T A B L E   8 C .  S T A T E W I D E   A V E R A G E   T O T A L   C O S T - T O - C H A R G E   R A T I O S   ( C C R s )   F O R   L T C H s  D E C E M B E R   2 0 0 9 	 	 
 
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 
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 
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 
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 
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 
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 
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 
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 	 	 
 
 " * A l l   c o u n t i e s   i n   t h e   S t a t e   o r   T e r r i t o r y   a r e   c l a s s i f i e d   a s   u r b a n ,   w i t h   t h e   e x c e p t i o n   o f   M a s s a c h u s e t t s ,   w h i c h   " 	 	 
 
 " h a s   a r e a s   d e s i g n a t e d   a s   r u r a l .     H o w e v e r ,   n o   s h o r t - t e r m   a c u t e   c a r e   I P P S   h o s p i t a l s   o r   L T C H s   a r e   l o c a t e d   i n   t h o s e   a r e a s   a s   o f   D e c e m b e r   2 0 0 9 . " 	 	 
 
 " * * N a t i o n a l   a v e r a g e   I P P S   t o t a l   C C R s ,   a s   d i s c u s s e d   i n   s e c t i o n   V . C . 2 .   o f   t h i s   A d d e n d u m . " 	 	 
 
 