| evidenceID | key | no | System generated unique identifier for the Medical Institution. There is no UI field for this attribute. | EVIDENCE_ID | | SVR_INT64 |
| caseParticipantRoleID | details | no | The Case Participant Role ID of the Household Member. | CASE_PARTICIPANT_ROLE_ID | | SVR_INT64 |
| institutionType | details | | Indicates the type of institution in which the individual resides. Examples include: Hospital, SNF/NF, Swing bed, ICF , ICF/MRDD facilities, Title XIX Institution, etc. This is populated from the 'MedicalInstitutionType' code table. The UI field name for this attribute is 'Institution Type'. | EVD_MEDICAL_INSTITUTION_TYPE | MedicalInstitutionType | SVR_STRING<10> |
| waiverType | details | | The type of waiver program on which the individual has been enrolled. Examples include: Brain Injury Waiver, Physical Disability Waiver, Elderly Waiver, etc. This is populated from the 'WaiverType' code table. The UI field name for this attribute is 'Waiver Type'. | EVD_MEDICAL_INSTITUTION_WAIVER_TYPE | WaiverType | SVR_STRING<10> |
| instCaseParticipantRoleID | details | yes | The Case Participant Role ID of the Medical Institution or service provider which is providing the services to the individual. The UI field name for this attribute is 'Medical Institution/Service Provider Participant'. | CASE_PARTICIPANT_ROLE_ID | | SVR_INT64 |
| dateEntered | details | | The date on which the individual entered the institution, or started on the waiver program. The UI field name for this attribute is 'Entered Date'. | CURAM_DATE | | SVR_DATE |
| endDate | details | | The date on which the individual left the institution, or the Waiver program ended. The UI field name for this attribute is 'End Date'. | CURAM_DATE | | SVR_DATE |
| expectedLengthOfStay | details | | The duration that the household member is expected to stay in the Medical Institution. This is populated from the 'ExpectedLengthOfStay' code table. The UI field name for this attribute is 'Expected Length of Stay'. | EVD_MEDICAL_INSTITUTION_EXPECTED_LENGTH_OF_STAY | ExpectedLengthOfStay | SVR_STRING<10> |
| undueHardshipReason | details | | The undue hardship that may exist as a result of the individual not receiving Medical Assistance Coverage. Examples include: At Risk Of Death, At Risk Of Permanent Disability. This is populated from the 'UndueHardshipReason' code table. The UI field name for this attribute is 'Undue Hardship Reason'. | EVD_MEDICAL_INSTITUTION_UNDUE_HARDSHIP_REASON | UndueHardshipReason | SVR_STRING<10> |
| undueHardshipCertifiedOn | details | | The date on which the potential Undue Hardship was certified. The UI field name for this attribute is 'Certified On'. | CURAM_DATE | | SVR_DATE |
| placedByType | details | | Classification of the individual or organization who placed the Household Member in the Medical Institution. Examples include: State, Self, Parent, Guardian, Other, etc. This is populated from the 'PlacedByType' code table. The UI field name for this attribute is 'Placed By Type'. | EVD_MEDICAL_INSTITUTION_PLACED_BY_TYPE | PlacedByType | SVR_STRING<10> |
| placedByCaseParticipantRoleID | details | yes | The Case Participant Role ID of the individual or organization who placed the individual in the Medical Institution. The UI field name for this attribute is 'Placed By Participant'. | CASE_PARTICIPANT_ROLE_ID | | SVR_INT64 |
| details | | The State of residence of the individual or organization that placed the household member in the Medical Institution, at the time of placement. This is populated from the 'AddressState' code table. The UI field name for this attribute is 'Placer's State Of Residence At Placement' | EVD_ADDRESS_STATE | AddressState | SVR_STRING<10> |
| applicationFiledByType | details | | Classification of the individual or organization who filed the application for Medical Assistance coverage for the individual in the Medical Institution. Examples include: State, Self, Parent, Guardian, Other, etc. This is populated from the 'ApplicationFiledByType' code table. The UI field name for this attribute is 'Application Filed By Type'. | EVD_MEDICAL_INSTITUTION_APPLICATION_FILED_BY_TYPE | ApplicationFiledByType | SVR_STRING<10> |
| filedByCaseParticipantRoleID | details | yes | The Case Participant Role ID of the individual or organization who filed the application for Medical Assistance coverage, for the individual in the Medical Institution. The UI field name for this attribute is 'Application Filed By Participant'. | CASE_PARTICIPANT_ROLE_ID | | SVR_INT64 |
| details | | Additional details related to the Medical Institution. The UI field name for this attribute is 'Comments'. | COMMENTS | | SVR_STRING<300> |
| appFilerRoleType | details | yes | The type of application filer. Examples include: Person, Product Provider, etc. This is populated from the 'PlacedByFiledBy' code table. The UI field name for this attribute is 'Application Filed By'. | EVD_MEDICAL_INSTITUTION_APPFILER_PLACER_TYPE | PlacedByFiledBy | SVR_STRING<10> |
| placerRoleType | details | yes | The type of individual/organization which placed the Household Member in the Medical Institution. Examples include: Employer, Person, Product Provider, Service Supplier, etc. A value would be selected here only if the placer is someone other than 'Self', and that placer exists in the system, but is not a Case Participant. This is populated from the 'PlacedByFiledBy' code table. The UI field name for this attribute is 'Placed By'. | EVD_MEDICAL_INSTITUTION_APPFILER_PLACER_TYPE | PlacedByFiledBy | SVR_STRING<10> |
