{"hospital":{"ccn":"330195","name":"LONG ISLAND JEWISH MEDICAL CENTER","city":"NEW HYDE PARK","state":"NY","zip":"11040","phone":"718-470-7000","ownership":"Voluntary non-profit - Private","website_domain":"catholichealthli.org","system":null},"version":1,"status":"published","eligibility":{"free_care_max_fpl":{"value":"300","layer":"documented","quote":"Patients qualify for 100% financial assistance if their family income is at or below 300% of the Federal Poverty Level Guidelines (FPL).","source_id":"fap-78d722f99fdbff5d","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"discount_tiers":{"value":[{"min_fpl_exclusive":"300","max_fpl_inclusive":"350","discount_percent":90},{"min_fpl_exclusive":"350","max_fpl_inclusive":"400","discount_percent":80}],"layer":"documented","quote":"Eligibility Percentage 100% 90% 80% % of Poverty Level 0% - 300% 301% - 350% 351% - 400%","source_id":"fap-7cb20089eb41b33c","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"asset_test":null,"residency":null,"insured_patients_covered":{"value":true,"layer":"documented","quote":"Financial assistance for medically necessary services is available on a sliding scale of up to 100% of charges, and up to a full waiver of co-payments and/or deductible after third-party insurance proceeds, based on financial need (i.e. uninsured and underinsured patients).","source_id":"fap-78d722f99fdbff5d","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"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","social_security_letter","tax_return","pay_stubs","bank_statements"],"layer":"documented","quote":"Acceptable forms of documentation to support family income (patient/guarantor and spouse) include the following:\n o Four (4) most recent pay stubs\n o Copy of Social Security payments that you and/or your spouse receive (benefit award letter or bank statement)\n o Copy of unemployment benefits\n o Copy of workers compensation benefits\n o Other income (e.g., alimony/maintenance, rental income, veterans’ benefits)\n o Three (3) most recent bank statements (checking and savings) (all pages)\n o Proof of student status (unofficial transcript or current class schedule)\n o Proof of support assistance from another person (letter from person supporting you if you are not paying rent)\n o Prior year tax return","source_id":"application-47f333e20efe466d","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"documents_reported":null,"submit_methods":null,"window_days_from_first_bill":null,"decision_days":{"value":30,"layer":"documented","quote":"Upon receipt of your completed application and all required documents, your application will be reviewed and our determination will be sent to you in writing within thirty (30) days.","source_id":"application-47f333e20efe466d","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"decision_days_reported":null},"collections":{"eca_wait_days":null,"collection_agencies":null},"contacts":{"phone":{"value":"631-465-6321","layer":"documented","quote":"Tel. number 631-465-6321","source_id":"fap-91887db5be47ad80","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"hours":null,"languages":{"value":["English","Spanish"],"layer":"documented","quote":"These documents are available in English and Spanish.","source_id":"fap-91887db5be47ad80","checked_on":"2026-10-13","confidence":1.0,"support_count":0}},"coverage":{"facilities":{"value":["Good Samaritan University Hospital","Mercy Hospital","St. Catherine of Siena Hospital","St. Charles Hospital","St. Francis Hospital & Heart Center","St. Joseph Hospital"],"layer":"documented","quote":"System Hospital – A hospital within the Catholic Health System that is required by New York State to be licensed or registered or similarly recognized as a hospital, including Good Samaritan University Hospital, Mercy Hospital, St.","source_id":"fap-78d722f99fdbff5d","checked_on":"2026-10-13","confidence":1.0,"support_count":0},"provider_list_url":null},"sources":[{"id":"fap-78d722f99fdbff5d","kind":"hospital_web","url":"https://www.catholichealthli.org/paying-your-care/financial-assistance/financial-assistance-policy","title":"Financial Assistance Policy | Catholic Health Long Island","fetched_on":"2026-10-13","sha256":"78d722f99fdbff5ded932353beaa9e9d99a365f3bc459fa3b0dd68655cf803e7","effective_date":null},{"id":"application-47f333e20efe466d","kind":"hospital_web","url":"https://www.catholichealthli.org/sites/default/files/CHS%20Hospital%20Financial%20Assistance%20Application%20-%20Final%20-%2020181002%20Form.pdf","title":"[PDF] Catholic Health Services of Long 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