If you have had a previous PUF file for the same site as your new file, you may note that the number of cases in the new file has decreased, especially for older diagnoses. The data you received this year are limited to cases reported by currently-accredited CoC hospitals. Cases reported by hospitals that are no longer accredited are excluded. Case reports for hospitals that are not currently accredited are not updated in the NCDB data, and their quality cannot be assured. The principal effect will be on cases more than 5-10 years old.