Pressure ulcers present serious health and economic consequences for nursing home residents. The Agency for Healthcare Research & Quality, in partnership with the New York State Department of Health, implemented the pressure ulcer module of On-Time Quality Improvement for Long Term Care (On-Time), a clinical decision support intervention to reduce pressure ulcer incidence rates. The objective of the study was to evaluate the effectiveness of the On-Time program in reducing the rate of in-house–acquired pressure ulcers among nursing home residents.