMENT PROVIDES SUPPORT TO MOTHERS AND FAMILIES GRIEVING THE LOSS OF AN INFANT THROUGH PERINATAL LOSS SUPPORT GROUPS AND ATLANTA WALK TO REMEMBER. THESE PROGRAMS REACHED 954 ATTENDEES AND ACCOUNTED FOR $11,216 IN COMMUNITY BENEFIT FROM FY 2017 TO FY 2018. ADVOCACY FOR COMMUNITY HEALTH IMPROVEMENT AND SAFETY: NORTHSIDE'S WOMEN'S SERVICES AND STRATEGIC PLANNING DEPARTMENTS PARTICIPATED IN TWO COMMITTEES THAT ADVOCATED FOR IMPROVEMENTS IN MATERNAL AND INFANT HEALTH IN GEORGIA: 1) THE GEORGIA PERINATAL QUALITY COLLABORATIVE AND 2) THE GEORGIA MATERNAL MORTALITY REVIEW COMMITTEE. NORTHSIDE REPRESENTATIVES DEDICATED 127 STAFF HOURS TO THESE EFFORTS, ACCOUNTING FOR $8,985 IN COMMUNITY BENEFIT. PREVENTIVE HEALTH BEHAVIORS COMMUNITY-BASED CLINICAL HEALTH SERVICES: NORTHSIDE CONTINUED TO PROVIDE ACCESS TO (NON-EMERGENT YET MEDICALLY-NECESSARY) OUTPATIENT SURGICAL AND ENDOSCOPY SERVICES THROUGH ITS FINANCIAL ACCESS SURGERY PROGRAM ("FASP"). NORTHSIDE PARTNERED WITH TWENTY DIFFERENT SAFETY-NET CLINICS AND FEDERALLY QUALIFIED HEALTH CENTERS FROM ACROSS THE METRO-ATLANTA REGION TO IMPROVE ACCESS TO MUCH NEEDED SPECIALTY CARE. OVER THE COURSE OF 2017-2018, THE FASP SERVED 915 UNINSURED/UNDERINSURED PATIENTS WHO OTHERWISE WOULD HAVE GONE UNTREATED UNTIL THEIR NEED BECAME SO GREAT THAT THEY WOULD HAVE NO OPTION BUT TO SEEK CARE IN A LOCAL HOSPITAL'S EMERGENCY ROOM. ALSO, AS NOTED IN ITS FY 2016 - FY 2018 IMPLEMENTATION STRATEGY, NORTHSIDE DID EXPAND THE FASP BY OPENING A NORTH GEORGIA LOCATION IN WOODSTOCK, CHEROKEE COUNTY. THIS LATEST FASP LOCATION BECAME OPERATIONAL IN APRIL 2018. OBESITY & DIABETES COMMUNITY HEALTH EDUCATION: NHC'S LEARNING & EDUCATIONAL DEVELOPMENT DEPARTMENT HOSTED 30 EVENTS AT COMMUNITY ELEMENTARY SCHOOLS IN FY 2018 RELATED TO OBESITY PREVENTION. THESE EVENTS WERE ATTENDED BY APPROXIMATELY 4,955 STUDENTS, ACCOUNTING FOR $17,257 IN COMMUNITY BENEFIT. REPORTING OUR COMMUNITY FINANCIALS NORTHSIDE FOLLOWS THE BEST PRACTICES OUTLINED BY THE CATHOLIC HEALTH ASSOCIATION WHEN REPORTING ITS COMMUNITY BENEFIT. ACCORDINGLY, NORTHSIDE PRESENTS ITS FINANCIALS IN TWO CATEGORIES: 1) REPORTABLE COMMUNITY BENEFIT WHICH INCLUDES INDIGENT AND CHARITY CARE, MEDICAID SHORTFALL AND OTHER COMMUNITY BENEFIT PROGRAMS, AND 2) TOTAL COMMUNITY SPEND WHICH INCLUDES REPORTABLE COMMUNITY BENEFIT PLUS BAD DEBT AND MEDICARE SHORTFALL. $210,270,000 FY 2018 REPORTABLE COMMUNITY BENEFIT $139,656,000 COST OF PROVIDING CHARITY CARE $62,548,000 UNREIMBURSED COST OF PROVIDING CARE TO MEDICAID BENEFICIARIES $8,066,000 COST OF OTHER COMMUNITY BENEFIT PROGRAMS $136,741,000 FY 2018 OTHER COMMUNITY SPEND $102,615,000 UNREIMBURSED COST OF PROVIDING CARE TO MEDICARE BENEFICIARIES $34,126,000 UNREIMBURSED COST OF PROVIDING CARE TO OTHER PATIENTS (I.E. BAD DEBT) $347,011,000 FY 2018 TOTAL COMMUNITY SPEND NORTHSIDE WILL CONTINUE TO BE MISSION-DRIVEN. WE WILL FOCUS OUR COMMUNITY BENEFIT ACTIVITIES ON THE HIGHEST PRIORITY NEEDS OF OUR COMMUNITY, DELIVERING A ROBUST ARRAY OF TARGETED PROGRAMS DESIGNED WITH A PARTICULAR FOCUS ON SERVING THE MOST VULNERABLE MEMBERS OF OUR COMMUNITY. 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