This government document is issued by Department of Aging for use in Pennsylvania
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https://www.google.com/url?client=internal-element-cse&cx=007572080359491747877:p5rt2izphxk&q=https://www.aging.pa.gov/publications/policy-procedure-manual/Documents/Chapter%2520V_Care%2520Management/Chapter%2520V%2520-%2520Care%2520Management%25207.27.2022.pdf&sa=U&ved=2ahUKEwj8u5HK8q_8AhX-aqQEHczRCSE4UBAWegQIAxAC&usg=AOvVaw0y9gYdQvlGUAAxOs2PKwfQ