4A (Expenses $ 1200109335 including grants of $ 0) (Revenue $ 1921377163)
"NORTH SHORE UNIVERSITY HOSPITAL (""NSUH"")IS A QUATERNARY CARE TEACHING HOSPITAL THAT SERVES AS THE CLINICAL CAMPUS FOR The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell. NSUH offers care in all Medical and Surgical Specialties including cardiovascular services, cancer care, orthopedics, maternal fetal medicine, women's health services and a major transplant program for heart, liver and kidney. The campus is home to the Feinstein Institutes for Medical Research. In 2021, NSUH had 44,009 inpatient discharges, delivered 6,310 babies, provided 71,540 emergency department visits and performed 20,813 ambulatory surgeries, including endoscopies and outpatient catheterizations."

4B (Expenses $ 1028932481 including grants of $ 0) (Revenue $ 597879660)
"NSUH Faculty Practice is an affiliated member of the Northwell Health (""Northwell"") and part of Northwell's medical group and ambulatory lines of service. It strives to make a measurable difference in the health status of the communities it serves by providing comprehensive health care regardless of ability to pay."

4C (Expenses $ 117873577 including grants of $ 0) (Revenue $ 122846802)
Syosset Hospital, a division of NSUH, is a community hospital that maintains a 911 response Emergency Department and inpatient services, including an intensive care unit, and telemetry unit, which serves as a surgical step-down unit. In 2021, the hospital had 3,514 inpatient discharges, provided 13,128 Emergency Department visits and performed 5,418 ambulatory surgeries.

4D (Expenses $ 284509678 including grants of $ 0) (Revenue $ 270379713)
OTHER

PART V, SECTION C - SUPPLEMENTAL INFORMATION
Part V, Section B, line 2: N/A Part V, Section B, line 3j: N/A Part V, Section B, line 5: The CHNA was facilitated by committees established within each of the six-county served by Northwell and its hospitals. External stakeholders included representatives from county health departments, area hospitals, academia, business, government agencies and community-based organizations with an emphasis on those who serve communities with health disparities. Quantitative and qualitative data was collected from diverse community organizations that serve the population-at-large, as well as those communities with significant health disparities. Community partners were invited to participate via community member and community-based organization/provider surveys, facilitated focus groups and community-based organization summits. Part V, Section B, line 6a: For a detailed listing of other hospital facilities go to web link: https://www.northwell.edu/doctors-and-care/locations?type=hospitals Part V, Section B, line 6b: For a detailed listing of other organizations go to web link: https://www.northwell.edu/sites/northwell.edu/files/2019-12/Northwell-Heal th-2019-CHNA-FINAL.pdf Part V, Section B, line 7a: Hospital facility's website/CHNA report go to web link: https://www.northwell.edu/education-and-resources/community-engagement/com munity-health-investment/needs-assessment-community-health-implementation- plan Part V, Section B, line 7d: N/A Part V, Section B, line 10a: https://www.northwell.edu/education-and-resources/community-engagement/com munity-health-investment/needs-assessment-community-health-implementation- plan Part V, Section B, line 11: The Northwell Health Implementation Plan for 2019-2021 includes the goals, objectives, activities, and performance measures planned to address the chosen New York State Prevention Agenda Priority Areas. The hospital identified and addressed primary needs based on an assessment of the highest ranked health priorities of the community, regulatory input, and resources available. For further information go to web link: https://www.northwell.edu/sites/northwell.edu/files/2020-01/Northwell-Heal th-NYSDOH%20-2019-2021-CHNA-and-CSP-Summary.pdf Part V, Section B, line 13b: N/A Part V, Section B, line 13h: The hospital also uses household size. Part V, Section B, line 15e: N/A Part V, Section B, line 16 a-c: https://www.northwell.edu/billing-and-insurance/financial-assistance-progr ams-policies/financial-assistance-policy Part V, Section B, line 16j: The policy is included in the hospital's Community Service Plan and provided at health fairs and presentations open to the community at no cost, in addition to mailing financial policy summary brochures. Part V, Section B, line 18e: N/A Part V, Section B, line 19e: N/A Part V, Section B, line 20e: Before initiating any of the actions, the hospital facility sends letters, makes telephone calls and utilizes presumptive eligibility. Part V, Section B, line 21c: N/A Part V, Section B, line 21d: N/A Part V, Section B, line 23: N/A Part V, Section B, line 24: N/A

PART VI - SUPPLEMENTAL INFORMATION
"Question 1: Part I, Line 3c: This hospital is an affiliated entity of Northwell Health, Inc. (""Northwell""). Northwell uses FPG to determine eligibility and utilizes the New York State Department of Health (NYSDOH) guidelines regarding the consideration of resources. Resource tests cannot be used to deny financial assistance, but only to ""upgrade"" a patient's level of obligation, up to the legal maximum permitted under the financial assistance law. Part I, Line 6a: The Community Benefit report is prepared by the hospital, in conjunction with an affiliated entity (Northwell) of the hospital. The Community Benefit Report is accessible to the public and can be accessed on the Northwell website https://www.northwell.edu/education-and-resources/community-engagement/com munity-health-investment/needs-assessment-community-health-implementation- plan Part I, 7: Row (a) The cost of charity care was determined by utilizing the ratio of cost-to-charges (RCC) calculated on Worksheet 2 applied to gross charges written off for patients qualifying for charity under the hospital's financial assistance policy. Bad Debt was not reported in any row of Part I, Line 7. Row (b) The Ratio of Cost-to-Charges method (or RCC) is used to determine the cost of ancillary services. An RCC is developed from these costs, and that RCC is applied to total Medicaid gross ancillary services charges to determine the cost of services provided to Medicaid patients. Row (e) In general, costs associated with Community Health Improvement Services were determined by adding indirect or overhead costs to the direct costs of the activity. Indirect costs were calculated as a percentage of direct costs. Direct costs for staff expenses were calculated using average system hourly rates, and were adjusted to account for fringe benefits, using a blended rate based on the ratio of total employee benefit expenses to total salary and wages. On March 13, 2020, the Federal Government issued an emergency declaration under Section 501(b) of the Stafford Act, Public Health Service Act and National Emergencies Act due to the Covid-19 global pandemic. At the forefront of New York State's pandemic response, Northwell Health rose to the occasion leading on the front lines and behind the scenes. Northwell transformed areas in each of its hospitals to admit and care for Covid-19 patients, reimagining ways to deliver treatment while safeguarding those who step up to care for patients. In addition, Northwell conducted research and clinical trials in search of new treatments. At New York's Covid-19 epicenter, Northwell led the response to the pandemic partnering with the Department of Health to set-up an Army field hospital in New York City and over 100 testing sites in the five boroughs of New York City, Nassau, Suffolk, and Westchester counties. Treating more coronavirus patients than any other organization, the health system gained valuable insights for the next widespread medical crisis. As a result of Northwell's extensive Covid-19 relief efforts, the health system incurred significant costs associated with infectious disease education, training, personal protective equipment, and other essential supplies which are reflected in the costs reported. Northwell continued their efforts throughout 2021 as Covid-19 cases resurged in our service area. These costs are offset by the obligated federal funding Northwell reported in their year-end December 31, 2021, audited financial statements. Row (f) The Bad Debt Expense that appears on Form 990, Part IX, Line 25 column (A), but not included for purposes of calculating the percentage in this column is equal to the amount reported on Form 990, Part X. The costs related to health professions education were determined by utilizing the step down method of cost finding. Row (h) Costs associated with research activities were determined by adding indirect, or overhead, costs to the direct costs of the activity. Indirect costs were calculated as a percentage of costs. Row (i) The cost of in-kind contributions to community groups is comprised of the direct costs of personnel whose compensated time was donated to various charities and community groups. The salaries and wages were adjusted to include benefits using a rate based on the ratio of total employee benefit expenses to total salary and wages. Indirect costs were calculated as a percentage of direct costs. Column (f) for Rows (c)-(k) The percentage of Net Community Benefit Expense divided by Total Expense for the hospital (to calculate the percent of total expense). Note: For the entire Northwell Health Inc. and affiliates, Part I, Line 7 (Row K, Column F) is approximately 17% of expenses. Part II: All community building activities improve access to health services and address federal, state, or local public health priorities, as well as leverage public health department activities, and in doing so, they provide relief of government burden. These activities broadly serve low-income, underserved patients, and include: collaboration with various community coalitions, system-wide recycling initiative, organizational response to worldly disasters, and bioterrorism efforts. Northwell has taken the lead in increasing awareness of gun violence as a public health issue. The Gun Violence Prevention Forum brought together physicians, researchers, policy experts, health care executives, NYPD counterterrorism and victims' advocates to share their thoughts on how leaders in health care can address this national public health crisis. Northwell's bioterrorism & disaster preparedness includes Center for Emergency Medical Services, has a designated Bioterrorism Resource Center, and has conducted staff training for more than 100 hospitals and area first responders and invested heavily in the infrastructure needed for large-scale emergencies. During catastrophes (both natural and terrorism), Northwell provides a safe haven for thousands of patients, outside nursing home residents, and community members seeking shelter. Northwell assists with the transport of patients and stand ready to contribute food, medicine, and blankets for both affiliated and non-affiliated hospital patients. Investment in a field hospital has furthered the public health infrastructure needed for mass casualties that could result from a terrorist attack, natural attack, or large-scale emergency. Part III, Line 2: For patients who were determined by Northwell to have the ability to pay but did not, the uncollected amounts are recorded as bad debt expense. The amount of gross charges written off is reduced by any charity care or other discounts provided to the patient, as well as any payments received. Bad debt expense reported on this line is reported net of governmental or private offsetting funds. Part III, Line 3: N/A Part III, Line 4: For patients who were determined by Northwell to have the ability to pay but did not, the uncollected amounts are recorded as bad debt expense. Part III, Line 8: Medicare costs are determined utilizing a combination of the step-down method of cost findings and a cost per unit of service. Cost per unit of service is used to calculate the routine cost of services provided to Medicare patients. The Ratio of Cost to Charges method (or RCC) is used to determine the cost of ancillary services. An RCC is developed from these costs, and that RCC is applied to total Medicare gross ancillary services charges to determine the cost of services provided to Medicare patients. Part III, Line 9b: The organization's collection policy is standard to all accounts regardless of insurance status (e.g. insured, underinsured, and uninsured). The hospital's collection policy states that they will not send patient accounts to collection if a decision on a financial assistance application is pending, or if a patient is determined to be eligible for Medicaid at the time services were rendered and for which services Medicaid payment is available. Question 2: NEEDS ASSESSMENT: The Community Health Needs Assessment (CHNA) is performed on an ongoing basis. Northwell conducts and participates in population, demographic, and health status evaluations of our respective hospitals' service areas based on county regions and the communities we serve. There is a special effort to include individuals with health disparities and organizations who serve these communities in the CHNA process. The CHNA includes the analysis of primary and secondary data. Multi-year analyses, trends and projections are developed, which identify areas of need for the continuum of health care services. Primary data is obtained through a combination of qualitative analysis of community-based organization (CBO), informant interviews and surveys, individual community member surveys, and participation in collaborative partner meetings. These meetings include representatives from the Departments of Health, CBOs, academic institutions, government agencies, and hospitals. Ongoing input c"