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Policy Effective Date (Date Posted):

Download: Policy File

Download: Application File

General Information

Hospital:

SAN GORGONIO MEMORIAL HOSPITAL

600 N. HIGHLAND SPRINGS AVENUE
BANNING, CA 92220
http://www.sgmh.org/

License:

General Acute Care Hospital
Total Beds: 79
Emergency Room: Yes
more... Link to Atlas

Contact:

Lynn Gomez
(951) 769-2169

OSHPD ID:

106331326

Fair Pricing Policy Information Show FPL Chart

Policy Effective Date:

12/30/1999

Download:

Federal Poverty Level for Free Care:

210%

Discount Payment Effective Date:

12/30/1999

Discount Payments

FPL Range: 211%-249%
Payment Basis:
Other: Sliding scale discount

FPL Range: 250%-350%
Payment Basis:
Medicare

FPL Range: 0%-0%
Payment Basis:

Other Discount Payment Information:

Application Form Information

Application Form Eff Date:

1/30/2008

Download:

Income Type Used:

Salary Received
Interest Received
Pension Received

Language Information

Available Languages:

English
Other: Spanish Translator Available

Additional Information

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