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Hospital Details
Policy Effective Date (Date Posted):
2022-2023 (Most Recent)
2022-2023 (6/24/2022)
2020-2021 (1/31/2020)
2018-2019 (10/22/2019)
2018-2019 (10/22/2019)
2018-2019 (2/2/2018)
2016-2017 (1/6/2017)
2014-2015 (6/18/2015)
2014-2015 (5/7/2015)
2014-2015 (2/18/2015)
2014-2015 (2/13/2015)
2014-2015 (2/13/2015)
2014-2015 (12/30/2014)
2014-2015 (12/29/2014)
2014-2015 (12/29/2014)
2014-2015 (6/4/2014)
2012-2013 (2/6/2012)
2010-2011 (2/10/2010)
2008-2009 (3/5/2009)
2008-2009 (1/21/2009)
2008-2009 (1/19/2009)
2008-2009 (1/19/2009)
2008-2009 (1/13/2009)
Go
Download:
Policy File
Download:
Application File
General Information
Hospital:
THOUSAND OAKS SURGICAL HOSPITAL, A CAMPUS OF LOS ROBLES HOSP & MED CTR
401 ROLLING OAKS DRIVE
THOUSAND OAKS, CA 91361
http://www.losrobleshospital.com
License:
General Acute Care Hospital
Total Beds:
21
Emergency Room:
Yes
more...
Contact:
Taylor Randalls
(615) 234-6150
OSHPD ID:
106564121
Fair Pricing Policy Information
Show FPL Chart
Policy Effective Date:
7/1/2020
Download:
Policy File
Federal Poverty Level for Free Care:
400%
Discount Payment Effective Date:
7/7/2020
Discount Payments
Discount Payment
1
FPL Range:
401
%-
600
%
Payment Basis:
Other: Balance capped at 10% of annual income.
Discount Payment
2
FPL Range:
601
%-
800
%
Payment Basis:
Other: Balance capped at 12% of annual income.
Discount Payment
3
FPL Range:
801
%-
999
%
Payment Basis:
Other: Balance capped at 15% of annual income.No FPL max
Other Discount Payment Information:
Application Form Information
Application Form Eff Date:
6/10/2022
Download:
Application File
Income Type Used:
Salary Received
Interest Received
Pension Received
Language Information
Available Languages:
English
Spanish
Additional Information
Family
Size
100%
150%
200%
250%
300%
350%
400%
