HCAI Syfphr

Search > Results > Details

Hospital Details

Policy Effective Date (Date Posted):

Download: Policy File

Download: Application File

General Information

Hospital:

LAGUNA HONDA HOSPITAL AND REHABILITATION CENTER

375 LAGUNA HONDA BOULEVARD
SAN FRANCISCO, CA 94116
http://www.sfdph.org/dph/comupg/oservices/medSvs/LHH/

License:

General Acute Care Hospital
Total Beds: 780
Emergency Room: Yes
more... Link to Atlas

Contact:

Admissions and Eligibility Department
(415) 759-3325

OSHPD ID:

106380865

Fair Pricing Policy Information Show FPL Chart

Policy Effective Date:

1/1/2015

Download:

Policy File

Federal Poverty Level for Free Care:

133%

Discount Payment Effective Date:

4/1/2014

Discount Payments

Discount Payment 1

FPL Range: 133%-200%
Payment Basis:
Other: 60% of DRG

Discount Payment 2

FPL Range: 201%-350%
Payment Basis:
Other: 80% of DRG

Discount Payment 3

FPL Range: 0%-0%
Payment Basis:

Other Discount Payment Information:

Application Form Information

Application Form Eff Date:

4/1/2014

Download:

Application File

Income Type Used:

Salary Received
Interest Received
Pension Received

Language Information

Available Languages:

English

Additional Information

Patient Liab. is based on FPL level and Service Type: Out Patient 0-133% FPL = 0 Pt. Liab. LTC 0%-100% FPL = Zero Pt. Liab for first 15 days of LTC., and thirty five dollars per day after the first 15 days of LTC. Inpatients who have FPL levels of 101%-350% FPL are charges a Pt. Liab. based on FPL level and description of Service

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