Payment Arrangements


Horn Memorial Hospital offers financial assistance and charity care for qualified patients. Below is our policy and application forms.

Payment requirements as of 01/01/2016 will be:

Balance Owed
$1.00 - $49.99
$50.00 - $100.00
$100.01 - $250.00
$250.01 - $750.00
$750.01 - $1200.00
$1200.01 - $2000.00
$2000.01 or greater
Minimum REGULAR Monthly Payment Required
Payment in full (100%)
33% of the monthly balance
25% of the monthly balance
10% of the monthly balance
8% of the monthly balance
7.5% of the month balance
5.5% of the monthly balance, to be paid in full within 18 months

Payments received that are below the minimum payment amount noted above will be returned to the patient with a letter of explanation.

Financial Assistance Policy


Financial Assistance Plain Language Summary


Sliding Fee Scale


Sliding Fee Scale for HPC


Financial Assistance Application


Authorization to Release Information


Please ensure you have the following compiled and completed:

SIGNED and completed application
Copy of current Federal Tax Return
Copies of last 3 pay/social security stubs
Copies of last 3 bank statements

If you have questions regarding financial assistance please contact the HMH Business Office at 712.364.3311.

01-01-2019 Charge Rates

  • Admitting Clerk - 10/14/2015

    Duties include admitting patients for hospital services and answering the main hospital ph… View job
  • Courier - 10/23/2018

    Transports laboratory specimens to Mapleton and Odebolt Horn Physicians Clinics following … View job
  • Full Time Registered Nurse - 12/7/2012

    Full time RN to work overnights 8 and 12 hour shifts on the Med-Surg-Peds floor along with… View job
  • General Application - 11/30/1999

    Horn Memorial Hospital is currently looking for professional healthcare employees. If you … View job

1. Mapleton

412 Main Street
Mapleton, IA 51034
712-364-3311

2. Ida Grove

701 East Second Street
Ida Grove, IA 51445
712-364-3311

3. Odebolt

300 South Maple
Odebolt, IA 51458
712-364-3311