hospital that competes with Middlefield has opened a wellness center that offers a comprehensive array of preventative and wellness services to the community . This facility is attracting young families to seek services at this location . Most of Middlefield ' s managed care contracts are more than 2 years old . There are little reliable utilization and reimbursement data available . No one at Middlefield Hospital is assigned to manage these contracts or maintain ongoing relationships with managed care companies . The Joint Commission survey is scheduled for next year , and there are significant problems with the hospital ' s quality improvement program . The health plan offered to employees is getting more expensive each year . In fact , the costs are increasing at a rate of 20 % each year . This is adding significantly to the hospital ' s operational costs . The inpatient mental health services and neo-natal intensive care unit continue to lose money for the hospital .