Section Mof theApplicationDES015Five Yearsor 60Months1159CLienWorksheetEquityValueDHMH257Five Yearsof TaxReturnsEmergencyServicesOnly4255Statementof IntentCost ofCare4245Physician'sReportLumpSumPaymentUnearnedIncomeAVSQuarterlyBankStatementsForm9709BuyInMandatoryClearancesLivestockCertificationPeriodEligibilityDetailsPageTerm LifeInsurancePolicyPolicyAlert08-1TardyRedetSection Mof theApplicationDES015Five Yearsor 60Months1159CLienWorksheetEquityValueDHMH257Five Yearsof TaxReturnsEmergencyServicesOnly4255Statementof IntentCost ofCare4245Physician'sReportLumpSumPaymentUnearnedIncomeAVSQuarterlyBankStatementsForm9709BuyInMandatoryClearancesLivestockCertificationPeriodEligibilityDetailsPageTerm LifeInsurancePolicyPolicyAlert08-1TardyRedet

Long Term Care Bingo! - Call List

(Print) Use this randomly generated list as your call list when playing the game. There is no need to say the BINGO column name. Place some kind of mark (like an X, a checkmark, a dot, tally mark, etc) on each cell as you announce it, to keep track. You can also cut out each item, place them in a bag and pull words from the bag.


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  1. Section M of the Application
  2. DES 015
  3. Five Years or 60 Months
  4. 1159C Lien Worksheet
  5. Equity Value
  6. DHMH 257
  7. Five Years of Tax Returns
  8. Emergency Services Only
  9. 4255 Statement of Intent
  10. Cost of Care
  11. 4245 Physician's Report
  12. Lump Sum Payment
  13. Unearned Income
  14. AVS
  15. Quarterly Bank Statements
  16. Form 9709
  17. Buy In
  18. Mandatory Clearances
  19. Livestock
  20. Certification Period
  21. Eligibility Details Page
  22. Term Life Insurance Policy
  23. Policy Alert 08-1
  24. Tardy Redet