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Hospital Details

Policy Effective Date (Date Posted):

Download: Policy File

Download: Application File

General Information

Hospital:

JEROLD PHELPS COMMUNITY HOSPITAL

733 CEDAR STREET
GARBERVILLE, CA 95542
http://www.shchd.org

License:

General Acute Care Hospital
Total Beds: 17
Emergency Room: Yes
more... Link to Atlas

Contact:

same
(707) 923-3921

OSHPD ID:

106121031

Fair Pricing Policy Information Show FPL Chart

Policy Effective Date:

1/1/2022

Download:

Policy File

Federal Poverty Level for Free Care:

400%

Discount Payment Effective Date:

1/1/2022

Discount Payments

Discount Payment 1

FPL Range: 400%-400%
Payment Basis:
Medicare
Medi-Cal
Healthy Families
Worker's Compensation
Other Government Insurance
Other: all insured with high medical expenses

Discount Payment 2

FPL Range: 0%-0%
Payment Basis:

Discount Payment 3

FPL Range: 0%-0%
Payment Basis:

Other Discount Payment Information:

Discount of 20% for any uninsured patient if paid within 30 days

Application Form Information

Application Form Eff Date:

1/1/2022

Download:

Application File

Income Type Used:

Salary Received
Pension Received

Language Information

Available Languages:

English
Spanish

Additional Information

revision to add the debt collection procedures - attached at the end of the financial assistance policy

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