| A | B |
|---|
| Dispalys institutional status | AEIDC |
| Indicates if institution is Medicaid certified | AEIII |
| Institution for developmentally disabled | CRF/DD |
| Determines if placement is appropriate. | PAS |
| Intent to remain in Indiana | Residency |
| Under 21 or over 65 may be eligible while residing here | Psychiatric facility |
| Must be broad enough to encompass applying for assistance | POA |
| Medicaid will not pay this if A/R refuses pre-screening | Per diem |
