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Hospital Details
Policy Effective Date (Date Posted):
2022-2023 (Most Recent)
2014-2015 (3/20/2014)
2012-2013 (4/18/2012)
2010-2011 (1/21/2010)
2008-2009 (6/12/2008)
2008-2009 (6/12/2008)
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Download:
Policy File
Download:
Application File
General Information
Hospital:
EMANATE HEALTH INTER-COMMUNITY HOSPITAL
210 W. SAN BERNARDINO ROAD
COVINA, CA 91723
http://emanatehealth.org
License:
General Acute Care Hospital
Total Beds:
191
Emergency Room:
Yes
more...
Contact:
Sally De La O
(626) 732-3105
OSHPD ID:
106190413
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:
401
%-
450
%
Payment Basis:
Other: Patient responsible for 25% of total bill.
Discount Payment
2
FPL Range:
451
%-
500
%
Payment Basis:
Other: Patient responsible for 50% of total bill.
Discount Payment
3
FPL Range:
501
%-
550
%
Payment Basis:
Other: Patient responsible for 75% of total bill
Other Discount Payment Information:
Application Form Information
Application Form Eff Date:
12/27/2007
Download:
Application File
Income Type Used:
Salary Received
Language Information
Available Languages:
English
Spanish
Other: Mandarin
Additional Information
Family
Size
100%
150%
200%
250%
300%
350%
400%
