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Policy Effective Date (Date Posted):

Download: Policy File

Download: Application File

General Information

Hospital:

MAD RIVER COMMUNITY HOSPITAL

3800 JANES ROAD
ARCATA, CA 95521
http://www.madriverhospital.com

License:

General Acute Care Hospital
Total Beds: 78
Emergency Room: Yes
more... Link to Atlas

Contact:

Niesje Walton
(707) 825-4934

OSHPD ID:

106121002

Fair Pricing Policy Information Show FPL Chart

Policy Effective Date:

9/1/2004

Download:

Federal Poverty Level for Free Care:

100%

Discount Payment Effective Date:

9/1/2004

Discount Payments

FPL Range: 101%-350%
Payment Basis:
Other: Discount is on a sliding scale

FPL Range: 0%-0%
Payment Basis:

FPL Range: 0%-0%
Payment Basis:

Other Discount Payment Information:

Application Form Information

Application Form Eff Date:

9/1/2021

Download:

Income Type Used:

Salary Received
Pension Received
Other: Unemployment, Disability, all Social Security

Language Information

Available Languages:

English
Spanish

Additional Information

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