1. Definitions of State living arrangement variations for Pennsylvania

Code Definition C Living with an essential person (EP) Apply OS code “C” to recipients who are not living in the household of another or in a foster care home for adults and who have one or more EP’s as defined under the Federal rules. D Living in the household of another with an EP Apply OS code “D” to recipients who live in the household of another and have one or more EP’s as defined under the Federal rules. G Living in a domiciliary care facility Apply OS code “G” to adult persons (age 18 and over) certified by the State to reside in non-medical residential care facilities. H Living in a personal care boarding home (PCBH) Apply OS code “H” to adult persons (age 18 and over) certified by the State to reside in non-medical residential care facilities. Y Optional supplementation waived Use code “Y” to indicate that a recipient is eligible for an optional supplement, but waived their right to receive supplementation. Z No supplement cases OS code “Z” includes all recipients who are residing in a medical facility that Title XIX pays more than 50 percent of the cost of care and recipients in FLA “A” or FLA “B” who receive a State-administered supplement.