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Therapy-induced nuclear factor kappa B (NF-B) activation upregulates APOBEC, which promotes genomic instability by catalyzing the deamination of cytidine to uracil in single-stranded DNA [105]

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(Other sources of data that the MAC may consider in determining an LTCH's CCR include data from a different cost reporting period for the LTCH, data from the cost reporting period preceding the period in which the hospital began to be paid as an LTCH (that is, the period of at least 6 months that it was paid as a short-term, acute care hospital), or data from other comparable LTCHs, such as LTCHs in the same chain or in the same region.) Consistent with our historical practice of using the best available data, in this proposed rule, we are proposing to use our established methodology for determining the LTCH statewide average CCRs, based on the most recent complete IPPS total CCR data from the December 2022 update of the PSF