Facility and Community Component cover memo

Community Component
(Baseline)
Introduction IN
Enumeration EN
Health Insurance HI
Discount Membership DM
Access to Care AC
Satisfaction with Care SC
Usual Source of Care US
Health Status and Functioning HF
Demographic-Income DI
Closing Materials CL
Interviewer Remarks IR
Interrupt CT
Restart CE
Housing Characteristics HA
Contact Information for HA AH
(Supplements)
Knowledge and Needs KN
Income and Assets IA
Patient Activation PA
Prescription Drug PD

(Core)
Name-Address Update UPD
Introduction IN
Enumeration Summary ENS
Enumeration EN
Health Insurance HI
Discount Membership DM
Utilization Summary UTS
Dental Utilization-Events DU
Emergency Room Utilization Events ER
Inpatient Utilization-Events IP
Outpatient Hospital Utilization-Event OP
Institutional Utilization IU
Home Health Utilization Summary HHS
Home Health Utilization-Events HH
Medical Provider Utilization-Events MP
Other Medical Expenses Utilization OM
Prescribed Medicine Summary PMS
Prescribed Medicine Utilization PM
Charge Question-Statement ST
Charge-Post Statement PS
Charge Question-No Statement NS
Charge-Payment Summary CPS
Closing Materials CL
Interviewer Remarks IR
Interrupt CT
Restart CE

Facility Component
(Facility Eligibility Screener)
Facility Questionnaire FQ
(Baseline)
Residence History RH
Background BQ
Health Insurance IN
Health Status HS

(Core)
Residence History RH
Use of Health Care Services US
Prescribed Medicines PM
Expenditures EX

Note: This hardcopy representation includes original sections in sequence. Therefore, if
a section is presented in the Baseline it was not duplicated in the Core.