SANTA ROSA MEMORIAL HOSPITAL-MONTGOMERY

SANTA ROSA MEMORIAL HOSPITAL-MONTGOMERY
1165 MONTGOMERY DRIVE
SANTA ROSA, CA  95405
http://stjosephhealth.com

Contact:

Melinda Medeiros
(707) 525-5300 Ext. 3410

License:

General Acute Care Hospital
Total Beds:  283
Emergency Room:  Yes

OSHPD ID:

106491064

Fair Pricing Policy Information  

Policy Effective Date:3/1/2020

Download:

Policy File

PDF Document Icon

Federal Poverty Level for Free Care:

200%

Discount Payment Effective Date:1/1/2015

Discount Payments:

Discount Payment 1

FPL Range: 201%-350%
Payment Basis:
Medicare
Other: Sliding scale Medicare discount

Discount Payment 2

FPL Range: 351%-500%
Payment Basis:
Other: Average PPO/HMO Rates

Discount Payment 3

FPL Range: 0%-0%
Payment Basis:

Other Discount Payment Information:

Application Form Information

Application Form Eff Date:5/1/2019

Download:

Application File

PDF Document Icon

Income Type Used:

Salary Received
Interest Received
Pension Received
Other: See application for details

Language Information

Available Languages:

English
Spanish

Source” : https://syfphr.oshpd.ca.gov/SearchDetail.aspx?oshpdid=106491064

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