{"hospital":{"ccn":"141330","name":"HOPEDALE HOSPITAL","city":"HOPEDALE","state":"IL","zip":"61747","phone":"309-449-3321","ownership":"Voluntary non-profit - Private","website_domain":"hopedalemc.com","system":null},"version":1,"status":"published","eligibility":{"free_care_max_fpl":{"value":"200","layer":"documented","quote":"Patients whose family income is at or below 200% of the FPL are eligible to receive free care.","source_id":"summary-a68a9eea86f34bd9","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":{"value":["Homeless or received care from a homeless clinic","Mental incapacitation with no one to act on patient’s behalf","Recent personal bankruptcy","Incarceration in penal institution","Affiliation with a religious order or vow of poverty","Patients who receive grant assistance for medical services","Participation in Women, Infants and Children programs (WIC)","Supplemental Nutrition Assistance Program (SNAP)","IL Free Lunch and Breakfast Program","IHDA’s Rental Housing Support Program","Low income Home Energy Assistance Program (LIHEAP)","Temporary Assistance for Needy Families (TANF)"],"layer":"documented","quote":"Presumptive eligibility may be determined on the basis of individual life circumstances that may include one or more of the following: 1. Homeless or received care from a homeless clinic); 2. Patient is deceased with no known estate 3. Mental incapacitation with no one to act on patient’s behalf 4. Medicaid Eligibility, but not on date of service or for non-covered or unfunded services (e.g. Medicaid spend-down); 5. Recent personal bankruptcy 6. Incarceration in penal institution 7. Affiliation with a religious order or vow of poverty 8. Patients who receive grant assistance for medical services 9. Participation in Women, Infants and Children programs (WIC); 10. Supplemental Nutrition Assistance Program (SNAP); 11. IL Free Lunch and Breakfast Program; 12. IHDA’s Rental Housing Support Program; 13. Low income Home Energy Assistance Program (LIHEAP) 14. Temporary Assistance for Needy Families (TANF) 15. Enrollment in an organized community based program providing access to medical care that accesses and documents limited low-income financial status as criterion for membership. 16. Loss of breadwinner in household or recent unemployment of said person.","source_id":"fap-810cf23a65c25ecb","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"state_programs":null},"apply":{"form_url":null,"form_version":null,"documents_required":{"value":["proof_of_income","social_security_letter","pay_stubs"],"layer":"documented","quote":"state unemployment claim AND final pay stub from last job oMonthly Pension amount letter oDisability income amount letter oSocial security income amount letter oProof of income from rental properties oProof of income from child support oProof of income from alimony oIf you have NO income, written statement from the person who supports you on how this support is paid for and how much they spend per month.","source_id":"application-8e9294e26df7048c","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"documents_reported":null,"submit_methods":{"value":[{"kind":"mail","detail":"Hopedale Medical Complex\nPatient Accounts Office\nPO Box 267, Hopedale, IL 61747"}],"layer":"documented","quote":"Return the application with the requested documentation/income verification to:","source_id":"summary-a68a9eea86f34bd9","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"window_days_from_first_bill":null,"decision_days":{"value":45,"layer":"documented","quote":"Requests for charity shall be processed promptly and HMC shall notify the patient or applicant in writing within 45 days of receipt of a completed application.","source_id":"fap-810cf23a65c25ecb","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"decision_days_reported":null},"collections":{"eca_wait_days":{"value":120,"layer":"documented","quote":"No extraordinary collections actions will begin prior to 120 days from the date of the first post discharge billing statement.","source_id":"fap-810cf23a65c25ecb","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"collection_agencies":null},"contacts":{"phone":{"value":"309-449-3321","layer":"documented","quote":"[309-449-3321](tel:1-309-449-3321)","source_id":"fap-d5eabeb18cbe9468","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"hours":null,"languages":null},"coverage":{"facilities":{"value":["Hopedale Medical Complex","Patient Accounts Office"],"layer":"documented","quote":"Hopedale Medical Complex\nPatient Accounts Office\nPO Box 267, Hopedale, IL 61747\n309-449-4377","source_id":"fap-d5eabeb18cbe9468","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"provider_list_url":null},"sources":[{"id":"fap-d5eabeb18cbe9468","kind":"hospital_web","url":"http://hopedalemc.com/patients-visitors/current-patients/financial-assistance-program","title":"Financial Assistance Program - Hopedale Medical Complex","fetched_on":"2026-10-13","sha256":"d5eabeb18cbe9468c6d62b27e65626c5c0c28b2a6b8575138349032bc63f1210","effective_date":null},{"id":"summary-a68a9eea86f34bd9","kind":"hospital_web","url":"https://hopedalemc.com/media-library/documents/Financial-Assistance-Summary.pdf","title":"Financial-Assistance-Summary.pdf","fetched_on":"2026-10-13","sha256":"a68a9eea86f34bd9dace379e1584e4bef01add1c98b0006d147f4d9b9c0716b4","effective_date":null},{"id":"billing-90c68616c3417382","kind":"hospital_web","url":"https://www.hopedalemc.com/patients/billing-and-insurance","title":"HMC Billing & Insurance | Hopedale Medical Complex","fetched_on":"2026-10-13","sha256":"90c68616c3417382d753a215d2545b7023cc2191ef091337587997131e87ce03","effective_date":null},{"id":"fap-09747cc0cb39128f","kind":"hospital_web","url":"https://hopedalemc.com/patients-visitors/current-patients/financial-assistance-program","title":"Financial Assistance Program - Hopedale Medical Complex","fetched_on":"2026-10-13","sha256":"09747cc0cb39128fa6ddfcb04fffcd9f749fa34e3d262ea3d3b48acb02cac9f3","effective_date":null},{"id":"fap-810cf23a65c25ecb","kind":"hospital_web","url":"https://hopedalemc.com/media-library/documents/Financial-Assistance-Policy-July-2016_GoverningBoardFinal.pdf","title":"Financial Assistance Policy","fetched_on":"2026-10-13","sha256":"810cf23a65c25ecb8411a52a31b6b1fc799fdc4c9e3423b31eb33b1164c72338","effective_date":null},{"id":"fap-2742b38d29699ceb","kind":"hospital_web","url":"http://hopedalemc.com/media-library/documents/Financial-Assistance-Policy-July-2016_GoverningBoardFinal.pdf","title":"Financial Assistance Policy","fetched_on":"2026-10-13","sha256":"2742b38d29699ceb7af4dcb47556f8a274dd61d98b606a107b3b7ff2a4e0e59e","effective_date":null},{"id":"application-8e9294e26df7048c","kind":"hospital_web","url":"https://hopedalemc.com/media-library/documents/Financial-Assistance-Program-2019.pdf","title":"Download Application","fetched_on":"2026-10-13","sha256":"8e9294e26df7048cba67807b616e306c03e121c04b1a2c2f71a3f4604324600f","effective_date":null}],"accuracy":null}