The patient, an elderly woman with type 1 diabetes mellitus, developed hypoglycemia at the nursing home and was unresponsive. In the emergency department, her decreased blood sugar was treated with intravenous D5W. A urinary tract infection was also present and was treated with antibiotics. The urine culture grew Pseudomonas, sensitive to Cipro. After admission, her chronic systolic congestive heart failure exacerbated to an acute stage, probably secondary to the hypoglycemic reaction, which responded to oxygen, diuretics and rest. Her insulin was restarted at a lower dosage. Discharge diagnoses: (1) Acute on chronic systolic congestive heart failure secondary to hypoglycemia, (2) type 1 diabetes mellitus with coma, (3) urinary tract infection due to Pseudomonas. 1 Principal Diagnosis 3 Secondary Diagnoses What is the POA indicator for the acute systolic heart failure?