You have been the CEO of Middlefield Hospital for 2 1/2 years and finally resolved the workforce challenges that plagued the hospital when you first arrived. In a recent meeting, the chief financial officer (CFO) indicated that the financial performance of the hospital has been deteriorating over the last 6 months. The hospital is not meeting its budget and he is concerned about the future. The new facility across town has continued to cut into Middlefield's market share by admitting more patients. The number of admissions to Middlefield Hospital is declining each month, and more uninsured patients are seeking services at your facility.