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pdfHH1
HH1
Page Order # :
Design Screen Type:
Yes/No
Fields:
Field 1:
HHPRPROF
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
10
Roster Name:
Roster Type:
DISPLAY INSTRUCTIONS:
Context header display:
Question display:
If SP reported a Home Health visit during the current round, display
"Besides what you already mentioned, [since (REFERENCE
DATE)/between (REFERENCE DATE) and (DATE OF
DEATH/DATE OF INSTITUTIONALIZATION)]".
Else display "[Since (REFERENCE DATE)/Between(REFERENCE
DATE) and (DATE OF DEATH/DATE OF
INSTITUTIONALIZATION)]".
If SP is deceased, display "was (SP)"
Else if proxy interview, display "has (SP) been".
Else display "have you been".
If SP reported a Home Health Professional in Home Health
Summary, display "other".
Else do not display.
Display "at home" in BOLD.
Always display "[Health professionals…]" in brackets.
Multi Field display:
Roster/Grid Instructions:
Roster/Grid display:
Report display:
11:19:56 AM Thursday, February 26, 2009
Page 1 of 92
HH1
TEXT:
Context Header:
Int. Instr I:
SHOW CARD HH1
Question Text:
(Besides what you have already mentioned,) [(Since/since)
(REFERENCE DATE)/(Between/between) (REFERENCE DATE)
and (DATE OF DEATH/DATE OF INSTITUTIONALIZATION)], [have
you been/has (SP) been/was (SP)] helped at home by any (other)
health or medical professionals, such as those listed on this card?
[Health professionals include nurse (visiting nurse, private duty
nurse, etc.), doctor, social worker, therapist, and hospice worker.]
Int. Instr II:
INPUT FIELDS / ROUTING
11:20:04 AM Thursday, February 26, 2009
Page 2 of 92
HH1
( HHQ1010 )
HHPRPROF
Field1:
Cheshire Name:
Item Text display:
HRND.HHPRPROF
Do not display response option 3/IndicatedYesByDataprep.
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Enumerated
TProbe
FieldSize:
Min Value:
Max Value:
Mask:
1
No
No
Number Label
1 Yes
Route
HH2 - PROVIDER_HHP ( HHQ1020 )
2
English text: YES
No
3
English text: NO
IndicatedYesByDataPrep
HH18 - HHPRFRND ( HHQ1310 )
DO NOT DISPLAY.
DATA EDITING ONLY.
English text: INDICATED YES BY DATAPREP
Attribute
Don't know
Route
HH18 - HHPRFRND ( HHQ1310 )
Refusal
HH18 - HHPRFRND ( HHQ1310 )
BACKGROUND VARIABLE ASSIGNMENTS
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
59
SPStatus
SP is Alive and not institutionalized =
MRES.SPALIVE=1/Alive or empty
SP is Alive =
MRES.SPALIVE=1/Alive, 2/AliveAndInstitute, or EMPTY
11:20:12 AM Thursday, February 26, 2009
Page 3 of 92
HH1
SP is Institutionalized =
MRES.SPALIVE=2/AliveAndInstitute
SP is Deceased =
MRES.SPALIVE=3/Deceased.
163
HHCurrentRound
If SP reported a Home Health visit in the current round =
There is an EVNT & HERO where
(HERO.HEROEVNT=EVNT.EVNTNUM &
HERO.HERORND=current round & HERO.HERODFLG
^=1/Yes and (HERO.OTHMEALS^= empty or
HERO.HELPUNIT^=empty)).
164
HHProfAskedAbout
If SP reported a Home Health Professional in Home
Health Summary =
There is an EVNT & HERO where (HERO.HEROEVNT =
EVNT.EVNTNUM & HERO.HERORND = current round &
HERO.HERODFLG ^= 1/Yes & HERO.PROFPROB =
1/Yes).
DESIGN NOTES
11:20:12 AM Thursday, February 26, 2009
Page 4 of 92
HH2
HH2
Page Order # :
Design Screen Type:
Roster
Fields:
Field 1:
PROVIDER_HHP
Enable Functions:
HELP
COMMENTS
JUMPBACK
No
Yes
Yes
Roster Name:
Provider Roster
Roster Type:
Single Item Select
Roster Functions:
Add Item
Edit Item
Delete Item
Search Item
Yes
Yes
No
No
Grid Functions:
Add Line
Delete Line
No
No
20
Display as ' Add a Provider '
Display as ' Edit a Provider '
DISPLAY INSTRUCTIONS:
Context header display:
Question display:
Display "PERSON" in interviewer instructions in BOLD.
Multi Field display:
Roster/Grid Instructions:
Display all Providers except for Providers where
PROV.PROVNUM=01 and 02, which are reserved for PM and OM
events.
Display providers in order of entry.
Display the following providers as protected rows:
1) Providers who have provided home health care during the current
round.
Roster/Grid display:
COL #
HEADER
INSTRUCTIONS
1
Provider Name
Display Provider Name,
PROV.PROVNAME
2
SubProvider Name
If PROV.SUBPROV ^= empty, display
SubProvider name,
PROV.SUBPROV.
Else do not display.
Report display:
TEXT:
11:20:14 AM Thursday, February 26, 2009
Page 5 of 92
HH2
Context Header:
Int. Instr I:
Question Text:
What is the name of the health professional who helped [you/(SP)]
at home [since (REFERENCE DATE)/between (PREVIOUS ROUND
INTERVIEW DATE) and (DATE OF DEATH/DATE OF
INSTITUTIONALIZATION)]?
Int. Instr II:
ENTER NAME OF PERSON WHO HELPED. DO NOT ENTER THE
NAME OF PLACE OR ORGANIZATION.
ADD OR SELECT ONLY ONE PROVIDER.
INPUT FIELDS / ROUTING
Field1:
Cheshire Name:
PROVIDER_HHP
( HHQ1020 )
TEMP
Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
String
TProvPick4
1
No
No
Number Label
1 [Continuous answer.]
FieldSize:
Min Value:
Max Value:
Mask:
4
Route
HH3 - PROVSPEC ( HHQ1030 )
BACKGROUND VARIABLE ASSIGNMENTS
NOTE: The following database instructions will not be stored on PROV until after
determining if PROVIDER works for an organization. If Provider added at HH2 works for an
organization (HH4 - WORKSFOR = 1/OrganizationGiven), we do not store the HH2
Provider Name on PROV.
HH Provider Roster details will be collected on PROV:
PROV key = PROV.PROVBASE + PROV.PROVNUM
PROV.PROVNUM = Number of Provider selected at HH2.
If Provider added at Provider Roster, see PROVIDER ROSTER POP-UP specifications for
pop-up window programming instructions.
Variables populated in Provider Roster Pop-Up Window:
PROV.PROVNUM
PROV.PROVRNDC
Provider number
Round number
11:20:17 AM Thursday, February 26, 2009
Page 6 of 92
HH2
PROV.PROVNAME
Provider name
If Provider added, set provider type as instructed below.
PROVTYPE
If adding a new provider, set PROV.PROVTYPE =
6/HomeHealthProfessionals
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
160
HHProviderCurrRnd
Provider has provided HH care in current round =
For this PROV, there is an EVNT where
(EVNT.EVNTPROV=PROV.PROVNUM) & a HERO
where (HERO.HEROEVNT=EVNT.EVNTNUM &
HERO.HERORND=currend round &
HERO.HERODFLG^=1/Yes & (OTHMEALS ^= empty or
HELPUNIT^=empty)).
DESIGN NOTES
Begin Loop 1: Probe for one provider, one home health visit. Collect event
details for this home health provider visit.
11:20:17 AM Thursday, February 26, 2009
Page 7 of 92
HH3
HH3
Page Order # :
Design Screen Type:
Code 1
Fields:
Field 1:
PROVSPEC
Field 2:
PROVSPOS
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:
Display Provider Name for Home Health provider currently being
asked about, PROV.PROVNAME.
Multi Field display:
Vertical Alignment
Roster/Grid Instructions:
Roster/Grid display:
Report display:
TEXT:
Context Header:
Int. Instr I:
Question Text:
What kind of health professional is (PROVIDER NAME)?
Int. Instr II:
INPUT FIELDS / ROUTING
11:20:27 AM Thursday, February 26, 2009
Page 8 of 92
HH3
11:20:43 AM Thursday, February 26, 2009
Page 9 of 92
HH3
PROVSPEC
Field1:
Cheshire Name:
( HHQ1030 )
PROV.PROVSPEC
Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Enumerated
TProvspec
1
No
No
Number Label
1 Dentist
2
FieldSize:
Min Value:
Max Value:
Mask:
Route
HH4 - WORKSFOR ( HHQ1050 )
English text: DENTIST/DENTAL PROVIDER
MedicalDoctor
HH4 - WORKSFOR ( HHQ1050 )
4
English text: MEDICAL DOCTOR
Audiologist
English text: AUDIOLOGIST
Chiropractor
5
English text: CHIROPRACTOR
ClinicalSocialWorker
HH4 - WORKSFOR ( HHQ1050 )
6
English text: CLINICAL SOCIAL WORKER
Dietitian
HH4 - WORKSFOR ( HHQ1050 )
7
English text: DIETITIAN-NUTRITIONIST
HearingTherapist
HH4 - WORKSFOR ( HHQ1050 )
8
English text: HEARING THERAPIST
HomeHealthAide
HH4 - WORKSFOR ( HHQ1050 )
9
English text: HOME HEALTH/HEALTH AIDE
Homemaker
HH4 - WORKSFOR ( HHQ1050 )
3
HH4 - WORKSFOR ( HHQ1050 )
HH4 - WORKSFOR ( HHQ1050 )
10
English text: HOMEMAKER
HospiceWorker
HH4 - WORKSFOR ( HHQ1050 )
11
English text: HOSPICE WORKER
IvTherapist
HH4 - WORKSFOR ( HHQ1050 )
12
English text: I.V. THERAPIST
Nurse
HH4 - WORKSFOR ( HHQ1050 )
13
English text: NURSE (RN)
NursePractitioner
HH4 - WORKSFOR ( HHQ1050 )
English text: NURSE PRACTITIONER
11:21:11 AM Thursday, February 26, 2009
Page 10 of 92
HH3
14
NursesAide
HH4 - WORKSFOR ( HHQ1050 )
15
English text: NURSE'S AIDE
OccupationalTherapist
HH4 - WORKSFOR ( HHQ1050 )
16
English text: OCCUPATIONAL THERAPIST (OT)
Optometrist
HH4 - WORKSFOR ( HHQ1050 )
17
English text: OPTOMETRIST (OD)
Osteopath
HH4 - WORKSFOR ( HHQ1050 )
18
English text: OSTEOPATH (DO)
Paramedic
HH4 - WORKSFOR ( HHQ1050 )
19
English text: PARAMEDIC
PhysicalTherapist
HH4 - WORKSFOR ( HHQ1050 )
20
English text: PHYSICAL THERAPIST (PT)
PhysiciansAssistant
HH4 - WORKSFOR ( HHQ1050 )
21
English text: PHYSICIAN'S ASSISTANT
Podiatrist
HH4 - WORKSFOR ( HHQ1050 )
22
English text: PODIATRIST (FOOT DOCTOR)
Psychologist
HH4 - WORKSFOR ( HHQ1050 )
23
English text: PSYCHOLOGIST
RespiratoryTherapist
HH4 - WORKSFOR ( HHQ1050 )
25
English text: RESPIRATORY THERAPIST
SocialWorker
English text: SOCIAL/CASE WORKER
SpeechTherapist
HH4 - WORKSFOR ( HHQ1050 )
26
English text: SPEECH THERAPIST
MentalHealth
HH4 - WORKSFOR ( HHQ1050 )
24
HH4 - WORKSFOR ( HHQ1050 )
28
English text: THERAPIST (MENTAL HEALTH)
XrayTechnician
HH4 - WORKSFOR ( HHQ1050 )
English text: X-RAY TECHNICIAN
LicensedPracticalNurse
HH4 - WORKSFOR ( HHQ1050 )
29
English text: LICENSED PRACTICAL NURSE (LPN)
Acupuncturist
HH4 - WORKSFOR ( HHQ1050 )
27
31
English text: ACUPUNCTURIST
Homeopath
English text: HOMEOPATH
MassageTherapist
32
English text: MASSAGE THERAPIST
Naturopath
HH4 - WORKSFOR ( HHQ1050 )
33
English text: NATUROPATH
LicensedCounselor
HH4 - WORKSFOR ( HHQ1050 )
34
English text: LICENSED PROFESSIONAL COUNSELOR [LPC]
LabTechnician
HH4 - WORKSFOR ( HHQ1050 )
30
HH4 - WORKSFOR ( HHQ1050 )
HH4 - WORKSFOR ( HHQ1050 )
English text: LAB TECHNICIAN
11:21:45 AM Thursday, February 26, 2009
Page 11 of 92
HH3
91
Other
HH3 - PROVSPOS ( HHQ1040 )
English text: OTHER MEDICAL PROVIDER SPECIALTY
Attribute
Don't know
Route
HH4 - WORKSFOR ( HHQ1050 )
Refusal
HH4 - WORKSFOR ( HHQ1050 )
Field2:
Cheshire Name:
PROVSPOS
( HHQ1040 )
PROV.PROVSPOS
Item Text display:
Display "(SPECIFY)" in same blue font used for interviewer
instructions.
Item Text:
OTHER MEDICAL PROVIDER (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
HH4 - WORKSFOR ( HHQ1050 )
BACKGROUND VARIABLE ASSIGNMENTS
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
DESIGN NOTES
Called by BOX ST31A and NS31A if HP provider added in ST or NS.
11:21:49 AM Thursday, February 26, 2009
Page 12 of 92
HH4
HH4
Page Order # :
Design Screen Type:
Code 1
Fields:
Field 1:
WORKSFOR
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 Provider Name for Home Health provider currently being
asked about, PROV.PROVNAME.
Multi Field display:
Roster/Grid Instructions:
Roster/Grid display:
Report display:
TEXT:
Context Header:
Int. Instr I:
Question Text:
Who does (PROVIDER NAME) work for, that is, for what place or
organization?
[PROBE: Or does (PROVIDER NAME) work for himself/herself?]
Int. Instr II:
INPUT FIELDS / ROUTING
11:21:51 AM Thursday, February 26, 2009
Page 13 of 92
HH4
WORKSFOR
Field1:
Cheshire Name:
( HHQ1050 )
HERO.WORKSFOR
Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Enumerated
TWorksfor
1
No
No
Number Label
1 OrganizationGiven
2
FieldSize:
Min Value:
Max Value:
Mask:
Route
HH5 - PROVIDER_HHPORG ( HHQ1060 )
English text: NAME OF ORGANIZATION GIVEN
WorksForSelf
BOX HH1AA - (HHQ1065 )
English text: WORKS FOR SELF
Attribute
Don't know
Route
BOX HH1AA - (HHQ1065 )
Refusal
BOX HH1AA - (HHQ1065 )
BACKGROUND VARIABLE ASSIGNMENTS
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
DESIGN NOTES
The purpose of HH4 is to determine if the Home Health Provider selected
earlier (ex: at HH2, HH19 or in ST/NS) works for an organization. If so,
HH4-WORKSFOR = 1/OrganizationGiven, we will then probe for the name
of the organization at the HH5 provider roster. The name of the
organization selected at HH5 will then be the Provider that will get
referenced in the remaining event detail questions in HH.
11:21:56 AM Thursday, February 26, 2009
Page 14 of 92
HH4
The response to HH4 is stored on HERO which is linked to the Home
Health Event. Since the Home Health event records are generated at BOX
HH1AA, the response to HH4 - WORKSFOR will need to be copied to the
HERO generated at BOX HH1AA.
11:21:57 AM Thursday, February 26, 2009
Page 15 of 92
HH5
HH5
Page Order # :
Design Screen Type:
Roster
Fields:
Field 1:
PROVIDER_HHPORG
Enable Functions:
HELP
COMMENTS
JUMPBACK
No
Yes
Yes
Roster Name:
Provider Roster
Roster Type:
Single Item Select
Roster Functions:
Add Item
Edit Item
Delete Item
Search Item
Yes
Yes
No
No
Grid Functions:
Add Line
Delete Line
No
No
50
Display as ' Add a Provider '
Display as ' Edit a Provider '
DISPLAY INSTRUCTIONS:
Context header display:
Question display:
The SP has just reported that the Provider just selected works for
an organization. HH5 will collect the name of this organization. At
HH5, continue to display the Provider Name for the Home Health
provider selected prior to HH5, PROV.PROVNAME.
Always display "Who does (PROVIDER NAME)….]" in brackets.
Multi Field display:
Roster/Grid Instructions:
Display all Providers except for Providers where
PROV.PROVNUM=01 and 02, which are reserved for PM and OM
events.
Display providers in order of entry.
Display the following providers as protected rows:
1) Providers who have provided home health care during the current
round.
Roster/Grid display:
COL #
11:21:58 AM Thursday, February 26, 2009
HEADER
INSTRUCTIONS
1
Provider Name
Display Provider Name,
PROV.PROVNAME.
2
SubProvider Name
If PROV.SUBPROV ^=empty, display
SubProvider name,
PROV.SUBPROV.
Else do not display.
Page 16 of 92
HH5
Report display:
TEXT:
Context Header:
Int. Instr I:
[Who does (PROVIDER NAME) work for, that is, what place or
organization?]
Question Text:
[PROBE: Who would (you/SP) call if (PROVIDER NAME) did not
show up?]
ADD OR SELECT ONLY ONE PROVIDER.
Int. Instr II:
INPUT FIELDS / ROUTING
Field1:
Cheshire Name:
PROVIDER_HHPORG
( HHQ1060 )
TEMP
Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
String
TProvPick4
1
No
No
Number Label
1 [Continuous answer.]
FieldSize:
Min Value:
Max Value:
Mask:
4
Route
BOX HH1AA - (HHQ1065 )
BACKGROUND VARIABLE ASSIGNMENTS
HH Provider Roster details will be collected on PROV:
PROV key = PROV.PROVBASE + PROV.PROVNUM
PROV.PROVNUM = Number of Provider selected at HH5.
If Provider added at Provider Roster, see PROVIDER ROSTER POP-UP specifications for
pop-up window programming instructions.
Variables populated in Provider Roster Pop-Up Window:
PROV.PROVNUM
PROV.PROVRNDC
PROV.PROVNAME
Provider number
Round number
Provider name
11:22:01 AM Thursday, February 26, 2009
Page 17 of 92
HH5
If Provider added, set provider type as instructed below.
Set who works for this provider, PROV.SUBPROV, as the name of the Provider selected
prior to HH5 (ex. at HH2, HH19 or in ST/NS).
If the Provider selected prior to HH5 was added as a new Provider, delete this Provider
record.
See additional instructions below:
PROVTYPE
If Provider added at HH5, set PROV.PROVTYPE =
6/HomeHealthProfessionals.
SUBPROV
PROV.SUBPROV = PROV.PROVNAME for Provider
selected prior to HH5 (ex: HH2, HH19 or in ST/NS).
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
160
HHProviderCurrRnd
Provider has provided HH care in current round =
For this PROV, there is an EVNT where
(EVNT.EVNTPROV=PROV.PROVNUM) & a HERO
where (HERO.HEROEVNT=EVNT.EVNTNUM &
HERO.HERORND=currend round &
HERO.HERODFLG^=1/Yes & (OTHMEALS ^= empty or
HELPUNIT^=empty)).
DESIGN NOTES
At HH5, we are still asking about the Provider selected earlier (ex: at HH2,
HH19, ST, NS, UTS). HH5 probes for the name of the organization that the
Provider works for. The name of the organization selected at HH5 will then
be the Provider Name that will be displayed in the remaining event detail
questions in HH.
11:22:01 AM Thursday, February 26, 2009
Page 18 of 92
BOX HH1AA
BOX HH1AA
11:22:01 AM Thursday, February 26, 2009
Page Order # :
55
Page 19 of 92
BOX HH1AA
BOX INSTRUCTIONS
( HHQ1065 )
IF HH4 - WORKSFOR = 1/OrganizationGiven, SET HOME HEALTH
PROVIDER FOR THIS VISIT TO THE HOME HEALTH ORGANIZATION
SELECTED AT HH5 AND GO TO HH6 - HHPLACE ( HHQ1080 ).
ELSE SET HOME HEALTH PROVIDER FOR THIS VISIT TO THE FIRST
PROVIDER SELECTED AND GO TO BOX HH1BB - (HHQ1102 ).
ASSIGNMENTS
Home Health event details are stored on PROV, EVNT and HERO.
If there is an existing EVNT where EVNT.EVNTTYPE = 'HP' or 'HF' and
EVNT.EVNTPROV=this PROV.PROVNUM, we will collect current round Home Health
event details linked to this existing EVNT. Check against all EVNT records, including
EVNTs where EVNT.EVNTDFLG = 1/Yes.
However, if an existing home health EVNT does not exist for this provider, we will create a
new EVNT.
HH Provider Roster details will be collected on PROV:
PROV key = PROV.PROVBASE + PROV.PROVNUM
PROV.PROVNUM = Number of Provider selected at HH5, if HH2 or HH19 provider worked
for an organization and HH5 asked, otherwise at HH2 or HH19.
Even t details will be collected on EVNT and HERO:
EVNT key = EVNT.EVNTBASE + EVNT.EVNTNUM
EVNT.EVNTNUM = Number of home health EVNT idenitified or created in HH.
HERO key = HERO.HEROBASE + HERO.HEROEVNT + HERO.HERORND
HERO.HEROEVNT = EVNT.EVNTNUM of home health EVNT identified or created in HH.
HERO.HERORND = current round.
If creating a new EVNT for this Home Health visit:
BASE.LASTEVNT holds the highest EVNT.EVNTNUM prior to fielding cases. Not all
EVNT records are fielded. The first time an EVNT record is generated in the field,
BASE.LASTEVNT should be >= to the highest EVNT.EVNTNUM fielded. The new
EVNT.EVNTNUM should be calculated based on BASE.LASTEVNT + 001. Each time an
EVNT record is generated in the field, BASE.LASTEVNT will be updated to match the
highest EVNT.EVNTNUM in the field. Therefore, each time an EVNT record is generated in
the field, the new EVNT.EVNTNUM should be calculated based on BASE.LASTEVNT +
001. See detailed instructions below.
Create a current round HERO for this HH Event. The response to HH4 - WORKSFOR
should be copied to this HERO.WORKSFOR.
Set additional variables as specified below:
EVNTNUM
If adding a new EVNT, set new EVNT.EVNTNUM =
BASE.LASTEVNT + 001. This assumes that
BASE.LASTEVNT is
incremented each time an EVNT record is generated
in the field.
EVNTRNDC
If adding a new EVNT, set EVNT.EVNTRNDC =
current round.
11:22:02 AM Thursday, February 26, 2009
Page 20 of 92
BOX HH1AA
LASTEVNT
If adding a new EVNT, once new EVNT record is
generated, set BASE.LASTEVNT = new
EVNT.EVNTNUM.
EVNTPROV
If adding a new EVNT, if HH4 - WORKSFOR =
1/OrganizationGiven, set
EVNT.EVNTPROV=PROV.PROVNUM of provider
selected at HH5.
Else set EVNT.EVNTPROV = PROV.PROVNUM
selected at HH2, HH19 or in ST or NS.
EVNTTYPE
If adding a new EVNT, set EVNT.EVNTTYPE.
If Provider selected at HH2 or HH5, set
EVNT.EVNTTYPE = 'HP'.
Else set EVNT.EVNTTYPE = 'HF'.
STEVTYPE
If adding a new EVNT, set EVNT.STEVTYPE.
If Provider selected at HH2 or HH5, set
EVNT.STEVTYPE = 8/HP.
Else set EVNT.STEVTYPE = 9/HF.
EVNTDFLG
If EVNT.EVNTDFLG=1/Yes, update
EVNT.EVNTDFLG=EMPTY.
HEROEVNT
Create a new HERO and set
HERO.HEROEVNT=EVNT.EVNTNUM.
HERORND
HERO.HERORND=current round.
WORKSFOR
Copy response from HH4 - WORKSFOR to
HERO.WORKSFOR.
EVCHGFLG
If adding an EVNT, and if currently administering ST
or NS, set
EVNT.EVCHGFLG = 1/Yes.
TECHNICAL NOTES
DESIGN NOTES
11:22:02 AM Thursday, February 26, 2009
Page 21 of 92
HH6
HH6
Page Order # :
Design Screen Type:
Code 1
Fields:
Field 1:
HHPLACE
Field 2:
HHPLACOS
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:
60
Roster Name:
Roster Type:
DISPLAY INSTRUCTIONS:
Context header display:
Question display:
Display Provider Name for Home Health provider currently being
asked about, PROV.PROVNAME.
Multi Field display:
Vertical Alignment
Roster/Grid Instructions:
Roster/Grid display:
Report display:
TEXT:
Context Header:
Int. Instr I:
Question Text:
What kind of place or organization is (PROVIDER NAME)?
Int. Instr II:
INPUT FIELDS / ROUTING
11:22:07 AM Thursday, February 26, 2009
Page 22 of 92
HH6
11:22:23 AM Thursday, February 26, 2009
Page 23 of 92
HH6
HHPLACE
Field1:
PROV.HHPLACE
Cheshire Name:
Item Text display:
( HHQ1080 )
If PROV.HHPLACE has already been filled,
PROV.HHPLACE ^= empty, display previously collected
response and allow it to be updated.
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Enumerated
THhplace
1
No
No
Number Label
1 ManagedCarePlan
FieldSize:
Min Value:
Max Value:
Mask:
Route
BOX HH1BB - (HHQ1102 )
3
English text: MANAGED CARE PLAN (SUCH AS HMO)
MealProgram
HH7 - OTHMEALS ( HHQ1100 )
English text: MEAL PROGRAM (SUCH AS MEALS ON WHEELS)
VisitingNurse
BOX HH1BB - (HHQ1102 )
4
English text: VISITING NURSE ASSOCIATION
HomeHealthAgency
BOX HH1BB - (HHQ1102 )
2
6
English text: HOME HEALTH AGENCY
Hospital
English text: HOSPITAL
PrivatePhysician
7
English text: PRIVATE PHYSICIAN/GROUP PRACTICE
Hospice
BOX HH1BB - (HHQ1102 )
5
BOX HH1BB - (HHQ1102 )
BOX HH1BB - (HHQ1102 )
9
English text: HOSPICE
Rehabilitation
BOX HH1BB - (HHQ1102 )
English text: REHABILITATION OR SPORTS MEDICINE THERAPY
LocalGovernment
BOX HH1BB - (HHQ1102 )
10
English text: LOCAL GOVERNMENT ORGANIZATION
Church
BOX HH1BB - (HHQ1102 )
11
English text: CHURCH OR COMMUNITY ORGANIZATION
RetirementHome
BOX HH1BB - (HHQ1102 )
91
English text: ASSISTED LIVING/RETIREMENT HOME
Other
HH6 - HHPLACOS ( HHQ1090 )
8
English text: OTHER (SPECIFY)
11:22:46 AM Thursday, February 26, 2009
Page 24 of 92
HH6
Attribute
Don't know
Route
BOX HH1BB - (HHQ1102 )
Refusal
BOX HH1BB - (HHQ1102 )
Field2:
Cheshire Name:
Item Text display:
HHPLACOS
( HHQ1090 )
PROV.HHPLACOS
Display "(SPECIFY)" in same blue font used for interviewer
instructions.
If PROV.HHPLACOS has already been filled,
PROV.HHPLACOS ^= empty, display previously collected
response and allow it to be updated.
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
BOX HH1BB - (HHQ1102 )
BACKGROUND VARIABLE ASSIGNMENTS
PROV.HHPLACE may have already been asked prior to HH6. If PROV.HHPLACE was
previously set to 91/Other, and has been changed and the current round response to
PROV.HHPLACE ^= 91/Other, PROV.HHPLACOS needs to be reset to EMPTY. See
additional instructions below.
HHPLACOS
If current response to HH6 - PROV.HHPLACE ^=
91/Other, then HH6 - PROV.HHPLACOS should be
set to empty.
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
11:22:51 AM Thursday, February 26, 2009
Page 25 of 92
HH6
DESIGN NOTES
11:22:51 AM Thursday, February 26, 2009
Page 26 of 92
HH7
HH7
Page Order # :
Design Screen Type:
Yes/No
Fields:
Field 1:
OTHMEALS
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 Provider Name for Home Health provider currently being
asked about, PROV.PROVNAME.
Multi Field display:
Roster/Grid Instructions:
Roster/Grid display:
Report display:
TEXT:
Context Header:
Int. Instr I:
Question Text:
[Between (REFERENCE DATE) and (today/DATE OF DEATH/
DATE OF INSTITUTIONALIZATION)], did (PROVIDER NAME)
provide any services to [you/(SP)] other than delivering meals?
Int. Instr II:
INPUT FIELDS / ROUTING
11:22:53 AM Thursday, February 26, 2009
Page 27 of 92
HH7
OTHMEALS
Field1:
Cheshire Name:
( HHQ1100 )
HERO.OTHMEALS
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 HH1BB - (HHQ1102 )
English text: YES
No
BOX HH1BB - (HHQ1102 )
English text: NO
Attribute
Don't know
Route
BOX HH1BB - (HHQ1102 )
Refusal
BOX HH1BB - (HHQ1102 )
BACKGROUND VARIABLE ASSIGNMENTS
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
DESIGN NOTES
11:22:57 AM Thursday, February 26, 2009
Page 28 of 92
BOX HH1BB
BOX HH1BB
Page Order # :
75
BOX INSTRUCTIONS
( HHQ1102 )
IF TYPE OF HOME HEALTH PROVIDER IS A MEAL PROGRAM THAT DID
NOT PROVIDE ANY OTHER SERVICES BESIDES MEALS, GO TO BOX
HH3 - (HHQ1280 ).
ELSE IF (HOME HEALTH PROVIDER IS A FRIEND OR RELATIVE) OR
(TYPE OF HOME HEALTH PROVIDER IS A LOCAL GOVERNMENT,
CHURCH OR COMMUNITY ORGANIZATION), GO TO HH11 - HELPUNIT (
HHQ1200 ).
ELSE GO TO BOX HH1 - (HHQ1110 ).
ASSIGNMENTS
TECHNICAL NOTES
159
MealsNoOtherServices
HH Provider is a Meal program that did not provide
services besides meals =
For this PROV, there is an EVNT where
(EVNT.EVNTPROV=PROVNUM) & a HERO where
(HERO.HEROEVNT=EVNTNUM &
HERO.HERORND=current round & (HERODFLG^=1/Yes
& OTHMEALS = 2/No,DK,RF)).
157
HHFriendRelative
Home Health provider is a friend or relative =
PROV.HHFTYPE = 1/Friend or 2/Relative.
158
HHProvGovtChurch
Type of Home Health Provider is a local government,
church or community organization =
PROV.HHPLACE = 9/LocalGovernment or 10/Church.
DESIGN NOTES
BOX HH1BB is called from HHS if the SP reports that a Home Health
provider from the previous round is still providing home health care in the
current round.
11:22:57 AM Thursday, February 26, 2009
Page 29 of 92
BOX HH1
BOX HH1
Page Order # :
80
BOX INSTRUCTIONS
( HHQ1110 )
IF (SP REPORTED RECEIVING HEALTH CARE SERVICES THROUGH V.A.
IN THE CURRENT ROUND OR ANY PREVIOUS ROUND) AND (IF THIS
PROVIDER IS ASSOCIATED WITH V.A. IS UNKNOWN), GO TO HH8 VAPLACE ( HHQ1130 ).
ELSE GO TO BOX HH1A - (HHQ1150 ).
ASSIGNMENTS
TECHNICAL NOTES
423
SPReceivedCaretThruV
A
SP reported receiving health care services through V.A.in
the current or any previous round =
There is an HRND where HRND.HRNDRND = current
round and HRND.VACOVER = 1/Yes.
HRND.VACOVER is set at BOX HI20 or collected at HI36.
127
ProviderVAUnknown
If Provider is associated with V.A. is unknown =
PROV.VAPLACE = empty.
DESIGN NOTES
11:22:57 AM Thursday, February 26, 2009
Page 30 of 92
HH8
HH8
Page Order # :
Design Screen Type:
Yes/No
Fields:
Field 1:
VAPLACE
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:
Display Provider Name for Home Health provider currently being
asked about, PROV.PROVNAME.
If someone works for this provider, display "(PROVIDER NAME)".
Else display "(PROVIDER NAME) associated with".
Multi Field display:
Roster/Grid Instructions:
Roster/Grid display:
Report display:
TEXT:
Context Header:
Int. Instr I:
Question Text:
Is [(PROVIDER NAME) associated with/(PROVIDER NAME)] a
Department of Veterans Affairs, or V.A., facility?
Int. Instr II:
INPUT FIELDS / ROUTING
11:23:00 AM Thursday, February 26, 2009
Page 31 of 92
HH8
VAPLACE
Field1:
Cheshire Name:
( HHQ1130 )
PROV.VAPLACE
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 HH1A - (HHQ1150 )
English text: YES
No
BOX HH1A - (HHQ1150 )
English text: NO
Attribute
Don't know
Route
BOX HH1A - (HHQ1150 )
Refusal
BOX HH1A - (HHQ1150 )
BACKGROUND VARIABLE ASSIGNMENTS
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
166
SomeoneWorksForProv If someone works for this Provider =
PROV.SUBPROV ^= empty.
DESIGN NOTES
11:23:05 AM Thursday, February 26, 2009
Page 32 of 92
BOX HH1A
BOX HH1A
11:23:05 AM Thursday, February 26, 2009
Page Order # :
120
Page 33 of 92
BOX HH1A
BOX INSTRUCTIONS
( HHQ1150 )
IF (SP COVERED BY A MANAGED CARE PLAN ANYTIME DURING THE
CURRENT ROUND) AND (IF THIS PROVIDER IS ASSOCIATED WITH A
MANAGED CARE PLAN IS UNKNOWN), GO TO HH10A - HMOASSOC (
HHQ1160 ).
ELSE IF (SP COVERED BY A MANAGED CARE PLAN ANYTIME DURING
THE CURRENT ROUND) AND (THIS PROVIDER IS NOT ASSOCIATED
WITH A MANAGED CARE PLAN), GO TO HH10B - HMOREFER ( HHQ1170
).
ELSE GO TO HH11 - HELPUNIT ( HHQ1200 ).
ASSIGNMENTS
TECHNICAL NOTES
52
DeletedPlans
Deleted plans that are not valid for displays or checks =
Any PLAN where (PLAN.PLANDFLG=1/Yes or
PLAN.MHMODFLG=1/Yes or PLAN.PLANHIDE=1/Yes or
PLAN.LOSEPLFG ^=EMPTY) is a deleted PLAN.
2
ManagedCarePlan
SP covered by a Managed Care Plan anytime during
current round =
There is a PLRO.PLROPLAN=PLAN.PLANUM &
PLRO.PLRORND=current round &
((PLRO.PPRVHMO=1/Yes) or (PLAN.PLANTYPE =
5/MHMO & PLRO.COVANYTM=1/Yes) or
(PLRO.MCAIDHMO=1/Yes)). See T.N. 52.
128
ProviderHMOUnknown
If Provider is associated with a Managed Care plan is
unknown =
PROV.HMOASSOC=empty.
130
ProviderNotHMO
Provider is not associated with a Managed Care plan =
PROV.HMOASSOC=2/No, DK, or RF.
129
ProviderAssocHMO
Provider is associated with a Managed Care plan =
PROV.HMOASSOC=1/Yes.
DESIGN NOTES
If the SP belongs to a managed care plan (HMO), we ask each provider
selected/added if the provider is associated with an HMO. This question,
which is asked throughout utilization and cost series, is only asked once
in the study for each provider. The response is never updated. (this
design may change in the future).
If the SP belongs to an HMO, and we have not asked this question for this
provider, HMOASSOC=empty, you are routed to HMOASSOC. If we have
already asked this question about this provider, and the provider
responded to HMOASSOC=No, DK or RF, you are routed to
HMOREFER, skipping HMOASSOC, to determine if the SP was referred
to this provider by their HMO.
If SP does not belong to an HMO or this provider already reported being
associated with the HMO, you skip HMOASSOC and HMOREFER.
11:23:05 AM Thursday, February 26, 2009
Page 34 of 92
HH10A
HH10A
Page Order # :
Design Screen Type:
Yes/No
Fields:
Field 1:
HMOASSOC
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 Provider Name for Home Health provider currently being
asked about, PROV.PROVNAME.
Multi Field display:
Roster/Grid Instructions:
Roster/Grid display:
Report display:
Display all managed care plans SP was covered by anytime during
the current round.
Display managed care plan name(s) below question text.
Display plans in the following order: Medicare Managed Care plans,
Medicaid Managed Care plans, and Private Managed Care plans. If
there is more than one plan for any specific plan type, display in
order of entry.
Column 1, header = "MANAGED CARE PLANS".
Column 1, display= If Medicaid Managed Care Plan, display
"Medicaid Managed Care Plan".
Else display health insurance plan name "(PLAN NAME) Managed
Care Plan".
TEXT:
Context Header:
11:23:08 AM Thursday, February 26, 2009
Page 35 of 92
HH10A
Int. Instr I:
Is (PROVIDER NAME) associated with [your/(SP’s)] [READ
MANAGED CARE PLAN NAME(S) BELOW] plan?
Question Text:
Int. Instr II:
INPUT FIELDS / ROUTING
HMOASSOC
Field1:
Cheshire Name:
( HHQ1160 )
PROV.HMOASSOC
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
HH11 - HELPUNIT ( HHQ1200 )
English text: YES
No
HH10B - HMOREFER ( HHQ1170 )
English text: NO
Attribute
Don't know
Route
HH10B - HMOREFER ( HHQ1170 )
Refusal
HH10B - HMOREFER ( HHQ1170 )
BACKGROUND VARIABLE ASSIGNMENTS
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
52
DeletedPlans
11:23:13 AM Thursday, February 26, 2009
Deleted plans that are not valid for displays or checks =
Page 36 of 92
HH10A
Any PLAN where (PLAN.PLANDFLG=1/Yes or
PLAN.MHMODFLG=1/Yes or PLAN.PLANHIDE=1/Yes or
PLAN.LOSEPLFG ^=EMPTY) is a deleted PLAN.
2
ManagedCarePlan
SP covered by a Managed Care Plan anytime during
current round =
There is a PLRO.PLROPLAN=PLAN.PLANUM &
PLRO.PLRORND=current round &
((PLRO.PPRVHMO=1/Yes) or (PLAN.PLANTYPE =
5/MHMO & PLRO.COVANYTM=1/Yes) or
(PLRO.MCAIDHMO=1/Yes)). See T.N. 52.
107
PlanIsMCaidHMO
SP is covered by a Medicaid Managed Care Plan during
the current round =
There is a PLAN where PLAN.PLANTYPE=2/Medicaid &
PLRO where (PLRO.PLROPLAN=PLAN.PLANNUM &
PLRO.PLRORND=current round &
PLRO.MCAIDHMO=1/Yes).
Exclude Deleted Plans. See T.N. 52.
111
PlanIsMCareHMO
SP is covered by a Medicare Managed Care Plan during
the current round =
There is a PLAN where PLAN.PLANTYPE=5/MHMO &
PLRO where (PLRO.PLROPLAN=PLAN.PLANNUM &
PLRO.PLRORND=current round &
PLRO.COVANYTM=1/Yes).
Exclude Deleted Plans. See T.N. 52.
112
PlanIsPrivateHMO
SP is covered by a Private Managed Care Plan during
the current round =
There is a PLAN where PLAN.PLANTYPE=4/PrivatePlan
& PLRO where (PLRO.PLROPLAN=PLAN.PLANNUM &
PLRO.PLRORND=current round &
PLRO.PPRVHMO=1/Yes).
Exclude Deleted Plans. See T.N. 52.
106
HIPlanName
Health Insurance Plan Roster is stored on PLAN.
Plan name = PLAN.PLNAME.
DESIGN NOTES
11:23:15 AM Thursday, February 26, 2009
Page 37 of 92
HH10B
HH10B
Page Order # :
Design Screen Type:
Yes/No
Fields:
Field 1:
HMOREFER
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
140
Roster Name:
Roster Type:
DISPLAY INSTRUCTIONS:
Context header display:
Question display:
Display Provider Name for Home Health provider currently being
asked about, PROV.PROVNAME.
Multi Field display:
Roster/Grid Instructions:
Roster/Grid display:
Report display:
Display all managed care plans SP was covered by anytime during
the current round.
Display managed care plan name(s) below question text.
Display plans in the following order: Medicare Managed Care plans,
Medicaid Managed Care plans, and Private Managed Care plans. If
there is more than one plan for any specific plan type, display in
order of entry.
Column 1, header = "MANAGED CARE PLANS".
Column 1, display= If Medicaid Managed Care Plan, display
"Medicaid Managed Care Plan".
Else display health insurance plan name "(PLAN NAME) Managed
Care Plan".
TEXT:
Context Header:
11:23:18 AM Thursday, February 26, 2009
Page 38 of 92
HH10B
Int. Instr I:
[Were you/Was (SP)] referred to (PROVIDER NAME) by [READ
MANAGED CARE PLAN NAME(S) BELOW]?
Question Text:
Int. Instr II:
INPUT FIELDS / ROUTING
HMOREFER
Field1:
Cheshire Name:
( HHQ1170 )
EVNT.HMOREFER
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
HH11 - HELPUNIT ( HHQ1200 )
English text: YES
No
HH10D - NOGOHMO ( HHQ1180 )
English text: NO
Attribute
Don't know
Route
HH11 - HELPUNIT ( HHQ1200 )
Refusal
HH11 - HELPUNIT ( HHQ1200 )
BACKGROUND VARIABLE ASSIGNMENTS
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
52
DeletedPlans
11:23:23 AM Thursday, February 26, 2009
Deleted plans that are not valid for displays or checks =
Page 39 of 92
HH10B
Any PLAN where (PLAN.PLANDFLG=1/Yes or
PLAN.MHMODFLG=1/Yes or PLAN.PLANHIDE=1/Yes or
PLAN.LOSEPLFG ^=EMPTY) is a deleted PLAN.
2
ManagedCarePlan
SP covered by a Managed Care Plan anytime during
current round =
There is a PLRO.PLROPLAN=PLAN.PLANUM &
PLRO.PLRORND=current round &
((PLRO.PPRVHMO=1/Yes) or (PLAN.PLANTYPE =
5/MHMO & PLRO.COVANYTM=1/Yes) or
(PLRO.MCAIDHMO=1/Yes)). See T.N. 52.
107
PlanIsMCaidHMO
SP is covered by a Medicaid Managed Care Plan during
the current round =
There is a PLAN where PLAN.PLANTYPE=2/Medicaid &
PLRO where (PLRO.PLROPLAN=PLAN.PLANNUM &
PLRO.PLRORND=current round &
PLRO.MCAIDHMO=1/Yes).
Exclude Deleted Plans. See T.N. 52.
111
PlanIsMCareHMO
SP is covered by a Medicare Managed Care Plan during
the current round =
There is a PLAN where PLAN.PLANTYPE=5/MHMO &
PLRO where (PLRO.PLROPLAN=PLAN.PLANNUM &
PLRO.PLRORND=current round &
PLRO.COVANYTM=1/Yes).
Exclude Deleted Plans. See T.N. 52.
112
PlanIsPrivateHMO
SP is covered by a Private Managed Care Plan during
the current round =
There is a PLAN where PLAN.PLANTYPE=4/PrivatePlan
& PLRO where (PLRO.PLROPLAN=PLAN.PLANNUM &
PLRO.PLRORND=current round &
PLRO.PPRVHMO=1/Yes).
Exclude Deleted Plans. See T.N. 52.
106
HIPlanName
Health Insurance Plan Roster is stored on PLAN.
Plan name = PLAN.PLNAME.
DESIGN NOTES
11:23:23 AM Thursday, February 26, 2009
Page 40 of 92
HH10D
HH10D
Page Order # :
Design Screen Type:
Code 1
Fields:
Field 1:
NOGOHMO
Field 2:
NOGOHMOS
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:
155
Roster Name:
Roster Type:
DISPLAY INSTRUCTIONS:
Context header display:
Question display:
Multi Field display:
Vertical Alignment
Roster/Grid Instructions:
Roster/Grid display:
Report display:
Display all managed care plans SP was covered by anytime during
the current round.
Display managed care plan name(s) below question text.
Display plans in the following order: Medicare Managed Care plans,
Medicaid Managed Care plans, and Private Managed Care plans. If
there is more than one plan for any specific plan type, display in
order of entry.
Column 1, header = "MANAGED CARE PLANS".
Column 1, display= If Medicaid Managed Care Plan, display
"Medicaid Managed Care Plan".
Else display health insurance plan name "(PLAN NAME) Managed
Care Plan".
TEXT:
Context Header:
11:23:28 AM Thursday, February 26, 2009
Page 41 of 92
HH10D
Int. Instr I:
Question Text:
What is the most important reason [you/(SP)] did not see a home
health provider associated with [READ MANAGED CARE PLAN
NAME(S) BELOW] or a home health provider that [READ
MANAGED CARE PLAN NAME(S) BELOW] would refer [you/(SP)]
to?
Int. Instr II:
SCROLL DOWN TO SEE RESPONSE CATEGORIES.
INPUT FIELDS / ROUTING
11:23:36 AM Thursday, February 26, 2009
Page 42 of 92
HH10D
NOGOHMO
Field1:
Cheshire Name:
Item Text display:
( HHQ1180 )
EVNT.NOGOHMO
Display responses in one column.
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Enumerated
Tnogohmo
1
No
No
Number Label
1 PlanNotCoverService
2
FieldSize:
Min Value:
Max Value:
Mask:
Route
HH11 - HELPUNIT ( HHQ1200 )
English text: PLAN DOES NOT COVER THE SERVICE SP WANTED
DifficultyDelayGettingService
HH11 - HELPUNIT ( HHQ1200 )
4
English text: DIFFICULTY OR DELAY IN GETTING SERVICES
SPProviderPreference
HH11 - HELPUNIT ( HHQ1200 )
English text: SP PROVIDER PREFERENCE
ServiceCoverdbyOtherInsurance
HH11 - HELPUNIT ( HHQ1200 )
5
English text: THIS SERVICE WAS COVERED BY OTHER INSURANCE SP HAS
NotinManagedCareTimeofEvent
HH11 - HELPUNIT ( HHQ1200 )
6
English text: NOT IN A MANAGED CARE PLAN AT TIME OF EVENT
NoChoiceMedEmergency
HH11 - HELPUNIT ( HHQ1200 )
3
91
English text: NO CHOICE - MEDICAL EMERGENCY OR OUT OF SERVICE AREA
Other
HH10D - NOGOHMOS ( HHQ1190 )
English text: OTHER
Attribute
Don't know
Route
HH11 - HELPUNIT ( HHQ1200 )
Refusal
HH11 - HELPUNIT ( HHQ1200 )
11:23:51 AM Thursday, February 26, 2009
Page 43 of 92
HH10D
NOGOHMOS
Field2:
Cheshire Name:
( HHQ1190 )
EVNT.NOGOHMOS
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
FieldSize:
Min Value:
Max Value:
Mask:
1
No
No
Number Label
1 [Continuous answer.]
30
Route
HH11 - HELPUNIT ( HHQ1200 )
BACKGROUND VARIABLE ASSIGNMENTS
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
52
DeletedPlans
Deleted plans that are not valid for displays or checks =
Any PLAN where (PLAN.PLANDFLG=1/Yes or
PLAN.MHMODFLG=1/Yes or PLAN.PLANHIDE=1/Yes or
PLAN.LOSEPLFG ^=EMPTY) is a deleted PLAN.
2
ManagedCarePlan
SP covered by a Managed Care Plan anytime during
current round =
There is a PLRO.PLROPLAN=PLAN.PLANUM &
PLRO.PLRORND=current round &
((PLRO.PPRVHMO=1/Yes) or (PLAN.PLANTYPE =
5/MHMO & PLRO.COVANYTM=1/Yes) or
(PLRO.MCAIDHMO=1/Yes)). See T.N. 52.
107
PlanIsMCaidHMO
SP is covered by a Medicaid Managed Care Plan during
the current round =
There is a PLAN where PLAN.PLANTYPE=2/Medicaid &
PLRO where (PLRO.PLROPLAN=PLAN.PLANNUM &
PLRO.PLRORND=current round &
PLRO.MCAIDHMO=1/Yes).
Exclude Deleted Plans. See T.N. 52.
11:23:53 AM Thursday, February 26, 2009
Page 44 of 92
HH10D
111
PlanIsMCareHMO
SP is covered by a Medicare Managed Care Plan during
the current round =
There is a PLAN where PLAN.PLANTYPE=5/MHMO &
PLRO where (PLRO.PLROPLAN=PLAN.PLANNUM &
PLRO.PLRORND=current round &
PLRO.COVANYTM=1/Yes).
Exclude Deleted Plans. See T.N. 52.
112
PlanIsPrivateHMO
SP is covered by a Private Managed Care Plan during
the current round =
There is a PLAN where PLAN.PLANTYPE=4/PrivatePlan
& PLRO where (PLRO.PLROPLAN=PLAN.PLANNUM &
PLRO.PLRORND=current round &
PLRO.PPRVHMO=1/Yes).
Exclude Deleted Plans. See T.N. 52.
106
HIPlanName
Health Insurance Plan Roster is stored on PLAN.
Plan name = PLAN.PLNAME.
DESIGN NOTES
11:23:53 AM Thursday, February 26, 2009
Page 45 of 92
HH11
HH11
Page Order # :
Design Screen Type:
Quantity Unit
Fields:
Field 1:
HELPUNIT
Field 2:
HELPNUM
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:
If someone works for this Provider, display "someone from
(PROVIDER NAME)".
Else display "(PROVIDER NAME)".
If someone works for this Provider, display "[Remember to include
all home health providers from (PROVIDER NAME)]". Always
display this sentence in brackets.
Else do not display.
Display Provider Name for Home Health provider currently being
asked about, PROV.PROVNAME.
If SP is alive and not institutionalized, display "has".
Else display "did."
Multi Field display:
Vertical Alignment
Roster/Grid Instructions:
Roster/Grid display:
Report display:
TEXT:
11:23:57 AM Thursday, February 26, 2009
Page 46 of 92
HH11
Context Header:
Int. Instr I:
[Between (REFERENCE DATE) and (today/DATE OF DEATH/
DATE OF INSTITUTIONALIZATION)], how many times (has/did)
[(PROVIDER NAME)/someone from (PROVIDER NAME)] come to
the home to help [you/(SP)]? [Remember to include all home health
providers from (PROVIDER NAME).]
Question Text:
Int. Instr II:
INPUT FIELDS / ROUTING
HELPUNIT
Field1:
Cheshire Name:
( HHQ1200 )
HERO.HELPUNIT
Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Enumerated
TTimeunit
1
No
No
Number Label
1 NumberOfTimes
English text: TOTAL NUMBER OF TIMES
2 TimesPerDay
FieldSize:
Min Value:
Max Value:
Mask:
Route
HH11 - HELPNUM ( HHQ1210 )
HH11 - HELPNUM ( HHQ1210 )
3
English text: NUMBER OF TIMES PER DAY
TimesPerWeek
4
English text: NUMBER OF TIMES PER WEEK
TimesPerMonth
HH11 - HELPNUM ( HHQ1210 )
HH11 - HELPNUM ( HHQ1210 )
English text: NUMBER OF TIMES PER MONTH
Attribute
Don't know
Route
HH12 - STAYUNIT ( HHQ1220 )
Refusal
HH12 - STAYUNIT ( HHQ1220 )
11:24:06 AM Thursday, February 26, 2009
Page 47 of 92
HH11
( HHQ1210 )
HELPNUM
Field2:
Cheshire Name:
HERO.HELPNUM
Item Text display:
Item Text:
Label:
Label Position:
NUMBER OF TIMES:
Left
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Integer
TTimenum
FieldSize:
Min Value:
Max Value:
Mask:
1
No
No
Number Label
1 [Continuous answer.]
1
999
Route
HH12 - STAYUNIT ( HHQ1220 )
BACKGROUND VARIABLE ASSIGNMENTS
SOFT EDIT CHECKS
Edit #1
If HELPUNIT = 1/NumberofTimes, then HELPNUM = 1-150.
Else if HELPUNIT = 2/TimesPerDay, then HELPNUM = 1-5.
Else if HELPUNIT = 3/TimesPerWeek, then HELPNUM = 1-35.
Else if HELPUNIT = 4/TimesPerMonth, then HELPNUM = 1-150.
If not true, display message: "THE AMOUNT ENTERED SEEMS
UNLIKELY. PLEASE VERIFY.".
HARD EDIT CHECKS
Edit #1
If HELPUNIT = 1/NumberofTimes, then HELPNUM = 1-365.
Else if HELPUNIT = 2/TimesPerDay, then HELPNUM = 1-8.
Else if HELPUNIT = 3/TimesPerWeek, then HELPNUM = 1-50.
Else if HELPUNIT = 4/TimesPerMonth, then HELPNUM = 1-200
If not true, display message: "INVALID RESPONSE. ENTRY NOT IN
RANGE. PLEASE REENTER."
TECHNICAL NOTES
59
SPStatus
SP is Alive and not institutionalized =
MRES.SPALIVE=1/Alive or empty
SP is Alive =
MRES.SPALIVE=1/Alive, 2/AliveAndInstitute, or EMPTY
SP is Institutionalized =
MRES.SPALIVE=2/AliveAndInstitute
11:24:08 AM Thursday, February 26, 2009
Page 48 of 92
HH11
SP is Deceased =
MRES.SPALIVE=3/Deceased.
166
SomeoneWorksForProv
If someone works for this Provider =
PROV.SUBPROV ^= empty.
DESIGN NOTES
11:24:08 AM Thursday, February 26, 2009
Page 49 of 92
HH12
HH12
Page Order # :
Design Screen Type:
Quantity Unit
Fields:
Field 1:
STAYUNIT
Field 2:
STAYHOUR
Field 3:
STAYMIN
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:
170
Roster Name:
Roster Type:
DISPLAY INSTRUCTIONS:
Context header display:
Question display:
Display Provider Name for Home Health provider currently being
asked about, PROV.PROVNAME.
If someone works for this provider, display "someone from
(PROVIDER NAME)".
Else display "(PROVIDER NAME)".
If Home Health provider only visited the SP once during the
specified reference period, HH11- HELPUNIT = 1/NumberOfTimes
and HH11 - HELPNUM = 1, display "How long did".
Else if SP is deceased or institutionalized, display "Generally
speaking, how long did.."
Else display "Generally speaking, how long does".
Display "in general" in last sentence in BOLD.
Multi Field display:
Vertical Alignment
Roster/Grid Instructions:
Roster/Grid display:
Report display:
11:24:12 AM Thursday, February 26, 2009
Page 50 of 92
HH12
TEXT:
Context Header:
Int. Instr I:
(Generally speaking, how long did/Generally speaking, how long
does/How long did)[PROVIDER NAME)/someone from (PROVIDER
NAME)] stay with [you/(SP)]? [INCLUDE TIME SPENT SHOPPING
OR RUNNING ERRANDS.]
Question Text:
[PROBE: We just need to know in general.]
Int. Instr II:
INPUT FIELDS / ROUTING
STAYUNIT
Field1:
Cheshire Name:
( HHQ1220 )
HERO.STAYUNIT
Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Enumerated
TLongunit
1
No
No
Number Label
1 HoursOnly
FieldSize:
Min Value:
Max Value:
Mask:
Route
HH12 - STAYHOUR ( HHQ1230 )
2
English text: HOURS ONLY
MinutesOnly
HH12 - STAYMIN ( HHQ1240 )
3
English text: MINUTES ONLY
HoursAndMinutes
HH12 - STAYHOUR ( HHQ1230 )
English text: HOURS AND MINUTES
Attribute
Don't know
Route
HH13 - NEEDNURS ( HHQ1250 )
Refusal
HH13 - NEEDNURS ( HHQ1250 )
11:24:20 AM Thursday, February 26, 2009
Page 51 of 92
HH12
Field2:
Cheshire Name:
STAYHOUR
( HHQ1230 )
HERO.STAYHOUR
Item Text display:
Item Text:
Label:
Label Position:
HOURS:
Left
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Integer
TLonghour
1
No
No
Number Label
1 [Continuous answer.]
FieldSize:
Min Value:
Max Value:
Mask:
1
24
Route
If HH12 - STAYUNIT = 1/HoursOnly, go to
HH13 - NEEDNURS.
Else go to HH12 - STAYMIN.
Field3:
Cheshire Name:
STAYMIN
( HHQ1240 )
HERO.STAYMIN
Item Text display:
Item Text:
Label:
Label Position:
MINUTES:
Left
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Integer
TStaymin
1
No
No
Number Label
1 [Continuous answer.]
FieldSize:
Min Value:
Max Value:
Mask:
1
59
Route
HH13 - NEEDNURS ( HHQ1250 )
BACKGROUND VARIABLE ASSIGNMENTS
11:24:22 AM Thursday, February 26, 2009
Page 52 of 92
HH12
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
59
SPStatus
SP is Alive and not institutionalized =
MRES.SPALIVE=1/Alive or empty
SP is Alive =
MRES.SPALIVE=1/Alive, 2/AliveAndInstitute, or EMPTY
SP is Institutionalized =
MRES.SPALIVE=2/AliveAndInstitute
SP is Deceased =
MRES.SPALIVE=3/Deceased.
166
SomeoneWorksForProv
If someone works for this Provider =
PROV.SUBPROV ^= empty.
DESIGN NOTES
11:24:22 AM Thursday, February 26, 2009
Page 53 of 92
HH13
HH13
Page Order # :
Design Screen Type:
Yes/No
Fields:
Field 1:
NEEDNURS
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:
Display Provider Name for Home Health provider currently being
asked about, PROV.PROVNAME.
If someone works for this provider, display "(PROVIDER NAME)".
Else display "(PROVIDER NAME) associated with".
If Home Health provider only visited the SP once time during the
specified reference period, HH11- HELPUNIT = 1/NumberOfTimes
and HH11 - HELPNUM = 1, display "Did".
Else if SP is deceased or institutionalized, display "Generally
speaking, did.."
Else display "Generally speaking, does".
Display "in general" in last sentence in BOLD.
Multi Field display:
Roster/Grid Instructions:
Roster/Grid display:
Report display:
TEXT:
Context Header:
11:24:25 AM Thursday, February 26, 2009
Page 54 of 92
HH13
Int. Instr I:
SHOW CARD HH2
Question Text:
(Generally speaking, did/Generally speaking, does/Did)
[(PROVIDER NAME)/someone from (PROVIDER NAME)] help
[you/(SP)] by giving any medical or nursing treatment, such as the
things shown on this card? ["MEDICAL OR NURSING
TREATMENT" MEANS SUCH THINGS AS APPLYING STERILE
BANDAGES OR DRESSINGS, GIVING MEDICATIONS, TAKING
BLOOD PRESSURE, GIVING SHOTS OR INJECTIONS.]
[PROBE: We just need to know in general.]
Int. Instr II:
INPUT FIELDS / ROUTING
NEEDNURS
Field1:
Cheshire Name:
( HHQ1250 )
HERO.NEEDNURS
Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Enumerated
THelpnurs
1
No
No
Number Label
1 YesAtLeastOne
2
English text: YES, AT LEAST ONE
No
FieldSize:
Min Value:
Max Value:
Mask:
Route
HH14 - NEEDMEAL ( HHQ1260 )
HH14 - NEEDMEAL ( HHQ1260 )
English text: NO
Attribute
Don't know
Route
HH14 - NEEDMEAL ( HHQ1260 )
Refusal
HH14 - NEEDMEAL ( HHQ1260 )
BACKGROUND VARIABLE ASSIGNMENTS
SOFT EDIT CHECKS
11:24:30 AM Thursday, February 26, 2009
Page 55 of 92
HH13
HARD EDIT CHECKS
TECHNICAL NOTES
59
SPStatus
SP is Alive and not institutionalized =
MRES.SPALIVE=1/Alive or empty
SP is Alive =
MRES.SPALIVE=1/Alive, 2/AliveAndInstitute, or EMPTY
SP is Institutionalized =
MRES.SPALIVE=2/AliveAndInstitute
SP is Deceased =
MRES.SPALIVE=3/Deceased.
166
SomeoneWorksForProv
If someone works for this Provider =
PROV.SUBPROV ^= empty.
DESIGN NOTES
11:24:30 AM Thursday, February 26, 2009
Page 56 of 92
HH14
HH14
Page Order # :
Design Screen Type:
Yes/No
Fields:
Field 1:
NEEDMEAL
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:
Display Provider Name for Home Health provider currently being
asked about, PROV.PROVNAME.
If someone works for this provider, display "(PROVIDER NAME)".
Else display "(PROVIDER NAME) associated with".
If Home Health provider only visited the SP once time during the
specified reference period, HH11- HELPUNIT = 1/NumberOfTimes
and HH11 - HELPNUM = 1, display "Did".
Else if SP is deceased or institutionalized, display "Generally
speaking, did.."
Else display "Generally speaking, does".
Display "in general" in last sentence in BOLD.
Multi Field display:
Roster/Grid Instructions:
Roster/Grid display:
Report display:
TEXT:
Context Header:
11:24:33 AM Thursday, February 26, 2009
Page 57 of 92
HH14
Int. Instr I:
SHOW CARD HH3
Question Text:
(Generally speaking, did/Generally speaking, does/Did)
[(PROVIDER NAME)/someone from (PROVIDER NAME)] help with
[your/(SP’s)] daily needs by doing things, such as the ones shown
on this card? [HELP WITH DAILY NEEDS MEANS HELP IN USING
THE TELEPHONE, DOING HOUSEWORK, PREPARING MEALS.]
[PROBE: We just need to know in general.]
Int. Instr II:
INPUT FIELDS / ROUTING
NEEDMEAL
Field1:
Cheshire Name:
( HHQ1260 )
HERO.NEEDMEAL
Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Enumerated
THelpnurs
1
No
No
Number Label
1 YesAtLeastOne
2
English text: YES, AT LEAST ONE
No
FieldSize:
Min Value:
Max Value:
Mask:
Route
HH15 - NEEDCARE ( HHQ1270 )
HH15 - NEEDCARE ( HHQ1270 )
English text: NO
Attribute
Don't know
Route
HH15 - NEEDCARE ( HHQ1270 )
Refusal
HH15 - NEEDCARE ( HHQ1270 )
BACKGROUND VARIABLE ASSIGNMENTS
SOFT EDIT CHECKS
HARD EDIT CHECKS
11:24:38 AM Thursday, February 26, 2009
Page 58 of 92
HH14
TECHNICAL NOTES
59
SPStatus
SP is Alive and not institutionalized =
MRES.SPALIVE=1/Alive or empty
SP is Alive =
MRES.SPALIVE=1/Alive, 2/AliveAndInstitute, or EMPTY
SP is Institutionalized =
MRES.SPALIVE=2/AliveAndInstitute
SP is Deceased =
MRES.SPALIVE=3/Deceased.
166
SomeoneWorksForProv
If someone works for this Provider =
PROV.SUBPROV ^= empty.
DESIGN NOTES
11:24:38 AM Thursday, February 26, 2009
Page 59 of 92
HH15
HH15
Page Order # :
Design Screen Type:
Yes/No
Fields:
Field 1:
NEEDCARE
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
200
Roster Name:
Roster Type:
DISPLAY INSTRUCTIONS:
Context header display:
Question display:
Display Provider Name for Home Health provider currently being
asked about, PROV.PROVNAME.
If someone works for this provider, display "(PROVIDER NAME)".
Else display "(PROVIDER NAME) associated with".
If Home Health provider only visited the SP once time during the
specified reference period, HH11- HELPUNIT = 1/NumberOfTimes
and HH11 - HELPNUM = 1, display "Did".
Else if SP is deceased or institutionalized, display "Generally
speaking, did.."
Else display "Generally speaking, does".
Display "in general" in last sentence in BOLD.
Multi Field display:
Roster/Grid Instructions:
Roster/Grid display:
Report display:
TEXT:
Context Header:
11:24:40 AM Thursday, February 26, 2009
Page 60 of 92
HH15
Int. Instr I:
SHOW CARD HH4
Question Text:
(Generally speaking, did/Generally speaking, does/Did)
[(PROVIDER NAME)/someone from (PROVIDER NAME)] help with
[your/(SP’s)] personal care by doing things such as those shown on
this card? [HELP WITH PERSONAL CARE MEANS HELP WITH
BATHING, SHOWERING, DRESSING, EATING, WALKING, USING
THE TOILET.]
[PROBE: We just need to know in general.]
Int. Instr II:
INPUT FIELDS / ROUTING
NEEDCARE
Field1:
Cheshire Name:
( HHQ1270 )
HERO.NEEDCARE
Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Enumerated
THelpnurs
1
No
No
Number Label
1 YesAtLeastOne
2
English text: YES, AT LEAST ONE
No
FieldSize:
Min Value:
Max Value:
Mask:
Route
BOX HH3 - (HHQ1280 )
BOX HH3 - (HHQ1280 )
English text: NO
Attribute
Don't know
Route
BOX HH3 - (HHQ1280 )
Refusal
BOX HH3 - (HHQ1280 )
BACKGROUND VARIABLE ASSIGNMENTS
SOFT EDIT CHECKS
11:24:46 AM Thursday, February 26, 2009
Page 61 of 92
HH15
HARD EDIT CHECKS
TECHNICAL NOTES
59
SPStatus
SP is Alive and not institutionalized =
MRES.SPALIVE=1/Alive or empty
SP is Alive =
MRES.SPALIVE=1/Alive, 2/AliveAndInstitute, or EMPTY
SP is Institutionalized =
MRES.SPALIVE=2/AliveAndInstitute
SP is Deceased =
MRES.SPALIVE=3/Deceased.
166
SomeoneWorksForProv
If someone works for this Provider =
PROV.SUBPROV ^= empty.
DESIGN NOTES
11:24:46 AM Thursday, February 26, 2009
Page 62 of 92
BOX HH3
BOX HH3
Page Order # :
210
BOX INSTRUCTIONS
( HHQ1280 )
IF CURRENTLY ADMINISTERING ST, GO TO BOX ST31B - (STQ1770 ).
ELSE IF CURRENTLY ADMINISTERING NS, GO TO BOX NS31B (NSQ1770 ).
ELSE IF CURRENTLY ADMINISTERING HHS, GO TO BOX HHS5 (HHS1090 ).
ELSE IF CURRENTLY ASKING ABOUT HOME HEALTH FRIENDS OR
FAMILY, GO TO BOX HH6 - (HHQ1520 ).
ELSE IF HOME HEALTH PROVIDER WORKED FOR SELF, GO TO HH16 HHPMORE ( HHQ1290 ).
ELSE GO TO HH17 - HHPOMORE ( HHQ1300 ).
ASSIGNMENTS
TECHNICAL NOTES
161
CurrAskAboutFriends
If currently asking about home health friends or family =
Coming from HH18 loop.
162
HHProvWorkForSelf
Home Health Provider works for self =
For this PROV, there is an EVNT where
(EVNT.EVNTPROV=PROV.PROVNUM) & a HERO
where (HERO.HEROEVNT=EVNT.EVNTNUM &
HERO.HERORND=currend round &
HERO.HERODFLG^=1/Yes &
(HERO.WORKSFOR=2/WorksForSelf, DK, or RF)).
DESIGN NOTES
If currently administering ST or NS, return to BOX ST31B or BOX NS31B.
11:24:46 AM Thursday, February 26, 2009
Page 63 of 92
HH16
HH16
Page Order # :
Design Screen Type:
Yes/No
Fields:
Field 1:
HHPMORE
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:
If SP is deceased, display "was (SP)"
Else if proxy interview, display "has (SP) been".
Else display "have you been".
Display "other" in "any other health" in BOLD.
Multi Field display:
Roster/Grid Instructions:
Roster/Grid display:
Report display:
Display all Providers who have provided home health care during the
current round.
Display Report below Question Text.
Display providers in order of entry.
Column 1, header = PROVIDER NAME
Column 1, display = Display Provider Name, PROV.PROVNAME.
Column 2, header = SUBPROVIDER
Colunn 2, display = If PROV.SUBPROV ^= empty, display
SubProvider name, PROV.SUBPROV.
Else do not display.
11:24:48 AM Thursday, February 26, 2009
Page 64 of 92
HH16
TEXT:
Context Header:
Int. Instr I:
[Since (REFERENCE DATE)/Between (REFERENCE DATE) and
(DATE OF DEATH/DATE OF INSTITUTIONALIZATION)], [have you
been/has (SP) been/was (SP)] helped at home by any other health
professionals?
Question Text:
Int. Instr II:
INPUT FIELDS / ROUTING
HHPMORE
Field1:
Cheshire Name:
( HHQ1290 )
TEMP
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
HH2 - PROVIDER_HHP ( HHQ1020 )
English text: YES
No
HH18 - HHPRFRND ( HHQ1310 )
English text: NO
Attribute
Don't know
Route
HH18 - HHPRFRND ( HHQ1310 )
Refusal
HH18 - HHPRFRND ( HHQ1310 )
BACKGROUND VARIABLE ASSIGNMENTS
SOFT EDIT CHECKS
11:24:54 AM Thursday, February 26, 2009
Page 65 of 92
HH16
HARD EDIT CHECKS
TECHNICAL NOTES
59
SPStatus
SP is Alive and not institutionalized =
MRES.SPALIVE=1/Alive or empty
SP is Alive =
MRES.SPALIVE=1/Alive, 2/AliveAndInstitute, or EMPTY
SP is Institutionalized =
MRES.SPALIVE=2/AliveAndInstitute
SP is Deceased =
MRES.SPALIVE=3/Deceased.
160
HHProviderCurrRnd
Provider has provided HH care in current round =
For this PROV, there is an EVNT where
(EVNT.EVNTPROV=PROV.PROVNUM) & a HERO
where (HERO.HEROEVNT=EVNT.EVNTNUM &
HERO.HERORND=currend round &
HERO.HERODFLG^=1/Yes & (OTHMEALS ^= empty or
HELPUNIT^=empty)).
DESIGN NOTES
End Loop 1: Probe for additional home health professionals.
NOTE: HH16 and HH17 are both End Loop probes, only one is asked
based on whether or not the last provider worked for self.
11:24:54 AM Thursday, February 26, 2009
Page 66 of 92
HH17
HH17
Page Order # :
Design Screen Type:
Yes/No
Fields:
Field 1:
HHPOMORE
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
230
Roster Name:
Roster Type:
DISPLAY INSTRUCTIONS:
Context header display:
Question display:
If SP is deceased, display "was (SP)"
Else if proxy interview, display "has (SP) been".
Else display "have you been".
Display "other" in "any other health" in BOLD.
Multi Field display:
Roster/Grid Instructions:
Roster/Grid display:
Report display:
Display all Providers who have provided home health care during the
current round.
Display Report below Question Text.
Display providers in order of entry.
Column 1, header = PROVIDER NAME
Column 1, display = Display Provider Name, PROV.PROVNAME.
Column 2, header = SUBPROVIDER
Colunn 2, display = If PROV.SUBPROV ^= empty, display
SubProvider name, PROV.SUBPROV.
Else do not display.
11:24:56 AM Thursday, February 26, 2009
Page 67 of 92
HH17
TEXT:
Context Header:
Int. Instr I:
Other than the persons who (have) visited [you/(SP)] from
(PROVIDER NAME) [or from the other(s) we’ve talked about], [have
you been/has (SP) been/was (SP)] helped at home by any other
health professionals [since (REFERENCE DATE)/between
(REFERENCE DATE) and (DATE OF DEATH/DATE OF
INSTITUTIONALIZATION)]? [DON’T INCLUDE ANY OTHER
PERSONS COMING FROM THE SAME ORG/
AGENCY LISTED BELOW]
Question Text:
Int. Instr II:
INPUT FIELDS / ROUTING
HHPOMORE
Field1:
Cheshire Name:
( HHQ1300 )
TEMP
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
HH2 - PROVIDER_HHP ( HHQ1020 )
English text: YES
No
English text: NO
Attribute
Don't know
Route
HH18 - HHPRFRND ( HHQ1310 )
Refusal
HH18 - HHPRFRND ( HHQ1310 )
HH18 - HHPRFRND ( HHQ1310 )
BACKGROUND VARIABLE ASSIGNMENTS
11:25:01 AM Thursday, February 26, 2009
Page 68 of 92
HH17
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
59
SPStatus
SP is Alive and not institutionalized =
MRES.SPALIVE=1/Alive or empty
SP is Alive =
MRES.SPALIVE=1/Alive, 2/AliveAndInstitute, or EMPTY
SP is Institutionalized =
MRES.SPALIVE=2/AliveAndInstitute
SP is Deceased =
MRES.SPALIVE=3/Deceased.
160
HHProviderCurrRnd
Provider has provided HH care in current round =
For this PROV, there is an EVNT where
(EVNT.EVNTPROV=PROV.PROVNUM) & a HERO
where (HERO.HEROEVNT=EVNT.EVNTNUM &
HERO.HERORND=currend round &
HERO.HERODFLG^=1/Yes & (OTHMEALS ^= empty or
HELPUNIT^=empty)).
DESIGN NOTES
End Loop 1: Probe for additional home health professionals.
NOTE: HH16 and HH17 are both End Loop probes, only one is asked
based on whether or not the last provider worked for self.
11:25:01 AM Thursday, February 26, 2009
Page 69 of 92
HH18
HH18
Page Order # :
Design Screen Type:
Yes/No
Fields:
Field 1:
HHPRFRND
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:
If SP reported a Home Health visit during the current round, display
"Besides what you have already talked about, [since (REFERENCE
DATE/between (REFERENCE DATE) and (DATE OF DEATH/DATE
OF INSTITUTIONALIZATION)]".
Else display "[Since (REFERENCE DATE)/Between (REFERENCE
DATE) and (DATE OF DEATH/DATE OF
INSTITUTIONALIZATION)]".
If SP is alive and not institutionalized, display "received"
Else display "receive"
Always display "(any other)".
Multi Field display:
Roster/Grid Instructions:
Roster/Grid display:
Report display:
TEXT:
Context Header:
Int. Instr I:
11:25:04 AM Thursday, February 26, 2009
SHOW CARD HH5
Page 70 of 92
HH18
(Besides what you have already talked about, [(Since/since)
(REFERENCE DATE)/(Between/between) (REFERENCE DATE)
and (DATE OF DEATH/DATE OF INSTITUTIONALIZATION)],
because of health problems [have you/has (SP)/did (SP)]
(received/receive) any personal care or help at home with daily
needs from (any other) persons who (do/did) not live with
(you/him/her), including home health aides, homemakers, friends,
neighbors, or relatives?
Question Text:
Int. Instr II:
INPUT FIELDS / ROUTING
HHPRFRND
Field1:
Cheshire Name:
Item Text display:
( HHQ1310 )
HRND.HHPRFRND
Do not display response option 3/IndicatedYesByDataprep.
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Enumerated
TProbe
1
No
No
Number Label
1 Yes
FieldSize:
Min Value:
Max Value:
Mask:
Route
HH19 - PROVIDER_HHF ( HHQ1320 )
2
English text: YES
No
3
English text: NO
IndicatedYesByDataPrep
BOX HH7 - (HHQ1545 )
DO NOT DISPLAY.
DATA EDITING ONLY.
English text: INDICATED YES BY DATAPREP
Attribute
Don't know
Route
BOX HH7 - (HHQ1545 )
Refusal
BOX HH7 - (HHQ1545 )
BACKGROUND VARIABLE ASSIGNMENTS
11:25:12 AM Thursday, February 26, 2009
Page 71 of 92
HH18
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
59
SPStatus
SP is Alive and not institutionalized =
MRES.SPALIVE=1/Alive or empty
SP is Alive =
MRES.SPALIVE=1/Alive, 2/AliveAndInstitute, or EMPTY
SP is Institutionalized =
MRES.SPALIVE=2/AliveAndInstitute
SP is Deceased =
MRES.SPALIVE=3/Deceased.
163
HHCurrentRound
If SP reported a Home Health visit in the current round =
There is an EVNT & HERO where
(HERO.HEROEVNT=EVNT.EVNTNUM &
HERO.HERORND=current round & HERO.HERODFLG
^=1/Yes and (HERO.OTHMEALS^= empty or
HERO.HELPUNIT^=empty)).
DESIGN NOTES
11:25:12 AM Thursday, February 26, 2009
Page 72 of 92
HH19
HH19
Page Order # :
Design Screen Type:
Roster
Fields:
Field 1:
PROVIDER_HHF
Enable Functions:
HELP
COMMENTS
JUMPBACK
No
Yes
Yes
Roster Name:
Provider Roster
Roster Type:
Single Item Select
Roster Functions:
Add Item
Edit Item
Delete Item
Search Item
Yes
Yes
No
No
Grid Functions:
Add Line
Delete Line
No
No
250
Display as ' Add a Provider '
Display as ' Edit a Provider '
DISPLAY INSTRUCTIONS:
Context header display:
Question display:
Display "PERSON" in Interviewer Instruction II in BOLD.
Multi Field display:
Vertical Alignment
Roster/Grid Instructions:
Display all Providers except for Providers where
PROV.PROVNUM=01 and 02, which are reserved for PM and OM
events.
Display providers in order of entry.
Display the following providers as protected rows:
1) Providers who have provided home health care during the current
round.
Roster/Grid display:
COL #
HEADER
INSTRUCTIONS
1
Provider Name
Display Provider Name,
PROV.PROVNAME
2
SubProvider Name
If PROV.SUBPROV ^= empty, display
SubProvider name,
PROV.SUBPROV.
Else do not display.
Report display:
TEXT:
11:25:13 AM Thursday, February 26, 2009
Page 73 of 92
HH19
Context Header:
Int. Instr I:
Question Text:
Who helped [you/(SP)]? What is the name of the person who
helped (you/him/her)?
Int. Instr II:
ENTER NAME OF PERSON WHO HELPED. DO NOT ENTER THE
NAME OF THE PLACE OR ORGANIZATION.
SELECT OR ADD ONLY ONE PERSON. DO NOT ENTER A
PERSON WHO LIVES WITH THE SP.
INPUT FIELDS / ROUTING
Field1:
Cheshire Name:
PROVIDER_HHF
( HHQ1320 )
TEMP
Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
String
TProvPick4
1
No
No
Number Label
1 [Continuous answer.]
FieldSize:
Min Value:
Max Value:
Mask:
4
Route
HH20 - HHFTYPE ( HHQ1330 )
BACKGROUND VARIABLE ASSIGNMENTS
HH Provider Roster details will be collected on PROV:
PROV key = PROV.PROVBASE + PROV.PROVNUM
PROV.PROVNUM = Number of Provider selected at HH19.
If Provider added at Provider Roster, see PROVIDER ROSTER POP-UP specifications for
pop-up window programming instructions.
Variables populated in Provider Roster Pop-Up Window:
PROV.PROVNUM
PROV.PROVRNDC
PROV.PROVNAME
Provider number
Round number
Provider name
If Provider added, set provider type as instructed below.
PROVTYPE
If adding a new provider, set PROV.PROVTYPE =
7/HomeHealthNotHHMembers.
11:25:15 AM Thursday, February 26, 2009
Page 74 of 92
HH19
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
160
HHProviderCurrRnd
Provider has provided HH care in current round =
For this PROV, there is an EVNT where
(EVNT.EVNTPROV=PROV.PROVNUM) & a HERO
where (HERO.HEROEVNT=EVNT.EVNTNUM &
HERO.HERORND=currend round &
HERO.HERODFLG^=1/Yes & (OTHMEALS ^= empty or
HELPUNIT^=empty)).
DESIGN NOTES
Begin Loop 2: Probe for one provider, one home health visit. Collect event
details for this home health provider visit.
11:25:15 AM Thursday, February 26, 2009
Page 75 of 92
HH20
HH20
Page Order # :
Design Screen Type:
Code 1
Fields:
Field 1:
HHFTYPE
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:
Display Provider Name for Home Health provider currently being
asked about, PROV.PROVNAME.
Multi Field display:
Roster/Grid Instructions:
Roster/Grid display:
Report display:
TEXT:
Context Header:
Int. Instr I:
Question Text:
Is (PROVIDER NAME) a friend or neighbor, a relative, or some other
type of home health provider?
Int. Instr II:
INPUT FIELDS / ROUTING
11:25:18 AM Thursday, February 26, 2009
Page 76 of 92
HH20
HHFTYPE
Field1:
Cheshire Name:
Item Text display:
( HHQ1330 )
PROV.HHFTYPE
If PROV.HHFTYPE has already been filled,
PROV.HHFTYPE ^= empty, display previously collected
response and allow it to be updated.
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Enumerated
THhftype
1
No
No
Number Label
1 Friend
2
3
FieldSize:
Min Value:
Max Value:
Mask:
Route
BOX HH3A - (HHQ1355 )
English text: FRIEND OR NEIGHBOR
Relative
English text: RELATIVE
Other
HH21 - HHFRELAT ( HHQ1340 )
BOX HH3A - (HHQ1355 )
English text: OTHER TYPE OF HOME HEALTH PROVIDER
Attribute
Don't know
Route
BOX HH3A - (HHQ1355 )
Refusal
BOX HH3A - (HHQ1355 )
BACKGROUND VARIABLE ASSIGNMENTS
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
DESIGN NOTES
Called by BOX ST31B or BOX NS31A if HF Provider added in ST or NS.
11:25:23 AM Thursday, February 26, 2009
Page 77 of 92
HH21
HH21
Page Order # :
Design Screen Type:
Code 1
Fields:
Field 1:
HHFRELAT
Field 2:
HHFRELOS
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:
270
Roster Name:
Roster Type:
DISPLAY INSTRUCTIONS:
Context header display:
Question display:
Display Provider Name for Home Health provider currently being
asked about, PROV.PROVNAME.
Multi Field display:
Vertical Alignment
Roster/Grid Instructions:
Roster/Grid display:
Report display:
TEXT:
Context Header:
Int. Instr I:
Question Text:
How is (PROVIDER NAME) related to [you/(SP)]?
Int. Instr II:
INPUT FIELDS / ROUTING
11:25:34 AM Thursday, February 26, 2009
Page 78 of 92
HH21
11:25:52 AM Thursday, February 26, 2009
Page 79 of 92
HH21
HHFRELAT
Field1:
Cheshire Name:
Item Text display:
( HHQ1340 )
PROV.HHFRELAT
Do not display response option 1/SamplePerson.
If PROV.HHFRELAT has already been filled,
PROV.HHRELAT ^= empty, display previously collected
response and allow it to be updated.
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Enumerated
TRelaship
1
No
No
Number Label
1 SamplePerson
FieldSize:
Min Value:
Max Value:
Mask:
Route
BOX HH3A - (HHQ1355 )
2
English text: SAMPLE PERSON
Spouse
BOX HH3A - (HHQ1355 )
3
English text: SPOUSE
Son
BOX HH3A - (HHQ1355 )
4
English text: SON
Daughter
BOX HH3A - (HHQ1355 )
5
English text: DAUGHTER
Brother
BOX HH3A - (HHQ1355 )
6
English text: BROTHER
Sister
BOX HH3A - (HHQ1355 )
8
English text: SISTER
Father
English text: FATHER
Mother
9
English text: MOTHER
SonLaw
7
10
11
English text: SON-IN-LAW
DaughterLaw
English text: DAUGHTER-IN-LAW
Grandson
BOX HH3A - (HHQ1355 )
BOX HH3A - (HHQ1355 )
BOX HH3A - (HHQ1355 )
BOX HH3A - (HHQ1355 )
BOX HH3A - (HHQ1355 )
English text: GRANDSON
11:26:20 AM Thursday, February 26, 2009
Page 80 of 92
HH21
12
Granddaughter
BOX HH3A - (HHQ1355 )
13
English text: GRANDDAUGHTER
Nephew
BOX HH3A - (HHQ1355 )
14
English text: NEPHEW
Niece
BOX HH3A - (HHQ1355 )
50
English text: NIECE
Partner
BOX HH3A - (HHQ1355 )
51
English text: PARTNER/ROOMMATE
Friend
BOX HH3A - (HHQ1355 )
52
English text: FRIEND/NEIGHBOR
Boarder
BOX HH3A - (HHQ1355 )
53
English text: BOARDER
NurseAide
BOX HH3A - (HHQ1355 )
54
English text: NURSE/NURSE'S AIDE
LegalOfficer
BOX HH3A - (HHQ1355 )
55
English text: LEGAL/FINANCIAL OFFICER
Guardian
BOX HH3A - (HHQ1355 )
91
English text: GUARDIAN
OtherRelative
HH21 - HHFRELOS ( HHQ1350 )
92
English text: OTHER RELATIVE
OtherNonRelative
English text: OTHER NON-RELATIVE
Attribute
Don't know
Route
BOX HH3A - (HHQ1355 )
Refusal
BOX HH3A - (HHQ1355 )
11:26:37 AM Thursday, February 26, 2009
HH21 - HHFRELOS ( HHQ1350 )
Page 81 of 92
HH21
Field2:
Cheshire Name:
Item Text display:
HHFRELOS
( HHQ1350 )
PROV.HHFRELOS
Display "(SPECIFY)" in same blue font used for interviewer
instructions.
If PROV.HHFRELOS has already been filled,
PROV.HHRELOS ^= empty, display previously collected
response and allow it to be updated.
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
BOX HH3A - (HHQ1355 )
BACKGROUND VARIABLE ASSIGNMENTS
PROV.HHRELAT may have already been asked prior to HH21. If PROV.HHRELAT was
previously set to 91/OtherRelative or 92/OtherNonRelative, and has been changed and
current round response to PROV.HHRELAT ^= 91/OtherRelative and ^=
92/OtherNonRelative, PROV.HHFRELOS needs to be reset to EMPTY. See additional
instructions below.
HHFRELOS
If current response to HH21 - PROV.HHFRELAT ^=
91/OtherRelative and ^= 92/OtherNonRelative, then
HH21 - PROV.HHFRELOS should be set to empty.
SOFT EDIT CHECKS
Edit #1:
NOTE: PROV.HHFRELAT may have already been asked prior to
HH21. HH21 allows updates to HHFRELAT. The purpose of this
edit is to alert the interviewer when the relationship code changes.
If PROV.HHFRELAT was previously collected prior to HH21, the
current response to HH21 - HHFRELAT should match the previously
collected response.
If not true, display message: "YOU HAVE UPDATED THE
RELATIONSHIP CODE PREVIOUSLY ENTERED. PLEASE
VERIFY."
HARD EDIT CHECKS
11:26:39 AM Thursday, February 26, 2009
Page 82 of 92
HH21
TECHNICAL NOTES
DESIGN NOTES
11:26:39 AM Thursday, February 26, 2009
Page 83 of 92
BOX HH3A
BOX HH3A
Page Order # :
275
BOX INSTRUCTIONS
( HHQ1355 )
IF HH20 - HHFTYPE = 3/Other, GO TO HH3 - PROVSPEC ( HHQ1030 ).
ELSE IF HH20 - HHFTYPE = DK OR RF, GO TO HH4 - WORKSFOR (
HHQ1050 ).
ELSE GO TO BOX HH1AA - (HHQ1065 ).
ASSIGNMENTS
TECHNICAL NOTES
DESIGN NOTES
11:26:39 AM Thursday, February 26, 2009
Page 84 of 92
BOX HH6
BOX HH6
Page Order # :
400
BOX INSTRUCTIONS
( HHQ1520 )
IF (HOME HEALTH PROVIDER IS A FRIEND OR RELATIVE) OR (HOME
HEALTH PROVIDER WORKS FOR SELF), GO TO HH28 - HHFMORE (
HHQ1530 ).
ELSE GO TO HH29 - HHFOMORE ( HHQ1540 ).
ASSIGNMENTS
TECHNICAL NOTES
157
HHFriendRelative
Home Health provider is a friend or relative =
PROV.HHFTYPE = 1/Friend or 2/Relative.
162
HHProvWorkForSelf
Home Health Provider works for self =
For this PROV, there is an EVNT where
(EVNT.EVNTPROV=PROV.PROVNUM) & a HERO
where (HERO.HEROEVNT=EVNT.EVNTNUM &
HERO.HERORND=currend round &
HERO.HERODFLG^=1/Yes &
(HERO.WORKSFOR=2/WorksForSelf, DK, or RF)).
DESIGN NOTES
11:26:39 AM Thursday, February 26, 2009
Page 85 of 92
HH28
HH28
Page Order # :
Design Screen Type:
Yes/No
Fields:
Field 1:
HHFMORE
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
410
Roster Name:
Roster Type:
DISPLAY INSTRUCTIONS:
Context header display:
Question display:
If SP is alive and not institutionalized, display "received".
Else display "receive".
Display "other" in "any other persons" in BOLD.
Multi Field display:
Roster/Grid Instructions:
Roster/Grid display:
Report display:
Display all Providers who have provided home health care during the
current round.
Display Report below Question Text.
Display providers in order of entry.
Column 1, header = PROVIDER NAME
Column 1, display = Display Provider Name, PROV.PROVNAME.
Column 2, header = SUBPROVIDER
Colunn 2, display = If PROV.SUBPROV ^= empty, display
SubProvider name, PROV.SUBPROV.
Else do not display.
11:26:42 AM Thursday, February 26, 2009
Page 86 of 92
HH28
TEXT:
Context Header:
Int. Instr I:
[Since (REFERENCE DATE)/Between (REFERENCE DATE) and
(DATE OF DEATH/DATE OF INSTITUTIONALIZATION)], [have
you/has (SP)/did (SP)] (received/receive) personal care or help at
home with daily needs from any other persons who (do/did) not live
with (you/him/her)?
Question Text:
Int. Instr II:
INPUT FIELDS / ROUTING
HHFMORE
Field1:
Cheshire Name:
( HHQ1530 )
TEMP
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
HH19 - PROVIDER_HHF ( HHQ1320 )
English text: YES
No
BOX HH7 - (HHQ1545 )
English text: NO
Attribute
Don't know
Route
BOX HH7 - (HHQ1545 )
Refusal
BOX HH7 - (HHQ1545 )
BACKGROUND VARIABLE ASSIGNMENTS
SOFT EDIT CHECKS
11:26:51 AM Thursday, February 26, 2009
Page 87 of 92
HH28
HARD EDIT CHECKS
TECHNICAL NOTES
59
SPStatus
SP is Alive and not institutionalized =
MRES.SPALIVE=1/Alive or empty
SP is Alive =
MRES.SPALIVE=1/Alive, 2/AliveAndInstitute, or EMPTY
SP is Institutionalized =
MRES.SPALIVE=2/AliveAndInstitute
SP is Deceased =
MRES.SPALIVE=3/Deceased.
160
HHProviderCurrRnd
Provider has provided HH care in current round =
For this PROV, there is an EVNT where
(EVNT.EVNTPROV=PROV.PROVNUM) & a HERO
where (HERO.HEROEVNT=EVNT.EVNTNUM &
HERO.HERORND=currend round &
HERO.HERODFLG^=1/Yes & (OTHMEALS ^= empty or
HELPUNIT^=empty)).
DESIGN NOTES
End Loop 2: Probe for additional persons who provided home health care.
NOTE: HH28 and HH29 are both End Loop probes, only one is asked
based on whether or not the last provider was a friend or relative or worked
for self.
11:26:51 AM Thursday, February 26, 2009
Page 88 of 92
HH29
HH29
Page Order # :
Design Screen Type:
Yes/No
Fields:
Field 1:
HHFOMORE
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
420
Roster Name:
Roster Type:
DISPLAY INSTRUCTIONS:
Context header display:
Question display:
Display Provider Name for Home Health provider currently being
asked about, PROV.PROVNAME.
If SP is alive and not institutionalized, display "received".
Else display "receive".
Display "other" in "any other persons" in BOLD.
Multi Field display:
Roster/Grid Instructions:
Roster/Grid display:
Report display:
Display all Providers who have provided home health care during the
current round.
Display Report below Question Text.
Display providers in order of entry.
Column 1, header = PROVIDER NAME
Column 1, display = Display Provider Name, PROV.PROVNAME.
Column 2, header = SUBPROVIDER
Colunn 2, display = If PROV.SUBPROV ^= empty, display
SubProvider name, PROV.SUBPROV.
11:26:54 AM Thursday, February 26, 2009
Page 89 of 92
HH29
Else do not display.
TEXT:
Context Header:
Int. Instr I:
Other than the persons who have visited [you/(SP)] from
(PROVIDER NAME) [since (REFERENCE DATE)/between
(REFERENCE DATE) and (DATE OF DEATH/DATE OF
INSTITUTIONALIZATION)], [have you/has (SP)/did (SP)]
(received/receive) personal care or help at home with daily needs
from any other persons who (do/did) not live with (you/him/her)?
[DON’T INCLUDE ANY OTHER PERSONS COMING FROM THE
SAME ORG/AGENCY LISTED BELOW.]
Question Text:
Int. Instr II:
INPUT FIELDS / ROUTING
HHFOMORE
Field1:
Cheshire Name:
( HHQ1540 )
TEMP
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
HH19 - PROVIDER_HHF ( HHQ1320 )
English text: YES
No
BOX HH7 - (HHQ1545 )
English text: NO
Attribute
Don't know
Route
BOX HH7 - (HHQ1545 )
Refusal
BOX HH7 - (HHQ1545 )
BACKGROUND VARIABLE ASSIGNMENTS
11:27:01 AM Thursday, February 26, 2009
Page 90 of 92
HH29
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
59
SPStatus
SP is Alive and not institutionalized =
MRES.SPALIVE=1/Alive or empty
SP is Alive =
MRES.SPALIVE=1/Alive, 2/AliveAndInstitute, or EMPTY
SP is Institutionalized =
MRES.SPALIVE=2/AliveAndInstitute
SP is Deceased =
MRES.SPALIVE=3/Deceased.
160
HHProviderCurrRnd
Provider has provided HH care in current round =
For this PROV, there is an EVNT where
(EVNT.EVNTPROV=PROV.PROVNUM) & a HERO
where (HERO.HEROEVNT=EVNT.EVNTNUM &
HERO.HERORND=currend round &
HERO.HERODFLG^=1/Yes & (OTHMEALS ^= empty or
HELPUNIT^=empty)).
DESIGN NOTES
End Loop 2: Probe for additional persons who provided home health care.
NOTE: HH28 and HH29 are both End Loop probes, only one is asked
based on whether or not the last provider was a friend or relative or worked
for self.
11:27:01 AM Thursday, February 26, 2009
Page 91 of 92
BOX HH7
BOX HH7
Page Order # :
430
BOX INSTRUCTIONS
( HHQ1545 )
GO TO NEXT SECTION .
ASSIGNMENTS
TECHNICAL NOTES
DESIGN NOTES
11:27:01 AM Thursday, February 26, 2009
Page 92 of 92
| File Type | application/pdf |
| File Modified | 2010-04-05 |
| File Created | 0000-00-00 |