Exhibit 5. Medicare stage III and IV hospital-acquired pressure ulcer rates per 10,000 discharges for three states, FY 2009.

State	Number of secondary diagnosis fields reported by state	Hospital-acquired pressure ulcer rate in the first eight secondary diagnosis codes only	Hospital-acquired pressure ulcer rates in all HCUP secondary diagnosis codes	Ratio of HAC rates based on the first eight secondary diagnoses to HAC rates based on all reported HCUP secondary diagnoses
California	24	2.0	2.9	0.70
Florida	30	1.3	2.8	0.47
New York	14	2.6	6.8	0.38

NOTES: Hospital acquired (HAC) pressure ulcer rates per 10,000 discharges.

SOURCE: 2009 Hospital Cost and Utilization Project state data files data for California, Florida, and New York. See tables 2.3 and 2.11 in Healy, D. A., Spain, P. C., & Cromwell, J. (2011, September). Examination of spillover effects and unintended consequences of Medicare HACPOA program (CMS Contract No. HHSM-500-2005-00029I). Prepared for Centers for Medicare & Medicaid Services.