Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)

Medicare Current Beneficiary Survey (MCBS)

Attachment 4 Questionnaire Comprehensive Format Section by Section HA_05.01.0003

Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)

OMB: 0938-0568

Document [pdf]
Download: pdf | pdf
BOX HA1

BOX HA1

10:35:36 PM Thursday, June 25, 2009

Page Order # :

10


Page 1 of 75


BOX HA1
BOX INSTRUCTIONS
( HAQ1010 )	

IF (SP IS IN THE SUPPLEMENTAL SAMPLE) OR (SP DID NOT
RECEIVE THE HA SECTION IN THE PREVIOUS YEAR) OR (SP
MOVED IN THE PREVIOUS YEAR) OR (THE TYPE OF DWELLING
REPORTED IN THE PREVIOUS YEAR WAS UNKNOWN), GO TO
HAINTRO - HAINT ( HAQ1020 ).
ELSE IF (SP DID NOT PREVIOUSLY REPORT THAT THIS RESIDENCE
HAD RAMPS AT ENTRANCES) OR (SP DID NOT PREVIOUSLY REPORT
THAT THIS RESIDENCE HAD MODIFICATIONS TO ANY BATHROOM) OR
(SP DID NOT PREVIOUSLY REPORT THAT THIS RESIDENCE HAS
SPECIAL RAILINGS), GO TO HAINTRO2A - HAINT2 ( HAQ1110 ).
ELSE GO TO BOX HA1B - (HAQ1150 ).

ASSIGNMENTS

TECHNICAL NOTES
9

SuppORD

SP is in the Supplemental Sample =
MRES.INTTYPE=3/NewFromSupplement on MRES
where MRES.MRESRND = current round.

219

NoHA

SP did not receive the HA section in the previous year =
There is no HOUS where HOUS.HOUSRND = (current
round – 3).

220

DKDwelling

The Type of Dwelling reported in the previous year was

unknown =

(HOUS.DWELLING = DK or RF) on HOUS where

HOUS.HOUSRND = (current round - 3).


221

MovePrevYR

SP moved in the previous year =

(HRND.SPMOVED = 1/Yes or HRND.ADDRMOVE =

1/Yes) on HRND where HRND.HRNDRND > (current

round - 3).


442

SPNotReportRamp

SP did not previously report that this residence had

ramps at entrances =

On most recent HOUS where HOUS.HOUSRND <

current round and HOUS.HRAMPS ^= EMPTY,

HOUS.HRAMPS = 2/No, DK, or RF.


443

SPNotReportBathMods

SP did not previously report that this residence had

modifications to any bathroom =

On most recent HOUS where HOUS.HOUSRND <

current round and HOUS.HBATHRM ^= EMPTY,

HOUS.HBATHRM = 2/No, DK, or RF.


444

SPNotReportRailings

SP did not previously report that this residence has

special railings =

On most recent HOUS where HOUS.HOUSRND <

current round and HOUS.HRAILING ^= EMPTY,

HOUS.HRAILING = 2/No, DK, or RF.


DESIGN NOTES
Important note regarding BOX HA1:

10:35:36 PM Thursday, June 25, 2009	

Page 2 of 75

BOX HA1
The technical notes 442, 443, 444 need to be evaluated as separate
checks. It is important to check for the most recent HOUS record prior to
the current round where the HOUS field ^= EMPTY.
For each field being checked, the most recent HOUS record where the
HOUS field ^= EMPTY could be on different HOUS records.

10:35:36 PM Thursday, June 25, 2009

Page 3 of 75

HAINTRO

HAINTRO

Page Order # :

Design Screen Type:

No Entry

Fields:

Field 1:

HAINT

Enable Functions:

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:

Add Line
Delete Line

No
No

20

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:

Question display:

Multi Field display:


Roster/Grid Instructions:

Roster/Grid display:

Report display:


TEXT:

Context Header:
Int. Instr I:

IF THE SP IS HOMELESS, IS TRANSIENT WITH NO PERMANENT
HOME, OR IS IN JAIL OR PRISON, SELECT NEXT PAGE
WITHOUT READING THIS INTRODUCTION.

Question Text:

I would like to ask a few questions about [your/(SP’s)] housing
situation or living arrangements.

Int. Instr II:
INPUT FIELDS / ROUTING

10:35:37 PM Thursday, June 25, 2009

Page 4 of 75

HAINTRO
HAINT

Field1:
Cheshire Name:

( HAQ1020 )

TEMP

Item Text display:
Item Text:
Label:

Label Position:

Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TContinueEMPTY
1
No
No

Number Label
1 Continue

FieldSize:
Min Value:
Max Value:
Mask:

Route
HA1 - DWELLING ( HAQ1030 )

English text: CONTINUE
Attribute
Empty

Route
HA1 - DWELLING ( HAQ1030 )

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES

DESIGN NOTES

10:35:39 PM Thursday, June 25, 2009

Page 5 of 75

HA1

HA1

Page Order # :

Design Screen Type:

Code 1

Fields:	

Field 1:

DWELLING

Field 2:

DWELLOS

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:	

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:	

Add Line
Delete Line

No
No

Enable Functions:	

30

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:

Question display:

Multi Field display:

Vertical Alignment


Roster/Grid Instructions:

Roster/Grid display:

Report display:


TEXT:

Context Header:
Int. Instr I:	

SHOW CARD HA1
IF TYPE OF HOUSING IS OBVIOUS, CODE WITHOUT ASKING.
SELECT "SP IS HOMELESS/TRANSIENT/IN JAIL OR PRISON"
WITHOUT ASKING.

Question Text:	

[IF HOUSING TYPE IS NOT OBVIOUS, ASK:] Which of these best
describes [your/(SP’s)] home?

Int. Instr II:

10:35:42 PM Thursday, June 25, 2009	

Page 6 of 75

HA1
INPUT FIELDS / ROUTING
DWELLING

Field1:
Cheshire Name:
Item Text display:

( HAQ1030 )

HOUS.DWELLING
Display response options in the following order: 1, 2, 3, 4,
5, 6, 96, 91.

Item Text:
Label:

Label Position:

Field Type:

Type Name:

Answers Allowed:

Drop Down List:

Lookup File:

Lookup File Name:


Enumerated
TDwellin
1
No
No

Number Label
1 Detached

FieldSize:
Min Value:
Max Value:
Mask:

Route
HA2 - HLEVELS ( HAQ1050 )

3

English text: ONE-FAMILY, DETACHED
Duplex
English text: TWO-FAMILY OR DUPLEX
Apartment

4

English text: APARTMENT OR CONDOMINIUM BUILDING
MobileHome
HAINTRO2 - HAINT1 ( HAQ1090 )

5

English text: MOBILE HOME, TRAILER
Rowhouse

HA2 - HLEVELS ( HAQ1050 )

6

English text: ROWHOUSE, TOWNHOUSE
MotherInLawApartment

HA2 - HLEVELS ( HAQ1050 )

2

HA2 - HLEVELS ( HAQ1050 )
HA2 - HLEVELS ( HAQ1050 )

91

English text: "MOTHER-IN-LAW" APARTMENT
Other
HA1 - DWELLOS ( HAQ1040 )

96

English text: SOMETHING ELSE
HomelessJail

BOX HA4 - (HAQ1375 )

English text: SP IS HOMELESS/TRANSIENT/IN JAIL OR PRISON
Attribute
Don't know

Route
HA2 - HLEVELS ( HAQ1050 )

10:35:49 PM Thursday, June 25, 2009

Page 7 of 75

HA1

Field2:
Cheshire Name:

DWELLOS

( HAQ1040 )

HOUS.DWELLOS

Item Text display:

Display (SPECIFY) in the same blue font used for
interviewer instructions.

Item Text:

SOMETHING ELSE (SPECIFY)

Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

String
TOthrspec
1
No
No

Number Label
1 [Continuous answer.]

FieldSize:
Min Value:
Max Value:
Mask:

30

Route
HA2 - HLEVELS ( HAQ1050 )

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES

DESIGN NOTES

10:35:50 PM Thursday, June 25, 2009

Page 8 of 75

HA2

HA2

Page Order # :

Design Screen Type:

Code 1

Fields:

Field 1:

HLEVELS

Enable Functions:

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:

Add Line
Delete Line

No
No

40

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:
Question display:

Display the most recent Type of Dwelling collected:
If most recent HOUS.DWELLING = 1/Detached, 2/Duplex,
5/Rowhouse or 6/MotherInLawApartment, display "house".
Else if most recent HOUS.DWELLING = 3/Apartment, display
"apartment or condominium building".
Else if most recent HOUS.DWELLING = 91/Other or DK, display
"place of residence".

Multi Field display:

Roster/Grid Instructions:
Roster/Grid display:
Report display:

TEXT:
Context Header:

Int. Instr I:

Question Text:

How many levels are in [your/(SP’s)] (house/apartment or
	
condominium building/place of residence)?

Int. Instr II:
10:35:51 PM Thursday, June 25, 2009

Page 9 of 75

HA2
INPUT FIELDS / ROUTING
( HAQ1050 )

HLEVELS

Field1:
Cheshire Name:

HOUS.HLEVELS

Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
THlevels

FieldSize:
Min Value:
Max Value:
Mask:

1
No
No

Number Label
1 OneLevel
2
3

Route
HAINTRO2 - HAINT1 ( HAQ1090 )

English text: ONE
TwoLevels
English text: TWO
ThreeOrMoreLevels

HA3 - HELEVTR ( HAQ1060 )
HA3 - HELEVTR ( HAQ1060 )

English text: THREE OR MORE
Attribute
Don't know

Route
HA3 - HELEVTR ( HAQ1060 )

Refusal

HA3 - HELEVTR ( HAQ1060 )

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES
222

RecentDwelling

10:35:55 PM Thursday, June 25, 2009

SP's most recent Type of Dwelling collected =
HA1-DWELLING if HA1 asked in current round.
Otherwise, the most recent type of dwelling collected will
be the most recent HOUS record where
HOUS.DWELLING ^= empty.
Page 10 of 75

HA2
DESIGN NOTES

10:35:55 PM Thursday, June 25, 2009

Page 11 of 75


HA3

HA3

Page Order # :

Design Screen Type:

Yes/No

Fields:

Field 1:

HELEVTR

Enable Functions:

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:

Add Line
Delete Line

No
No

50

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:
Question display:

Display the most recent Type of Dwelling collected:
If most recent HOUS.DWELLING = 1/Detached, 2/Duplex,
5/Rowhouse or 6/MotherInLawApartment, display "house".
Else if most recent HOUS.DWELLING = 3/Apartment, display
"apartment or condominium building".
Else if most recent HOUS.DWELLING = 91/Other or DK, display
"place of residence".

Multi Field display:

Roster/Grid Instructions:
Roster/Grid display:
Report display:

TEXT:
Context Header:

Int. Instr I:

Question Text:

Does [your/(SP’s)] (house/apartment or condominium building/place
	
of residence) have an elevator?

Int. Instr II:
10:35:56 PM Thursday, June 25, 2009

Page 12 of 75

HA3
INPUT FIELDS / ROUTING
( HAQ1060 )

HELEVTR

Field1:	

HOUS.HELEVTR

Cheshire Name:
Item Text display:
Item Text:
Label:

Label Position:

Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TYesNoDKRF
1
No
No

Number Label	
1 Yes	
2

FieldSize:
Min Value:
Max Value:
Mask:

Route
HA4 - HONELEVL ( HAQ1070 )

English text: YES
No	
English text: NO

HA4 - HONELEVL ( HAQ1070 )

Attribute
Don't know

Route
HA4 - HONELEVL ( HAQ1070 )

Refusal

HA4 - HONELEVL ( HAQ1070 )

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES
222

RecentDwelling	

SP's most recent Type of Dwelling collected =
HA1-DWELLING if HA1 asked in current round.
Otherwise, the most recent type of dwelling collected will
be the most recent HOUS record where
HOUS.DWELLING ^= empty.

DESIGN NOTES

10:35:58 PM Thursday, June 25, 2009	

Page 13 of 75

HA4

HA4

Page Order # :

Design Screen Type:

Yes/No

Fields:

Field 1:

HONELEVL

Enable Functions:

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:

Add Line
Delete Line

No
No

60

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:
Question display:

Display the most recent Type of Dwelling collected:
If most recent HOUS.DWELLING = 1/Detached, 2/Duplex, or
5/Rowhouse, display "house".
Else if most recent HOUS.DWELLING = 3/Apartment or
6/MotherInLawApartment, display "own apartment or condominium".
Else if most recent HOUS.DWELLING = 91/Other or DK, display
"place of residence".

Multi Field display:

Roster/Grid Instructions:
Roster/Grid display:
Report display:

TEXT:
Context Header:

Int. Instr I:

Question Text:

Is the living space in [your/(SP’s)] (house/own apartment or
	
condominium/place of residence) all on one level?

Int. Instr II:
10:35:59 PM Thursday, June 25, 2009

Page 14 of 75

HA4
INPUT FIELDS / ROUTING
( HAQ1070 )

HONELEVL

Field1:	

HOUS.HONELEVL

Cheshire Name:
Item Text display:
Item Text:
Label:

Label Position:

Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TYesNoDKRF
1
No
No

Number Label	
1 Yes	
2

FieldSize:
Min Value:
Max Value:
Mask:

Route
HAINTRO2 - HAINT1 ( HAQ1090 )

English text: YES
No	
English text: NO

HA5 - HBTHLEVL ( HAQ1080 )

Attribute
Don't know

Route
HA5 - HBTHLEVL ( HAQ1080 )

Refusal

HA5 - HBTHLEVL ( HAQ1080 )

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES
222

RecentDwelling	

SP's most recent Type of Dwelling collected =
HA1-DWELLING if HA1 asked in current round.
Otherwise, the most recent type of dwelling collected will
be the most recent HOUS record where
HOUS.DWELLING ^= empty.

DESIGN NOTES

10:36:02 PM Thursday, June 25, 2009	

Page 15 of 75

HA5

HA5

Page Order # :

Design Screen Type:

Yes/No

Fields:

Field 1:

HBTHLEVL

Enable Functions:

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:

Add Line
Delete Line

No
No

70

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:
Question display:

Display the most recent Type of Dwelling collected:
If most recent HOUS.DWELLING = 1/Detached, 2/Duplex, or
5/Rowhouse, display "house".
Else if most recent HOUS.DWELLING = 3/Apartment or
6/MotherInLawApartment, display "own apartment or condominium".
Else if most recent HOUS.DWELLING = 91/Other or DK, display
"place of residence".
Display "or" in bold.

Multi Field display:

Roster/Grid Instructions:
Roster/Grid display:
Report display:

TEXT:
Context Header:

Int. Instr I:

Question Text:

10:36:03 PM Thursday, June 25, 2009

Does [your/(SP’s)] (house/own apartment or condominium/place of
	
residence) have either a full bathroom or a half bathroom on all
Page 16 of 75

HA5
levels?
[PROBE: Bathroom facilities must contain at least a flush toilet, or a
bathtub or shower.]
Int. Instr II:

INPUT FIELDS / ROUTING

( HAQ1080 )

HBTHLEVL

Field1:
Cheshire Name:

HOUS.HBTHLEVL

Item Text display:
Item Text:
Label:

Label Position:

Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TYesNoDKRF
1
No
No

Number Label
1 Yes
2

FieldSize:
Min Value:
Max Value:
Mask:

Route
HAINTRO2 - HAINT1 ( HAQ1090 )

English text: YES
No

HAINTRO2 - HAINT1 ( HAQ1090 )

English text: NO
Attribute
Don't know

Route
HAINTRO2 - HAINT1 ( HAQ1090 )

Refusal

HAINTRO2 - HAINT1 ( HAQ1090 )

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES
222

RecentDwelling

10:36:06 PM Thursday, June 25, 2009

SP's most recent Type of Dwelling collected =
Page 17 of 75

HA5
HA1-DWELLING if HA1 asked in current round.
Otherwise, the most recent type of dwelling collected will
be the most recent HOUS record where
HOUS.DWELLING ^= empty.
DESIGN NOTES

10:36:06 PM Thursday, June 25, 2009

Page 18 of 75

HAINTRO2

HAINTRO2

Page Order # :

Design Screen Type:

No Entry

Fields:

Field 1:

HAINT1

Enable Functions:

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:

Add Line
Delete Line

No
No

80

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:
Question display:

Display the most recent Type of Dwelling collected:
If most recent HOUS.DWELLING = 1/Detached, 2/Duplex,
5/Rowhouse or 6/MotherInLawApartment, display "house".
Else if most recent HOUS.DWELLING = 3/Apartment, display
"apartment or condominium building".
Else if most recent HOUS.DWELLING = 4/MobileHome, display
"mobile home".
Else if most recent HOUS.DWELLING = 91/Other or DK, display
"place of residence".

Multi Field display:

Roster/Grid Instructions:
Roster/Grid display:
Report display:

TEXT:
Context Header:

Int. Instr I:

Question Text:

10:36:07 PM Thursday, June 25, 2009

Next, I would like to ask about access or mobility modifications that

[you/(SP)] may have in (your/his/her) (house/apartment or
Page 19 of 75

HAINTRO2
condominium building/mobile home/place of residence).
Int. Instr II:

INPUT FIELDS / ROUTING

( HAQ1090 )

HAINT1

Field1:	

TEMP

Cheshire Name:
Item Text display:
Item Text:
Label:

Label Position:

Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TContinueEMPTY
1
No
No

Number Label	
1 Continue	

FieldSize:
Min Value:
Max Value:
Mask:

Route
BOX HA1AB - (HAQ1115 )

English text: CONTINUE
Attribute
Empty

Route
BOX HA1AB - (HAQ1115 )

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES
222

RecentDwelling	

SP's most recent Type of Dwelling collected =
HA1-DWELLING if HA1 asked in current round.
Otherwise, the most recent type of dwelling collected will
be the most recent HOUS record where
HOUS.DWELLING ^= empty.

DESIGN NOTES

10:36:09 PM Thursday, June 25, 2009	

Page 20 of 75

HAINTRO2A

HAINTRO2A

Page Order # :

Design Screen Type:

No Entry

Fields:

Field 1:

HAINT2

Enable Functions:

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:

Add Line
Delete Line

No
No

100

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:

Question display:

Multi Field display:


Roster/Grid Instructions:

Roster/Grid display:

Report display:


TEXT:

Context Header:
Int. Instr I:
Question Text:

When we were here about a year ago, we asked about access or
mobility modifications that may have been a part of [your/(SP’s)]
residence at that time. Now, I would like to update our information
about such modifications.

Int. Instr II:

INPUT FIELDS / ROUTING


10:36:10 PM Thursday, June 25, 2009

Page 21 of 75

HAINTRO2A
HAINT2

Field1:
Cheshire Name:

( HAQ1110 )

TEMP

Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TContinueEMPTY
1
No
No

Number Label
1 Continue

FieldSize:
Min Value:
Max Value:
Mask:

Route
BOX HA1AB - (HAQ1115 )

English text: CONTINUE
Attribute
Empty

Route
BOX HA1AB - (HAQ1115 )

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES

DESIGN NOTES

10:36:12 PM Thursday, June 25, 2009

Page 22 of 75

BOX HA1AB

BOX HA1AB

Page Order # :

105

BOX INSTRUCTIONS
( HAQ1115 )	

IF (SP IS IN THE SUPPLEMENTAL SAMPLE) OR (SP DID NOT
RECEIVE THE HA SECTION IN THE PREVIOUS YEAR) OR (SP
MOVED IN THE PREVIOUS YEAR) OR (THE TYPE OF DWELLING
REPORTED IN THE PREVIOUS YEAR WAS UNKNOWN) OR (SP DID NOT
PREVIOUSLY REPORT THAT THIS RESIDENCE HAD RAMPS AT
ENTRANCES ), GO TO HA6 - HRAMPS ( HAQ1120 ).
ELSE GO TO BOX HA1AC - (HAQ1125 ).

ASSIGNMENTS

TECHNICAL NOTES
9

SuppORD

SP is in the Supplemental Sample =
MRES.INTTYPE=3/NewFromSupplement on MRES
where MRES.MRESRND = current round.

219

NoHA

SP did not receive the HA section in the previous year =
There is no HOUS where HOUS.HOUSRND = (current
round – 3).

220

DKDwelling

The Type of Dwelling reported in the previous year was
unknown =
(HOUS.DWELLING = DK or RF) on HOUS where
HOUS.HOUSRND = (current round - 3).

221

MovePrevYR

SP moved in the previous year =
(HRND.SPMOVED = 1/Yes or HRND.ADDRMOVE =
1/Yes) on HRND where HRND.HRNDRND > (current
round - 3).

442

SPNotReportRamp

SP did not previously report that this residence had
ramps at entrances =
On most recent HOUS where HOUS.HOUSRND <
current round and HOUS.HRAMPS ^= EMPTY,
HOUS.HRAMPS = 2/No, DK, or RF.

DESIGN NOTES

10:36:12 PM Thursday, June 25, 2009	

Page 23 of 75

HA6

HA6

Page Order # :

Design Screen Type:

Yes/No

Fields:

Field 1:

HRAMPS

Enable Functions:

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:

Add Line
Delete Line

No
No

110

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:
Question display:

Display the most recent Type of Dwelling collected:
If most recent HOUS.DWELLING = 1/Detached, 2/Duplex,
5/Rowhouse or 6/MotherInLawApartment, display "house".
Else if most recent HOUS.DWELLING = 3/Apartment, display
"apartment or condominium building".
Else if most recent HOUS.DWELLING = 4/MobileHome, display
"mobile home".
Else if most recent HOUS.DWELLING = 91/Other or DK, display
"place of residence".
Always display "(any of)" and "(s)" in parenthesis.

Multi Field display:

Roster/Grid Instructions:
Roster/Grid display:
Report display:

TEXT:
Context Header:
Int. Instr I:

10:36:13 PM Thursday, June 25, 2009

Page 24 of 75

HA6
Does [your/(SP’s)] (house/mobile home/apartment or condominium
building/place of residence) have ramps at (any of) its entrance(s)?

Question Text:
Int. Instr II:

INPUT FIELDS / ROUTING


( HAQ1120 )

HRAMPS

Field1:
Cheshire Name:

HOUS.HRAMPS

Item Text display:
Item Text:
Label:

Label Position:

Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TYesNoDKRF
1
No
No

Number Label
1 Yes
2

FieldSize:
Min Value:
Max Value:
Mask:

Route
BOX HA1AC - (HAQ1125 )

English text: YES
No

BOX HA1AC - (HAQ1125 )

English text: NO
Attribute
Don't know

Route
BOX HA1AC - (HAQ1125 )

Refusal

BOX HA1AC - (HAQ1125 )

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES
222

RecentDwelling

10:36:16 PM Thursday, June 25, 2009

SP's most recent Type of Dwelling collected =
HA1-DWELLING if HA1 asked in current round.
Otherwise, the most recent type of dwelling collected will
Page 25 of 75

HA6
be the most recent HOUS record where
HOUS.DWELLING ^= empty.
DESIGN NOTES

10:36:16 PM Thursday, June 25, 2009

Page 26 of 75

BOX HA1AC

BOX HA1AC

Page Order # :

115

BOX INSTRUCTIONS
( HAQ1125 )	

IF (SP IS IN THE SUPPLEMENTAL SAMPLE) OR (SP DID NOT
RECEIVE THE HA SECTION IN THE PREVIOUS YEAR) OR (SP
MOVED IN THE PREVIOUS YEAR) OR (THE TYPE OF DWELLING
REPORTED IN THE PREVIOUS YEAR WAS UNKNOWN) OR (SP DID NOT
PREVIOUSLY REPORT THAT THIS RESIDENCE HAD MODIFICATIONS TO
ANY BATHROOM ), GO TO HA7 - HBATHRM ( HAQ1130 ).
ELSE GO TO BOX HA1AD - (HAQ1135 ).

ASSIGNMENTS

TECHNICAL NOTES
9

SuppORD

SP is in the Supplemental Sample =
MRES.INTTYPE=3/NewFromSupplement on MRES
where MRES.MRESRND = current round.

219

NoHA

SP did not receive the HA section in the previous year =
There is no HOUS where HOUS.HOUSRND = (current
round – 3).

220

DKDwelling

The Type of Dwelling reported in the previous year was
unknown =
(HOUS.DWELLING = DK or RF) on HOUS where
HOUS.HOUSRND = (current round - 3).

221

MovePrevYR

SP moved in the previous year =
(HRND.SPMOVED = 1/Yes or HRND.ADDRMOVE =
1/Yes) on HRND where HRND.HRNDRND > (current
round - 3).

443

SPNotReportBathMods

SP did not previously report that this residence had
modifications to any bathroom =
On most recent HOUS where HOUS.HOUSRND <
current round and HOUS.HBATHRM ^= EMPTY,
HOUS.HBATHRM = 2/No, DK, or RF.

DESIGN NOTES

10:36:16 PM Thursday, June 25, 2009	

Page 27 of 75

HA7

HA7

Page Order # :

Design Screen Type:

Yes/No

Fields:

Field 1:

HBATHRM

Enable Functions:

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:

Add Line
Delete Line

No
No

120

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:
Question display:

Display the most recent Type of Dwelling collected:
If most recent HOUS.DWELLING = 1/Detached, 2/Duplex or
5/Rowhouse, display "house".
Else if most recent HOUS.DWELLING = 3/Apartment or
6/MotherInLawApartment, display "own apartment or condominium".
Else if most recent HOUS.DWELLING = 4/MobileHome, display
"mobile home".
Else if most recent HOUS.DWELLING = 91/Other or DK, display
"place of residence".

Multi Field display:

Roster/Grid Instructions:
Roster/Grid display:
Report display:

TEXT:
Context Header:

Int. Instr I:

Question Text:

10:36:17 PM Thursday, June 25, 2009

Does [your/(SP’s)] (house/own apartment or condominium/mobile
	
home/place of residence) have modifications to any bathroom such
Page 28 of 75

HA7
as grab bars or a shower seat?
Int. Instr II:

INPUT FIELDS / ROUTING

( HAQ1130 )

HBATHRM

Field1:
Cheshire Name:

HOUS.HBATHRM

Item Text display:
Item Text:
Label:

Label Position:

Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TYesNoDKRF
1
No
No

Number Label
1 Yes
2

FieldSize:
Min Value:
Max Value:
Mask:

Route
BOX HA1AD - (HAQ1135 )

English text: YES
No

BOX HA1AD - (HAQ1135 )

English text: NO
Attribute
Don't know

Route
BOX HA1AD - (HAQ1135 )

Refusal

BOX HA1AD - (HAQ1135 )

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES
222

RecentDwelling

10:36:20 PM Thursday, June 25, 2009

SP's most recent Type of Dwelling collected =
HA1-DWELLING if HA1 asked in current round.
Otherwise, the most recent type of dwelling collected will
be the most recent HOUS record where
Page 29 of 75

HA7
HOUS.DWELLING ^= empty.
DESIGN NOTES

10:36:20 PM Thursday, June 25, 2009

Page 30 of 75

BOX HA1AD

BOX HA1AD

Page Order # :

125

BOX INSTRUCTIONS
( HAQ1135 )	

IF (SP IS IN THE SUPPLEMENTAL SAMPLE) OR (SP DID NOT
RECEIVE THE HA SECTION IN THE PREVIOUS YEAR) OR (SP
MOVED IN THE PREVIOUS YEAR) OR (THE TYPE OF DWELLING
REPORTED IN THE PREVIOUS YEAR WAS UNKNOWN) OR (SP DID NOT
PREVIOUSLY REPORT THAT THIS RESIDENCE HAS SPECIAL
RAILIINGS), GO TO HA8 - HRAILING ( HAQ1140 ).
ELSE GO TO BOX HA1B - (HAQ1150 ).

ASSIGNMENTS

TECHNICAL NOTES
9

SuppORD

SP is in the Supplemental Sample =
MRES.INTTYPE=3/NewFromSupplement on MRES
where MRES.MRESRND = current round.

219

NoHA

SP did not receive the HA section in the previous year =
There is no HOUS where HOUS.HOUSRND = (current
round – 3).

220

DKDwelling

The Type of Dwelling reported in the previous year was
unknown =
(HOUS.DWELLING = DK or RF) on HOUS where
HOUS.HOUSRND = (current round - 3).

221

MovePrevYR

SP moved in the previous year =
(HRND.SPMOVED = 1/Yes or HRND.ADDRMOVE =
1/Yes) on HRND where HRND.HRNDRND > (current
round - 3).

444

SPNotReportRailings

SP did not previously report that this residence has
special railings =
On most recent HOUS where HOUS.HOUSRND <
current round and HOUS.HRAILING ^= EMPTY,
HOUS.HRAILING = 2/No, DK, or RF.

DESIGN NOTES

10:36:20 PM Thursday, June 25, 2009	

Page 31 of 75

HA8

HA8

Page Order # :

Design Screen Type:

Yes/No

Fields:

Field 1:

HRAILING

Enable Functions:

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:

Add Line
Delete Line

No
No

130

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:
Question display:

Display the most recent Type of Dwelling collected:
If most recent HOUS.DWELLING = 1/Detached, 2/Duplex or
5/Rowhouse, display "house".
Else if most recent HOUS.DWELLING = 3/Apartment or
6/MotherInLawApartment, display "own apartment or condominium".
Else if most recent HOUS.DWELLING = 4/MobileHome, display
"mobile home".
Else if most recent HOUS.DWELLING = 91/Other or DK, display
"place of residence".

Multi Field display:

Roster/Grid Instructions:
Roster/Grid display:
Report display:

TEXT:
Context Header:

Int. Instr I:

Question Text:

10:36:21 PM Thursday, June 25, 2009

Other than stair railings, does [your/(SP’s)] (house/own apartment or
	
condominium/mobile home/place of residence) have special railings
Page 32 of 75

HA8
to help (you/him/her) move around?
Int. Instr II:

INPUT FIELDS / ROUTING

( HAQ1140 )

HRAILING

Field1:
Cheshire Name:

HOUS.HRAILING

Item Text display:
Item Text:
Label:

Label Position:

Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TYesNoDKRF
1
No
No

Number Label
1 Yes
2

FieldSize:
Min Value:
Max Value:
Mask:

Route
BOX HA1B - (HAQ1150 )

English text: YES
No

BOX HA1B - (HAQ1150 )

English text: NO
Attribute
Don't know

Route
BOX HA1B - (HAQ1150 )

Refusal

BOX HA1B - (HAQ1150 )

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES
222

RecentDwelling

10:36:24 PM Thursday, June 25, 2009

SP's most recent Type of Dwelling collected =
HA1-DWELLING if HA1 asked in current round.
Otherwise, the most recent type of dwelling collected will
be the most recent HOUS record where
Page 33 of 75

HA8
HOUS.DWELLING ^= empty.
DESIGN NOTES

10:36:24 PM Thursday, June 25, 2009

Page 34 of 75

BOX HA1B

BOX HA1B

Page Order # :

140

BOX INSTRUCTIONS
( HAQ1150 )	

IF (THE SP IS IN THE SUPPLEMENTAL SAMPLE) OR (SP DID NOT
RECEIVE THE HA SECTION IN THE PREVIOUS YEAR) OR (SP MOVED IN
THE PREVIOUS YEAR) OR (THE TYPE OF HOUSING REPORTED IN THE
PREVIOUS YEAR WAS UNKNOWN), GO TO HA9 - HOUSTYPE ( HAQ1160
).
ELSE IF TYPE OF HOUSING WAS REPORTED LAST TIME IT WAS ASKED,
GO TO HAINTRO3 - HAINT3 ( HAQ1200 ).
ELSE GO TO BOX HA4 - (HAQ1375 ).

ASSIGNMENTS

TECHNICAL NOTES
9

SuppORD

SP is in the Supplemental Sample =
MRES.INTTYPE=3/NewFromSupplement on MRES
where MRES.MRESRND = current round.

219

NoHA

SP did not receive the HA section in the previous year =
There is no HOUS where HOUS.HOUSRND = (current
round – 3).

221

MovePrevYR

SP moved in the previous year =
(HRND.SPMOVED = 1/Yes or HRND.ADDRMOVE =
1/Yes) on HRND where HRND.HRNDRND > (current
round - 3).

224

DKHousing

Type of Housing reported in the previous year is
unknown =
(HOUS.HOUSTYPE = DK or RF) on HOUS where
HOUS.HOUSRND = (current round - 3).

225

KnowHousing

Type of Housing was reported last time it was asked =
There is a HOUS where HOUS.HOUSTYPE = 1/Yes on
the most recent HOUS where HOUS.HOUSTYPE ^=
empty.

DESIGN NOTES

10:36:24 PM Thursday, June 25, 2009	

Page 35 of 75

HA9

HA9

Page Order # :

Design Screen Type:

Yes/No

Fields:

Field 1:

HOUSTYPE

Enable Functions:

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:

Add Line
Delete Line

No
No

150

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:
Question display:

Display the most recent Type of Dwelling collected:
If most recent HOUS.DWELLING = 1/Detached, 2/Duplex or
5/Rowhouse, display "house".
Else if most recent HOUS.DWELLING = 3/Apartment or
6/MotherInLawApartment, display "own apartment or condominium".
Else if most recent HOUS.DWELLING = 4/MobileHome, display
"mobile home".
Else if most recent HOUS.DWELLING = 91/Other or DK, display
"place of residence".

Multi Field display:

Roster/Grid Instructions:
Roster/Grid display:
Report display:

TEXT:
Context Header:
Int. Instr I:

SHOW CARD HA2

Question Text:

Please look at this card. Is [your/(SP’s)] (house/own apartment or
condominium/mobile home/place of residence) a part of one of these

10:36:25 PM Thursday, June 25, 2009

Page 36 of 75

HA9
communities?
Int. Instr II:

INPUT FIELDS / ROUTING

( HAQ1160 )

HOUSTYPE

Field1:
Cheshire Name:

HOUS.HOUSTYPE

Item Text display:
Item Text:
Label:

Label Position:

Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TYesNoDKRF
1
No
No

Number Label
1 Yes
2

FieldSize:
Min Value:
Max Value:
Mask:

Route
HA10 - HCOMUNTY ( HAQ1170 )

English text: YES
No

BOX HA3 - (HAQ1340 )

English text: NO
Attribute
Don't know

Route
HA10 - HCOMUNTY ( HAQ1170 )

Refusal

BOX HA3 - (HAQ1340 )

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES
4

Respondent

On MRES where MRES.MRESRND = current round:
A Proxy interview (respondent is a proxy) =
MRES.SPPROXY=2/Proxy.

10:36:28 PM Thursday, June 25, 2009

Page 37 of 75

HA9
MRES.RROSTNUM=ROST.ROSTNUM of respondent.
An SP interview (respondent is the SP) =
MRES.SPPROXY=1/SP.
MRES.RROSTNUM='01'.
DESIGN NOTES

10:36:28 PM Thursday, June 25, 2009

Page 38 of 75

HA10

HA10

Page Order # :

Design Screen Type:	

Code 1

Fields:	

Field 1:

HCOMUNTY

Field 2:

HCOMUNOS

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:	

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:	

Add Line
Delete Line

No
No

Enable Functions:	

160

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:

Question display:

Multi Field display:

Vertical Alignment


Roster/Grid Instructions:

Roster/Grid display:

Report display:


TEXT:

Context Header:
Int. Instr I:

SHOW CARD HA2

Question Text:

[IF NECESSARY, ASK:] Which category best describes
[your/(SP’s)] type of housing?

Int. Instr II:
INPUT FIELDS / ROUTING

10:36:31 PM Thursday, June 25, 2009	

Page 39 of 75

HA10
HCOMUNTY

Field1:
Cheshire Name:

( HAQ1170 )

HOUS.HCOMUNTY

Item Text display:
Item Text:
Label:

Label Position:

Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
THcomuny
1
No
No

Number Label
1 RetirementCommunity

FieldSize:
Min Value:
Max Value:
Mask:

Route
HA11 - HPERCARE ( HAQ1210 )

2

English text: RETIREMENT COMMUNITY
SeniorCitizensHousing

HA11 - HPERCARE ( HAQ1210 )

3

English text: SENIOR CITIZENS HOUSING
AssistedLivingFacility

HA11 - HPERCARE ( HAQ1210 )

4

English text: ASSISTED LIVING FACILITY
ContinuingCareCommunity

HA11 - HPERCARE ( HAQ1210 )

5

English text: CONTINUING CARE COMMUNITY
StagedLivingCommunity
HA11 - HPERCARE ( HAQ1210 )

6

English text: STAGED LIVING COMMUNITY
RetirementApartments
HA11 - HPERCARE ( HAQ1210 )

7

English text: RETIREMENT APARTMENTS
ChurchProvidedHousing

8

English text: CHURCH-PROVIDED HOUSING
PersonalCareHome
HA11 - HPERCARE ( HAQ1210 )

91

English text: PERSONAL OR RESIDENTIAL CARE HOME
Other
HA10 - HCOMUNOS ( HAQ1180 )

HA11 - HPERCARE ( HAQ1210 )

English text: OTHER
Attribute
Don't know

Route
HA11 - HPERCARE ( HAQ1210 )

Refusal

HA11 - HPERCARE ( HAQ1210 )

10:36:38 PM Thursday, June 25, 2009

Page 40 of 75

HA10

Field2:
Cheshire Name:

HCOMUNOS

( HAQ1180 )

HOUS.HCOMUNOS

Item Text display:

Display (SPECIFY) in the same blue font used for
interviewer instructions.

Item Text:

OTHER (SPECIFY)

Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

String
TOthrspec
1
No
No

Number Label
1 [Continuous answer.]

FieldSize:
Min Value:
Max Value:
Mask:

30

Route
HA11 - HPERCARE ( HAQ1210 )

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES

DESIGN NOTES

10:36:39 PM Thursday, June 25, 2009

Page 41 of 75

HAINTRO3

HAINTRO3

Page Order # :

Design Screen Type:	

No Entry

Fields:	

Field 1:

HAINT3

Enable Functions:	

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:	

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:	

Add Line
Delete Line

No
No

180

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:
Question display:	

If SP is the respondent, display "live".
Else display "lives".

Multi Field display:

Roster/Grid Instructions:
Roster/Grid display:
Report display:

TEXT:
Context Header:

Int. Instr I:

Question Text:

The type of community [you/(SP)] (live/lives) in sometimes gives its

residents access to personal care services. Next, I would like to
update our records regarding [your/(SP’s)] access to such services.

Int. Instr II:
INPUT FIELDS / ROUTING

10:36:40 PM Thursday, June 25, 2009	

Page 42 of 75

HAINTRO3
( HAQ1200 )

HAINT3

Field1:
Cheshire Name:

TEMP

Item Text display:
Item Text:
Label:

Label Position:

Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TContinueEMPTY
1
No
No

Number Label
1 Continue

FieldSize:
Min Value:
Max Value:
Mask:

Route
HA11 - HPERCARE ( HAQ1210 )

English text: CONTINUE
Attribute
Empty

Route
HA11 - HPERCARE ( HAQ1210 )

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES
4

Respondent

On MRES where MRES.MRESRND = current round:
A Proxy interview (respondent is a proxy) =
MRES.SPPROXY=2/Proxy.
MRES.RROSTNUM=ROST.ROSTNUM of respondent.
An SP interview (respondent is the SP) =
MRES.SPPROXY=1/SP.
MRES.RROSTNUM='01'.

DESIGN NOTES

10:36:42 PM Thursday, June 25, 2009

Page 43 of 75

HA11

HA11

Page Order # :

Design Screen Type:

Yes/No

Fields:

Field 1:

HPERCARE

Enable Functions:

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:

Add Line
Delete Line

No
No

190

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:

Question display:

Multi Field display:


Roster/Grid Instructions:

Roster/Grid display:

Report display:


TEXT:

Context Header:
Int. Instr I:

SHOW CARD HA3

Question Text:

Does [your/(SP’s)] place of residence give (you/him/her) access to
personal care services like any of those listed on this card?

Int. Instr II:
INPUT FIELDS / ROUTING

10:36:43 PM Thursday, June 25, 2009

Page 44 of 75

HA11
HPERCARE

Field1:
Cheshire Name:

( HAQ1210 )

HOUS.HPERCARE

Item Text display:
Item Text:
Label:

Label Position:

Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TYesNoDKRF
1
No
No

Number Label
1 Yes
2

FieldSize:
Min Value:
Max Value:
Mask:

Route
HA12 - MEALPROB ( HAQ1220 )

English text: YES
No

BOX HA3 - (HAQ1340 )

English text: NO
Attribute
Don't know

Route
HA12 - MEALPROB ( HAQ1220 )

Refusal

BOX HA3 - (HAQ1340 )

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES

DESIGN NOTES

10:36:45 PM Thursday, June 25, 2009

Page 45 of 75

HA12

HA12

Page Order # :

Design Screen Type:

List

Fields:

Field 1:

MEALPROB

Field 2:

MAIDPROB

Field 3:

WASHPROB

Field 4:

HELPPROB

Field 5:

TRANPROB

Field 6:

RECPROB

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:

Add Line
Delete Line

No
No

Enable Functions:

200

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:
Question display:

Display the most recent Type of Housing collected:

If most recent HOUS.HCOMUNTY = DK or RF, display "In

[your/(SP's) place of residence".

Else if most recent HOUS.HCOMUNTY = 6/RetirementApartment,

display "In these (TYPE OF HOUSING)".

Else display "In this (TYPE OF HOUSING)".

TYPE OF HOUSING:

If most recent HOUS.HCOMUNTY = 91/Other, display most recent

Other Specify Response text, HOUS.HCOMUNOS.

Else display most recent HOUS.HCOMUNTY response.


Multi Field display:

Vertical Alignment


Roster/Grid Instructions:
Roster/Grid display:

10:36:48 PM Thursday, June 25, 2009

Page 46 of 75

HA12
Report display:

TEXT:
Context Header:
Int. Instr I:
We are interested in personal services that might be available here
in addition to housing. [In (this/these) (TYPE OF HOUSING)/In
[your/(SP’s)] place of residence], [do you/does (SP)] have access
to…

Question Text:

Int. Instr II:
INPUT FIELDS / ROUTING
MEALPROB

Field1:
Cheshire Name:

( HAQ1220 )

HOUS.MEALPROB

Item Text display:

Display "a." before the question text.

Item Text:

prepared meals?

Label:

Label Position:

Field Type:

Type Name:

Answers Allowed:

Drop Down List:

Lookup File:

Lookup File Name:


Enumerated
TYesNoDKRF
1
No
No

Number Label
1 Yes
2

FieldSize:
Min Value:
Max Value:
Mask:

Route
HA12 - MAIDPROB ( HAQ1230 )

English text: YES
No

HA12 - MAIDPROB ( HAQ1230 )

English text: NO
Attribute
Don't know

Route
HA12 - MAIDPROB ( HAQ1230 )

Refusal

HA12 - MAIDPROB ( HAQ1230 )

10:36:53 PM Thursday, June 25, 2009

Page 47 of 75

HA12
MAIDPROB

Field2:
Cheshire Name:

( HAQ1230 )

HOUS.MAIDPROB

Item Text display:

Display "b." before the question text.

Item Text:

housekeeping, maid, or cleaning services?

Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TYesNoDKRF
1
No
No

Number Label
1 Yes
2

FieldSize:
Min Value:
Max Value:
Mask:

Route
HA12 - WASHPROB ( HAQ1240 )

English text: YES
No

HA12 - WASHPROB ( HAQ1240 )

English text: NO
Attribute
Don't know

Route
HA12 - WASHPROB ( HAQ1240 )

Refusal

HA12 - WASHPROB ( HAQ1240 )

10:36:59 PM Thursday, June 25, 2009

Page 48 of 75

HA12
WASHPROB

Field3:
Cheshire Name:

( HAQ1240 )

HOUS.WASHPROB

Item Text display:

Display "c." before the question text.

Item Text:

laundry services?

Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TYesNoDKRF
1
No
No

Number Label
1 Yes
2

FieldSize:
Min Value:
Max Value:
Mask:

Route
HA12 - HELPPROB ( HAQ1250 )

English text: YES
No

HA12 - HELPPROB ( HAQ1250 )

English text: NO
Attribute
Don't know

Route
HA12 - HELPPROB ( HAQ1250 )

Refusal

HA12 - HELPPROB ( HAQ1250 )

10:37:04 PM Thursday, June 25, 2009

Page 49 of 75

HA12
HELPPROB

Field4:
Cheshire Name:

( HAQ1250 )

HOUS.HELPPROB

Item Text display:

Display "d." before the question text.

Item Text:

help with medications?

Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TYesNoDKRF
1
No
No

Number Label
1 Yes
2

FieldSize:
Min Value:
Max Value:
Mask:

Route
HA12 - TRANPROB ( HAQ1260 )

English text: YES
No

HA12 - TRANPROB ( HAQ1260 )

English text: NO
Attribute
Don't know

Route
HA12 - TRANPROB ( HAQ1260 )

Refusal

HA12 - TRANPROB ( HAQ1260 )

10:37:10 PM Thursday, June 25, 2009

Page 50 of 75

HA12
TRANPROB

Field5:
Cheshire Name:

( HAQ1260 )

HOUS.TRANPROB

Item Text display:

Display "e." before the question text.

Item Text:

transportation?

Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TYesNoDKRF
1
No
No

Number Label
1 Yes
2

FieldSize:
Min Value:
Max Value:
Mask:

Route
HA12 - RECPROB ( HAQ1270 )

English text: YES
No

HA12 - RECPROB ( HAQ1270 )

English text: NO
Attribute
Don't know

Route
HA12 - RECPROB ( HAQ1270 )

Refusal

HA12 - RECPROB ( HAQ1270 )

10:37:15 PM Thursday, June 25, 2009

Page 51 of 75

HA12
( HAQ1270 )

RECPROB

Field6:

HOUS.RECPROB

Cheshire Name:
Item Text display:

Display "f." before the question text.

Item Text:

recreational services, such as exercise facilities, movies,
activities programs, library, card rooms, pool tables, etc.?

Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TYesNoDKRF
1
No
No

Number Label
1 Yes
2

FieldSize:
Min Value:
Max Value:
Mask:

Route
BOX HA2 - (HAQ1280 )

English text: YES
No

BOX HA2 - (HAQ1280 )

English text: NO
Attribute
Don't know

Route
BOX HA2 - (HAQ1280 )

Refusal

BOX HA2 - (HAQ1280 )

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES
223

RecentHousing	

SP's most recent Type of Housing collected =
HA10-HCOMUNTY if HA10 asked in current round.
Otherwise, the most recent type of community collected
will be the most recent HOUS record where
HOUS.HCOMUNTY ^= empty.

DESIGN NOTES

10:37:17 PM Thursday, June 25, 2009	

Page 52 of 75

BOX HA2

BOX HA2

Page Order # :

210

BOX INSTRUCTIONS
( HAQ1280 )	

IF SP HAD ACCESS TO AT LEAST ONE PERSONAL SERVICE LISTED AT
HA12, GO TO HA13 - SERVINCL ( HAQ1290 ).
ELSE GO TO BOX HA2A - (HAQ1300 ).

ASSIGNMENTS

TECHNICAL NOTES
227

PersonalServices

SP had access to at least one personal service at HA12 =
(HOUS.MEALPROB = 1/Yes or HOUS.MAIDPROB =
1/Yes or HOUS.WASHPROB = 1/Yes or
HOUS.HELPPROB = 1/Yes or HOUS.TRANPROB =
1/Yes or HOUS.RECPROB = 1/Yes) on HOUS where
HOUS.HOUSRND=current round.

DESIGN NOTES

10:37:17 PM Thursday, June 25, 2009	

Page 53 of 75

HA13

HA13

Page Order # :

Design Screen Type:

Code 1

Fields:

Field 1:

SERVINCL

Enable Functions:

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:

Add Line
Delete Line

No
No

220

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:

Question display:

Multi Field display:


Roster/Grid Instructions:

Roster/Grid display:

Report display:


TEXT:

Context Header:

Int. Instr I:

Question Text:

Are these services included as part of the cost of [your/(SP’s)]
	
housing or is there a separate charge for them?

Int. Instr II:
INPUT FIELDS / ROUTING

10:37:19 PM Thursday, June 25, 2009

Page 54 of 75

HA13
SERVINCL

Field1:
Cheshire Name:

( HAQ1290 )

HOUS.SERVINCL

Item Text display:
Item Text:
Label:

Label Position:

Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TServinc
1
No
No

Number Label
1 AllIncluded

FieldSize:
Min Value:
Max Value:
Mask:

Route
BOX HA2A - (HAQ1300 )

2

English text: ALL INCLUDED
SomeIncluded

3

English text: SOME INCLUDED/SOME SEPARATE
AllSeparate
BOX HA2A - (HAQ1300 )

BOX HA2A - (HAQ1300 )

English text: ALL SEPARATE
Attribute
Don't know

Route
BOX HA2A - (HAQ1300 )

Refusal

BOX HA2A - (HAQ1300 )

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES

DESIGN NOTES

10:37:22 PM Thursday, June 25, 2009

Page 55 of 75

BOX HA2A

BOX HA2A

Page Order # :

230

BOX INSTRUCTIONS
( HAQ1300 )	

IF (THE SP IS IN THE SUPPLEMENTAL SAMPLE) OR (SP DID NOT
RECEIVE THE HA SECTION IN THE PREVIOUS YEAR) OR (SP MOVED IN
THE PREVIOUS YEAR) OR (WHETHER OR NOT SP IS ALLOWED TO
CONTINUE LIVING IN HOME IF SUBSTANTIAL CARE IS NEEDED IS
UNKNOWN), GO TO HA14 - STAYPUT ( HAQ1310 ).
ELSE GO TO BOX HA4 - (HAQ1375 ).

ASSIGNMENTS

TECHNICAL NOTES
9

SuppORD

SP is in the Supplemental Sample =
MRES.INTTYPE=3/NewFromSupplement on MRES
where MRES.MRESRND = current round.

219

NoHA

SP did not receive the HA section in the previous year =
There is no HOUS where HOUS.HOUSRND = (current
round – 3).

221

MovePrevYR

SP moved in the previous year =
(HRND.SPMOVED = 1/Yes or HRND.ADDRMOVE =
1/Yes) on HRND where HRND.HRNDRND > (current
round - 3).

228

AllowedToStay

Whether or not SP is allowed to continue living in home if
substantial care is needed is unknown =
HOUS.STAYPUT = DK on HOUS where
HOUS.HOUSRND = (current round - 3).

DESIGN NOTES

10:37:22 PM Thursday, June 25, 2009	

Page 56 of 75

HA14

HA14

Page Order # :

Design Screen Type:

Yes/No

Fields:

Field 1:

STAYPUT

Enable Functions:

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:

Add Line
Delete Line

No
No

240

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:
Question display:

Display the most recent Type of Housing collected:

If most recent HOUS.HCOMUNTY = DK or RF, display "place".

Else display "(TYPE OF HOUSING)".

TYPE OF HOUSING:

If most recent HOUS.HCOMUNTY = 91/Other, display most recent

Other Specify Response text, HOUS.HCOMUNOS.

Else display most recent HOUS.HCOMUNTY response.

Display the most recent Type of Dwelling collected:

If most recent HOUS.DWELLING = 1/Detached, 2/Duplex,

5/Rowhouse or 6/MotherInLawApartment, display "house".

Else if most recent HOUS.DWELLING = 3/Apartment, display

"apartment or condominium".

Else if most recent HOUS.DWELLING = 4/MobileHome, display

"mobile home".

Else if most recent HOUS.DWELLING = 91/Other or DK, display

"home".

If SP is respondent, display "live".

Else display "lives".


Multi Field display:

10:37:23 PM Thursday, June 25, 2009

Page 57 of 75

HA14
Roster/Grid Instructions:
Roster/Grid display:
Report display:

TEXT:
Context Header:
Int. Instr I:
Question Text:

Would the [(TYPE OF HOUSING)/place] where [you/(SP)] currently
(live/lives) allow (you/him/her) to continue living in (your/his/her)
(house/apartment or condominium/mobile home/home) if
(you/he/she) needed substantial care?
[PROBE: Could [you/(SP)] stay where (you/he/she) (live/lives) now if
(you/he/she) needed a much greater level of care?]

Int. Instr II:
INPUT FIELDS / ROUTING

10:37:25 PM Thursday, June 25, 2009

Page 58 of 75

HA14
( HAQ1310 )

STAYPUT

Field1:

HOUS.STAYPUT

Cheshire Name:
Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TYesNoDKRF
1
No
No

Number Label
1 Yes
2

FieldSize:
Min Value:
Max Value:
Mask:

Route
HA16 - REQAGE ( HAQ1330 )

English text: YES
No

HA15 - CAREPART ( HAQ1320 )

English text: NO
Attribute
Don't know

Route
HA16 - REQAGE ( HAQ1330 )

Refusal

HA16 - REQAGE ( HAQ1330 )

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES
223

RecentHousing	

10:37:28 PM Thursday, June 25, 2009	

SP's most recent Type of Housing collected =
HA10-HCOMUNTY if HA10 asked in current round.
Otherwise, the most recent type of community collected
will be the most recent HOUS record where
HOUS.HCOMUNTY ^= empty.

Page 59 of 75

HA14
4

Respondent

On MRES where MRES.MRESRND = current round:
A Proxy interview (respondent is a proxy) =
MRES.SPPROXY=2/Proxy.
MRES.RROSTNUM=ROST.ROSTNUM of respondent.
An SP interview (respondent is the SP) =
MRES.SPPROXY=1/SP.
MRES.RROSTNUM='01'.

222

RecentDwelling	

SP's most recent Type of Dwelling collected =
HA1-DWELLING if HA1 asked in current round.
Otherwise, the most recent type of dwelling collected will
be the most recent HOUS record where
HOUS.DWELLING ^= empty.

DESIGN NOTES

10:37:28 PM Thursday, June 25, 2009	

Page 60 of 75

HA15

HA15

Page Order # :

Design Screen Type:

Yes/No

Fields:

Field 1:

CAREPART

Enable Functions:

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:

Add Line
Delete Line

No
No

250

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:
Question display:

Display the most recent Type of Housing collected:
If most recent HOUS.HCOMUNTY = DK or RF, display "this same
place of residence".
Else if most recent HOUS.HCOMUNTY = 6/RetirementApartments,
display "these same (TYPE OF HOUSING)".
Else display "this same (TYPE OF HOUSING)".
TYPE OF HOUSING:
If most recent HOUS.HCOMUNTY = 91/Other, display most recent
Other Specify Response text, HOUS.HCOMUNOS.
Else display most recent HOUS.HCOMUNTY response.

Multi Field display:

Roster/Grid Instructions:
Roster/Grid display:
Report display:

TEXT:
Context Header:
Int. Instr I:

10:37:30 PM Thursday, June 25, 2009

Page 61 of 75

HA15
If (you/he/she) needed substantial care, would that care be provided
in another part of [(this/these) same (TYPE OF HOUSING)/this same
place of residence]?

Question Text:	

Int. Instr II:
INPUT FIELDS / ROUTING
( HAQ1320 )

CAREPART

Field1:	

HOUS.CAREPART

Cheshire Name:
Item Text display:
Item Text:
Label:

Label Position:

Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TYesNoDKRF
1
No
No

Number Label	
1 Yes	
2

FieldSize:
Min Value:
Max Value:
Mask:

Route
HA16 - REQAGE ( HAQ1330 )

English text: YES
No	

HA16 - REQAGE ( HAQ1330 )

English text: NO
Attribute
Don't know

Route
HA16 - REQAGE ( HAQ1330 )

Refusal

HA16 - REQAGE ( HAQ1330 )

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES
223

RecentHousing	

10:37:33 PM Thursday, June 25, 2009	

SP's most recent Type of Housing collected =
HA10-HCOMUNTY if HA10 asked in current round.
Page 62 of 75

HA15
Otherwise, the most recent type of community collected
will be the most recent HOUS record where
HOUS.HCOMUNTY ^= empty.
DESIGN NOTES

10:37:33 PM Thursday, June 25, 2009

Page 63 of 75

HA16

HA16

Page Order # :

Design Screen Type:	

Yes/No

Fields:	

Field 1:

REQAGE

Enable Functions:	

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:	

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:	

Add Line
Delete Line

No
No

260

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:
Question display:	

If SP is the respondent, display "live".
Else display "lives".

Multi Field display:

Roster/Grid Instructions:
Roster/Grid display:
Report display:

TEXT:
Context Header:

Int. Instr I:

Question Text:

Does the place where [you/(SP)] (live/lives) now require residents to

be a certain age to live there or receive services?

Int. Instr II:
INPUT FIELDS / ROUTING

10:37:34 PM Thursday, June 25, 2009	

Page 64 of 75

HA16
( HAQ1330 )

REQAGE

Field1:
Cheshire Name:

HOUS.REQAGE

Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TYesNoDKRF
1
No
No

Number Label
1 Yes
2

FieldSize:
Min Value:
Max Value:
Mask:

Route
BOX HA3 - (HAQ1340 )

English text: YES
No

BOX HA3 - (HAQ1340 )

English text: NO
Attribute
Don't know

Route
BOX HA3 - (HAQ1340 )

Refusal

BOX HA3 - (HAQ1340 )

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES
4

Respondent

On MRES where MRES.MRESRND = current round:
A Proxy interview (respondent is a proxy) =
MRES.SPPROXY=2/Proxy.
MRES.RROSTNUM=ROST.ROSTNUM of respondent.
An SP interview (respondent is the SP) =
MRES.SPPROXY=1/SP.
MRES.RROSTNUM='01'.

10:37:37 PM Thursday, June 25, 2009

Page 65 of 75

HA16
DESIGN NOTES

10:37:37 PM Thursday, June 25, 2009

Page 66 of 75


BOX HA3

BOX HA3

Page Order # :

270

BOX INSTRUCTIONS
( HAQ1340 )	

IF HA5 - HBTHLEVL = 1/Yes OR HA7 - HBATHRM = 1/Yes, GO TO HA18 ­
NBRROOMS ( HAQ1360 ).
ELSE GO TO HA17 - PERSBATH ( HAQ1350 ).

ASSIGNMENTS

TECHNICAL NOTES

DESIGN NOTES

10:37:37 PM Thursday, June 25, 2009	

Page 67 of 75

HA17

HA17

Page Order # :

Design Screen Type:	

Yes/No

Fields:	

Field 1:

PERSBATH

Enable Functions:	

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:	

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:	

Add Line
Delete Line

No
No

280

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:

Question display:

Display "Own" in last sentence in BOLD.


Multi Field display:


Roster/Grid Instructions:

Roster/Grid display:

Report display:


TEXT:

Context Header:
Int. Instr I:
Question Text:

Now I have a few questions about the rooms in [your/(SP’s)] place of
residence.
[Do you/Does (SP)] have (your/his/her) own bathroom facilities?
[EXPLAIN IF NECESSARY: Own bathroom facilities may be defined
as the sink, flush toilet, and bathtub or shower used primarily by
[you/(SP)] and is not used on a regular basis by someone not living
in the household.]

Int. Instr II:
10:37:38 PM Thursday, June 25, 2009	

Page 68 of 75

HA17
INPUT FIELDS / ROUTING
PERSBATH

Field1:
Cheshire Name:

( HAQ1350 )

HOUS.PERSBATH

Item Text display:
Item Text:
Label:

Label Position:

Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TYesNoDKRF
1
No
No

Number Label
1 Yes
2

FieldSize:
Min Value:
Max Value:
Mask:

Route
HA18 - NBRROOMS ( HAQ1360 )

English text: YES
No
English text: NO

Attribute
Don't know

Route
HA18 - NBRROOMS ( HAQ1360 )

Refusal

HA18 - NBRROOMS ( HAQ1360 )

HA18 - NBRROOMS ( HAQ1360 )

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES

DESIGN NOTES

10:37:40 PM Thursday, June 25, 2009

Page 69 of 75

HA18

HA18

Page Order # :

Design Screen Type:

Numeric

Fields:

Field 1:

NBRROOMS

Enable Functions:

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:

Add Line
Delete Line

No
No

290

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:
Question display:

Display the most recent Type of Dwelling collected:
If most recent HOUS.DWELLING = 1/Detached, 2/Duplex or
5/Rowhouse, display "house".
Else if most recent HOUS.DWELLING = 3/Apartment or
6/MotherInLawApartment, display "own apartment or condominium".
Else if most recent HOUS.DWELLING = 4/MobileHome, display
"mobile home".
Else if most recent HOUS.DWELLING = 91/Other or DK, display
"place of residence".

Multi Field display:

Roster/Grid Instructions:
Roster/Grid display:
Report display:

TEXT:
Context Header:

Int. Instr I:

Question Text:

10:37:41 PM Thursday, June 25, 2009

How many rooms are there in [your/(SP’s)] (house/own apartment or
	
condominium/mobile home/place of residence), not counting
Page 70 of 75

HA18
bathrooms, hallways, or unfinished basements?
Int. Instr II:

INPUT FIELDS / ROUTING

NBRROOMS

Field1:
Cheshire Name:

( HAQ1360 )

HOUS.NBRROOMS

Item Text display:
Item Text:
Label:

Label Position:

Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Integer
TNbrooms


FieldSize:

Min Value:
Max Value:
Mask:

1
No
No

Number Label
1 [Continuous answer.]

1
35

Route
HA19 - PERKITCH ( HAQ1370 )

Attribute
Don't know

Route
HA19 - PERKITCH ( HAQ1370 )

Refusal

HA19 - PERKITCH ( HAQ1370 )

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS
NBRROOMS = 1 - 15.

If not true, display message "UNLIKELY RESPONSE. VERIFY AND

REENTER".

HARD EDIT CHECKS

TECHNICAL NOTES
222

RecentDwelling

SP's most recent Type of Dwelling collected =
HA1-DWELLING if HA1 asked in current round.
Otherwise, the most recent type of dwelling collected will
be the most recent HOUS record where
HOUS.DWELLING ^= empty.

DESIGN NOTES
10:37:43 PM Thursday, June 25, 2009

Page 71 of 75

HA18

10:37:43 PM Thursday, June 25, 2009

Page 72 of 75


HA19

HA19

Page Order # :

Design Screen Type:	

Yes/No

Fields:	

Field 1:

PERKITCH

Enable Functions:	

HELP
COMMENTS
JUMPBACK

No
Yes
Yes

Roster Functions:	

Add Item
Edit Item
Delete Item
Search Item

No
No
No
No

Grid Functions:	

Add Line
Delete Line

No
No

300

Roster Name:
Roster Type:

DISPLAY INSTRUCTIONS:
Context header display:

Question display:

Display "Own" in last sentence in BOLD.


Multi Field display:


Roster/Grid Instructions:

Roster/Grid display:

Report display:


TEXT:

Context Header:
Int. Instr I:
Question Text:

[Do you/Does (SP)] have (your/his/her) own kitchen?
[EXPLAIN IF NECESSARY: Own kitchen is defined as an area with
a sink, non-portable cooking equipment and a refrigerator used
primarily by [you/(SP)] and not on a regular basis by someone not
living in the household. Also includes kitchenettes.]

Int. Instr II:

INPUT FIELDS / ROUTING


10:37:44 PM Thursday, June 25, 2009	

Page 73 of 75

HA19
PERKITCH

Field1:
Cheshire Name:

( HAQ1370 )

HOUS.PERKITCH

Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

Enumerated
TYesNoDKRF
1
No
No

Number Label
1 Yes
2

FieldSize:
Min Value:
Max Value:
Mask:

Route
BOX HA4 - (HAQ1375 )

English text: YES
No

BOX HA4 - (HAQ1375 )

English text: NO
Attribute
Don't know

Route
BOX HA4 - (HAQ1375 )

Refusal

BOX HA4 - (HAQ1375 )

BACKGROUND VARIABLE ASSIGNMENTS

SOFT EDIT CHECKS

HARD EDIT CHECKS

TECHNICAL NOTES

DESIGN NOTES

10:37:47 PM Thursday, June 25, 2009

Page 74 of 75

BOX HA4

BOX HA4

Page Order # :

310

BOX INSTRUCTIONS
( HAQ1375 )

GO TO NEXT SECTION .
.

ASSIGNMENTS

TECHNICAL NOTES

DESIGN NOTES

10:37:47 PM Thursday, June 25, 2009

Page 75 of 75


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Authorhubbard_r
File Modified2010-04-02
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