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Hospital Details

Policy Effective Date (Date Posted):

Download: Policy File

Download: Application File

General Information

Hospital:

FAIRMONT HOSPITAL

15400 FOOTHILL BOULEVARD
SAN LEANDRO, CA 94578
http://www.acmedctr.org

License:

General Acute Care Hospital
Total Beds: 159
Emergency Room: Yes
more... Link to Atlas

Contact:

Paula Connors
(510) 437-4721

OSHPD ID:

106010811

Fair Pricing Policy Information Show FPL Chart

Policy Effective Date:

3/1/2004

Download:

Policy File

Federal Poverty Level for Free Care:

200%

Discount Payment Effective Date:

3/1/2004

Discount Payments

Discount Payment 1

FPL Range: 201%-350%
Payment Basis:
Other: 50% discount on billed charges

Discount Payment 2

FPL Range: 0%-0%
Payment Basis:

Discount Payment 3

FPL Range: 0%-0%
Payment Basis:

Other Discount Payment Information:

Application Form Information

Application Form Eff Date:

3/1/2008

Download:

Application File

Income Type Used:

Salary Received
Interest Received
Pension Received
Other: State Disability, UIB

Language Information

Available Languages:

English
Spanish
Vietnamese
Chinese

Additional Information

The enrollment forms are available in English, Spanish and Chinese. Alameda County Medical Center has had both a Charity and Discount Policy for years. The Charity Policy was put into effect 12/1/2000 but I am not sure of the date the Discount Policy was put in effect, but I know it has been at least five years. The attached policy covers both the Charity and Discount policies.

Family Size	100%	150%	200%	250%	300%	350%	400%