CHARITY CARE AND FINANCIAL ASSISTANCE SUMMARY
South Sunflower County Hospital is a community-owned hospital committed to providing financial assistance and charity care to persons who have health care needs and are uninsured, underinsured, ineligible for a government program, or otherwise unable to pay, for medically necessary care based on their individual financial situation.
Consistent with its mission to provide financially sustainable health care services for our community, by employing dedicated and compassionate staff focused on providing excellent quality patient care and superior customer service, South Sunflower County Hospital strives to ensure that the financial capacity of those who need health care services does not prevent them from receiving care. We will provide without discrimination and in full compliance with the Emergency Medical Treatment and Labor Act (EMTALA), care for emergency medical services regardless of their financial ability to pay for these services.
Financial Assistance or Charity Care is not a substitute for personal responsibility. Patients are expected to follow the procedure to obtain the charity forms and to contribute to the cost of their care based on the ability to pay.
Eligible Services include emergency medical services provided in an emergency room setting; services for a condition which, if not promptly treated, would lead to a change in the health status of the individual; non-elective inpatient and observation services; and medically necessary services, evaluated on a case-by-case basis at the hospital’s discretion.
Eligibility for charity care will be considered for those individuals who are residents of South Sunflower and Humphreys County and who are uninsured, underinsured, ineligible for any government health care benefit program, or otherwise unable to pay for their care, based on a determination of financial need in accordance with poverty income guidelines issued by the U.S. Department of Health and Human Services as outlined in the Financial Assistance Policy. The granting of charity care or financial assistance shall be based on an individualized determination of financial need, and shall not take into account age, gender, race, social or immigrant status, sexual orientation or religious affiliation.
During the application process, the patient or patient’s guarantor is required to cooperate and supply personal, financial and other information and documentation relevant to making a determination of financial need. Paper applications are available at all admission locations, emergency department and our website https://www.southsunflower.com/financial-assistance.
Please attach the following items:
A copy of your picture ID
W2 form or two of your most recent check stubs
Two household bills
The number of people living in your household.