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Westfields Hospital Rate Increase

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New Richmond, 54017

New Richmond Wisconsin 127 South Knowles Avenue 54017

NOTICE OF HOSPITAL RATE INCREASE

FOR westfields HOSPITAL, INC.

535 Hospital Road

New Richmond, WI 54017

Fiscal Year 01/01/2009 to 12/31/2009

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Revenue Previous New Dollar Percent

code charge element Rate Rate Increase Increase

111 Room & Board - Medical/Surgical $950.00 $1,020.00 $70.00 7.4%

112 Room & Board - Obstetrics 950.00 1,020.00 70.00 7.4%

113 Room & Board - Pediatrics 950.00 1,020.00 70.00 7.4%

170 Room & Board - Nursery 389.00 417.00 28.00 7.2%

206 Room & Board - Special Care 990.00 1,060.00 70.00 7.0%

214 Room & Board - Coronary Care 990.00 1,060.00 70.00 7.0%

401 Mammography - Diagnostic 170.00 182.00 12.00 7.0%

401 Mammography - Screening 146.00 156.00 10.00 6.8%

450 Emergency Room Visit 250.00 265.00 15.00 6.0%

722 Delivery 280.00 300.00 20.00 7.1%

723 Circumcision 440.00 471.00 31.00 7.0%

Westfields Hospital finds it necessary to increase prices in order to continue to provide the community with a modern facility and to keep pace with the increasing costs of providing care.

Annual percentage increase in total patient revenue: 7.0%

Effective date of increase: January 1, 2009.

Amount of last increase in total patient revenue as of January 1, 2008 of 9.9%

19L

WNAXLP

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