{"hospital":{"ccn":"140239","name":"JAVON BEA HOSPITAL","city":"ROCKFORD","state":"IL","zip":"61103","phone":"815-968-6861","ownership":"Voluntary non-profit - Private","website_domain":"mercyhealthsystem.org","system":null},"version":1,"status":"published","eligibility":{"free_care_max_fpl":{"value":"250","layer":"documented","quote":"For patients who are otherwise qualified and have a gross family household income equal to or less than 250% of the federal poverty guidelines, patient liability will be reduced by 100%.","source_id":"fap-e886db165a53f480","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"discount_tiers":null,"asset_test":null,"residency":null,"insured_patients_covered":null,"min_balance":null,"services_excluded":null},"programs":{"presumptive":null,"state_programs":null},"apply":{"form_url":null,"form_version":null,"documents_required":{"value":["proof_of_income","bank_statements","proof_of_residency"],"layer":"documented","quote":"□ Most recent statement for all checking, savings, and/or credit union accounts □ Information regarding value of, and income received from, owned properties (buildings/land) other than primary residence □ Other investment information (bonds, stocks, etc.,) other than the amounts held in, but not distributed from, IRA/401k retirement and 529 college savings accounts","source_id":"application-73ff4d07a6f43b12","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"documents_reported":null,"submit_methods":{"value":[{"kind":"portal","detail":"Mercyhealth MyChart App"}],"layer":"documented","quote":"We will accept your application for up to two hundred forty (240) days following the first billing statement for your care. You may also apply for this assistance through your Mercyhealth MyChart App.","source_id":"application-73ff4d07a6f43b12","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"window_days_from_first_bill":{"value":240,"layer":"documented","quote":"We will accept your application for up to two hundred forty (240) days following the first billing statement for your care.","source_id":"application-73ff4d07a6f43b12","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"decision_days":null,"decision_days_reported":null},"collections":{"eca_wait_days":null,"collection_agencies":null},"contacts":{"phone":null,"hours":null,"languages":null},"coverage":{"facilities":null,"provider_list_url":null},"sources":[{"id":"fap-6519dbe9757947be","kind":"hospital_web","url":"https://www.mercyhealthsystem.org/media/4a489025521d40ccb5e94f872b0b03f9/financial-assistance-policy-supporting-information.pdf","title":"[PDF] 2026 Federal Poverty Guidelines and Patient Responsible ...","fetched_on":"2026-10-13","sha256":"6519dbe9757947be64b60a61d2ae29d9966e4220e1adc060d6818bcc04443c68","effective_date":null},{"id":"application-73ff4d07a6f43b12","kind":"hospital_web","url":"https://forms.mercyhealthsystem.org/machform/view.php?id=283544","title":"Financial Assistance Application - Page 1 of 9","fetched_on":"2026-10-13","sha256":"73ff4d07a6f43b124834e94051f8a757a7e0b4d21fefc5cab9dabe134ade84a3","effective_date":null},{"id":"billing-ed86ba7f4e19ed35","kind":"hospital_web","url":"https://www.mercyhealthsystem.org/patientsvisitors/billing-information/financial-assistance","title":"Financial assistance l Mercyhealth","fetched_on":"2026-10-13","sha256":"ed86ba7f4e19ed35b26ebbac38dfdb378f1879e8c4bf267ab230295e91ef3ad7","effective_date":null},{"id":"fap-e886db165a53f480","kind":"hospital_web","url":"https://www.mercyhealthsystem.org/media/bd5f019a1dc14a9e8b06989107db282f/mercy-health-financial-assistance-policy-12-21-2021.pdf","title":"Mercyhealth Financial Assistance Policy in English","fetched_on":"2026-10-13","sha256":"e886db165a53f4805ee19a51570fc56f761813fc3f47e47d2f9a240a2daf339e","effective_date":null},{"id":"fap-2d6061dcb82c73db","kind":"hospital_web","url":"https://www.mercyhealthsystem.org/media/f983879a72f64d5b91d0bb6efa59b2b5/mercy-health-financial-assistance-policy-10-12-2021-002-spanish.pdf","title":"Mercyhealth Financial Assistance Policy in Spanish","fetched_on":"2026-10-13","sha256":"2d6061dcb82c73db9d4d0d6bca8f6b209677764457385e16edf90c386a8491f7","effective_date":null},{"id":"fap-3592ee39a7f404fd","kind":"hospital_web","url":"https://www.mercyhealthsystem.org/media/2fc339d81721418d8480d33b6711397a/financial-assistance-policy-supporting-information.pdf","title":"Supporting information","fetched_on":"2026-10-13","sha256":"3592ee39a7f404fd26b5fb78ac91476e18f1150f8a5eb908219994d4391068ce","effective_date":null},{"id":"application-e5a8f5d341d73c95","kind":"hospital_web","url":"https://www.mercyhealthsystem.org/media/3c828825613a4cf7a4af2feeb1d25a08/english-financial-assistance-application.pdf","title":"English application","fetched_on":"2026-10-13","sha256":"e5a8f5d341d73c9516af8ac9e84969928a3200b013ae1ca1df377f50ddd6c730","effective_date":null}],"accuracy":null}