Dynamic List Information
Dynamic List Data
Decision Number
PRRB Dec. No. 2010-D35
Case Name
Toyon 85-98 112% Hospital-Based Peer Group Mean; Catholic Healthcare West 96-98 112% Hospital-Based Peer Group Mean; Sutter Health 91-99 112% Hospital-Based Peer Group Mean; St. Joseph Health System 92-98 112% Hospital-Based Peer Group Mean; Toyon 1999 112% Hospital-Based Peer Group Mean; Toyon 2000 112% Hospital-Based Peer Group Mean; and Toyon 2001 112% Hospital-Based Peer Group Mean vs. BlueCross BlueShield Association/First Coast Service Options, Inc.
Issue
Whether CMS' methodology for determining the Provider's exception to the hospital-based skilled nursing facility (SNF) cost limits was proper.