MOUNTAINS COMMUNITY HOSPITAL
29101 HOSPITAL ROAD
LAKE ARROWHEAD, CA 92352
http://mchcares.com
Contact:
Yvonne Waggener
(909) 436-3202
License:
General Acute Care Hospital
Total Beds: 37
Emergency Room: Yes
OSHPD ID:
106361266
Fair Pricing Policy Information
Policy Effective Date:1/1/2015
Download:
Federal Poverty Level for Free Care:
200%
Discount Payment Effective Date:1/1/2015
Discount Payments:
Discount Payment 1
FPL Range: 201%-225%
Payment Basis:
Other: Patient pays 20% of Medicare interim rates
Discount Payment 2
FPL Range: 226%-250%
Payment Basis:
Other: Patient pays 40% of Medicare interim rates
Discount Payment 3
FPL Range: 251%-275%
Payment Basis:
Other: Patient pays 60% of Medicare interim rates
Other Discount Payment Information:
FPL 276%-300%. Patient pays 80% of Medicare interim rates Note – The above is the sliding scale payment schedule for uninsured patients. There is a separate table in the policy for Insured patients.
Application Form Information
Application Form Eff Date:2/17/2011
Download:
Income Type Used:Other: Patient family income
Language Information
Available Languages:
English
Spanish
Source” : https://syfphr.oshpd.ca.gov/SearchDetail.aspx?oshpdid=106361266