Nursing home care in a Medicaid-certified long-term care facility is available to clients for whom nursing home care is a medical necessity. Inability to live alone or prepare meals, to handle financial affairs etc., does not constitute medical necessity. Personal care may be more appropriate for individuals with physical dependencies. Individuals needing room and board and supervision of, or assistance with, activities of daily living may be more appropriately placed in a residential care setting. A physician must recommend all applicants for Medicaid long-term-care facility placement. The physician must certify the client's need for nursing home care. Clients with diagnoses of mental retardation or mental illness undergo a separate evaluation process, the results of which the physician must also certify. Applicants diagnosed with dementia in accordance with the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th Ed. (DSM-IV) may yet be eligible within the medical criteria for nursing home care unless they are violent or otherwise a danger to themselves or others.