HCAI Syfphr

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Policy Effective Date (Date Posted):

Download: Policy File

Download: Application File

General Information

Hospital:

SURPRISE VALLEY COMMUNITY HOSPITAL

741 N. MAIN STREET
CEDARVILLE, CA 96104
https://sites.google.com/view/svhealthcaredistrict

License:

General Acute Care Hospital
Total Beds: 26
Emergency Room: Yes
more... Link to Atlas

Contact:

Chanda Pedotti
(530) 279-6111

OSHPD ID:

106250955

Fair Pricing Policy Information Show FPL Chart

Policy Effective Date:

8/19/2022

Download:

Federal Poverty Level for Free Care:

400%

Discount Payment Effective Date:

8/19/2022

Discount Payments

FPL Range: 400%-400%
Payment Basis:
Other: Entire Bill

FPL Range: 0%-0%
Payment Basis:

FPL Range: 0%-0%
Payment Basis:

Other Discount Payment Information:

Patients that are homeless will be granted 100% financial assistance.

Application Form Information

Application Form Eff Date:

8/19/2022

Download:

Income Type Used:

Salary Received
Interest Received
Pension Received
Other: Assets

Language Information

Available Languages:

English

Additional Information

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